ASSESSMENT OF ANTI-MALARIA LOGISTIC MANAGEMENT SYSTEM PERFORMANCE AT PRIMARY HEALTH CARE LEVEL IN OYO STATE, NIGERIA

Abstract

Establishment of a functional Antimalarial Logistic Management System (AMLMS) is essential to the achievement of the goals of the Roll Back Malaria (RBM) Initiative. The AMLMS ensures the availability of anti-malaria drugs in Primary Health Care (PHC) centres and therefore facilitates prompt and adequate treatment of malaria. ln Nigeria, previous studies on AMLMS regarding malaria control were conducted in selected states excluding Oyo state. This study was therefore, conducted to assess the performance of AMLMS in selected PHCs in Oyo State. A cross-sectional descriptive study was carried out among AMLMS focal persons from 330 Global Funds (GE) supported PHCs in the 33 Local Government Areas (LGAs) of Oyo State. Three PHCs were randomly selected from the ten GF supported PHCs in each of the LGAs. A total of 99 focal persons were selected. A United State Agency for International Development (USAID)/Deliver project validated Logistic Indicator Assessment Tool (LIAT) was adapted and used to collect information on social demographic data, personnel training, supervision, Logistic Management information System (LMIS) and Drug Supply Chain. Availability, storage and safety of anti malaria drugs were assessed using an observational chekList. Performance of 99 staff was assessed on a 74-point scale which was scored and categorized into poor (<48 points) and good performance (>48 paints). Data were analyzed using descriptive statistics and Chi square test at p=0.05. Respondents mean age was 35.0 ± 7.2 years with 96.0% being females. The AMLMS focal persons were Nursers [57.6%], Community Health Extension workers (39.4%) and Pharmacy technicians [3.0%]. Only 29.0% had formal training on AMLMS. However, 58.6% received at least one on-the job training/ supervisory visit from Federal and State RBM teams on AMLMS in the PHCs within the month preceding the survey. The proportion of PHCs with anti-malaria LMIS record tools were: 66.7% (bin cards), 10.0% (inventory control cards), 75.8% (requisition booklets), 60.0% (dispensary register), 50.0% (morbidity register), 74.7% (summary report booklet). None of the PHCs had standard operating procedure manual. Although all respondents sent reports to their LGAs RBM focal person's monthly, however, only 11.0% sent completed reports for the month preceding this assessment. Forty eight percent of drugs supplied were determined at the PHCs. In the six months preceding the survey, 96.0% of the PHCs experienced stock-out of Artesunate/Amodiaquine and Artemether/Lumefantrine. The mean duration of stock-out for Artesunate/Amodiaquine and Artemether/Lumefantrine for under-fives was 96±38 days and 64±10 days respectively. Fifteen percent of the PHCs did not have any anti-malaria store while 58.6% had stores with security lock. Thirty-six percent of respondents had good AMLMS performance. Good performance was significantly associated with having had informal training on AMLMS (p<0.05). The performance of the Anti-malaria Logistic Management System was poor. Therefore staff training, provision of adequate anti-malaria drugs and recording tools are required to improve the system at the primary health care level in the state.