Process Evaluation of Antiretroviral Drugs Distribution at Health Facilities in Jimma Zone

Abstract

Background: Ethiopia has one of the largest populations of HIV infected people in the world, with an estimated 1.1 million people living with HIV in 2009. Anti Retroviral Therapy program is one of the interventions to avert HIV/AIDS. The final goal of the Anti Retroviral Therapy programme is to reduce HIV related morbidity, mortality, and mitigate the impact of the AIDS epidemic. To achieve these goals continuous supply management of Anti Retro Viral drugs is the main component. Effective Anti Retro Viral drugs distribution enable every HIV/AIDS patient who needs Anti Retro Viral drugs to get and use as required. The interest of stakeholders and unavailability of such previous study in the area initiated us to conduct this evaluation. Objective: This evaluation aimed to assess the level of implementation of Anti Retro Viral drugs distribution service in terms of availability of resources, compliance of the activities to national protocols and accommodation of the services. Methods: Case study design employing both quantitative and qualitative methods was conducted in Jimma Zone. The health facilities were selected using simple random sampling technique. Data collection methods were exit interview, document review, observation and expert interview. Quantitative data was analyzed using SPSS software. Qualitative data was analyzed manually and summarized into key thematic area. The achievement of the program was judged based on judgment matrix developed with stakeholders. Results: The availability of resources in the study area was 81.64% and judged as medium achievement. Some of key Standard Operating Procedure forms, Anti Retroviral Therapy trained pharmacy professionals, inventory control system and counseling guidelines were not available in some of the facilities. The compliance to national standards was 77.2% and judged as medium achievement, and the utilization of the key Standard Operating Procedure forms and using inventory control system both at dispensary and storage area was low. The accommodation of the service was 96.55% and judged as high achievement according to the rating parameter. The overall implementation of the program was 81.87% and judged as medium achievement. Conclusion: The resources needed and recommended by guidelines were available except Anti Retroviral Therapy trained pharmacy professionals and guidelines for counseling in some of health facilities. The utilization of key Standard Operating Procedure forms such as expiry date tracking chart, Anti Retro Viral drugs dispensing and consumption summary and stock record card was not low. Training of pharmacy professional on basic Anti Retroviral Therapy, making available the key Standard Operating Procedure forms and designing mechanisms to guarantee their utilization were the main recommendations.