Effect of devolution of health services on availability of medicines for Non-Communicable Diseases (Record no. 314918)

MARC details
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008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
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050 ## - LIBRARY OF CONGRESS CALL NUMBER
Classification number RA393W366 2019
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Wanjohi Eric
245 ## - TITLE STATEMENT
Title Effect of devolution of health services on availability of medicines for Non-Communicable Diseases
Remainder of title a case study of the Makueni County Referral Hospital
Statement of responsibility, etc Eric Wanjohi
260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT)
Place of publication, distribution, etc Nairobi;
Name of publisher, distributor, etc Strathmore University
Date of publication, distribution, etc 2019
300 ## - PHYSICAL DESCRIPTION
Extent xii, 66pg
520 ## - SUMMARY, ETC.
Summary, etc Kenya has witnessed a rapid epidemiological shift, with a surge in non-communicable diseases (NCDs) like diabetes and cardiovascular diseases, which often require lifelong treatment and can lead to impoverishment. One driver of excessive expenditure is medicines and related products. To prevent impoverishment from NCDs, counties must strengthen the management of commodities. However, frequent stock-outs at public facilities suggest weaknesses in supply chain management. This study sought to establish the effect of devolution of health services on the availability of medicines for NCDs at the Makueni County Referral Hospital in Makueni County. To achieve this, the study employed a mixed methods approach. First, the availability of selected medicines for NCDs was described before and after devolution (2011-2012 and 2017-2018). Then, the reasons underlying observed patterns, and staff perception on factors that may have influenced availability, both examined through in-depth interviews. The study found that three cardiovascular products, nifedipine, enalapril and hydrochlorothiazide were mostly unavailable pre-devolution. Post devolution, availability of nifedipine and hydrochlorothiazide improved substantially with enalapril availability remaining a challenge post devolution. Tracer diabetes medicines, metformin and glibenclamide had steady availability pre and post-devolution period. However, Insulin had good availability post devolution. Asthma drugs (salbutamol inhaler, salbutamol nebulising solution and budesonide inhaler) had higher stock out post-devolution.The relatively affordable amoxicillin, paracetamol and ibuprofen had good pre- and post-devolution availabilities, with ceftriaxone, a much more costly antibiotic, only having good availability post-devolution. Reasons for the increased availability included increased funding, better structured quarterly orders, better collaboration across actors, better public participation and an overall increase staff numbers. The study recommends that other health financing avenues be sought and that the county government reviews medicines budgets frequently. The study also recommends that county government should encourage public participation so as to know areas that need improvement
521 ## - TARGET AUDIENCE NOTE
Target audience note A thesis submitted in partial fulfillment of the requirements for the Degree of Master of Business Administration in Healthcare Management at Strathmore Business School
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Francis Wafula
Titles and other words associated with a name Dr.
Relator term Supervisor
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Ruth Kiraka
Titles and other words associated with a name Prof.
Relator term Dean
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name George Njenga
Titles and other words associated with a name Dr.
Relator term Dean
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier https://su-plus.strathmore.edu/handle/11071/6732
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Source of classification or shelving scheme Library of Congress Classification
Item type Thesis
CIN (SU) NI
Course Code MBA Healthcare Management

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