Izazovi U Menadzmentu Snabdevanja Lekovima Indija - SHAMIMA TAYOB FINAL EXAM
Izazovi U Menadzmentu Snabdevanja Lekovima Indija - SHAMIMA TAYOB FINAL EXAM
P U B L I C H E AL T H C AR E C E N T R E S I N T H E S E D I B E N G D I S T R I C T ,
G AU T E N G P R O V I N C E
With Dissertation
S H AM I M A T A Y O B
200818356
Supervisor: Ms EA Helberg
Co-supervisor: Dr S Bezuidenhout
Department of Pharmacy
2012
ACKNOWLEDGEMENTS
Mr. Johan van Niekerk and Ms. Meliza Coetzee for their
assistance in the data collection.
i
D E C L AR A T I O N
____________________________
Shamima Tayob
ii
CONTENTS
ACKNOWLEDGEMENTS ......................................................... i
D E C L AR A T I O N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i i
LIST OF FIGURES................................................................ xi
L I S T O F T AB L E S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x i v
L I S T O F AP P E N D I C E S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x v
L I S T O F AB B R E V I AT I O N S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x v i
A B S T R AC T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x v i i i
C H AP T E R 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 INTRODUCTION................................................... .1
1.2 BACKGROUND..................................................... .3
C H AP T E R 2 : L I T E R AT U R E R E V I E W . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2
iii
AFFORDABLE QUALITY ESSENTIAL
MEDICINES.................................................. .26
C H AP T E R 3 : M E T H O D O L O G Y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 5
C H AP T E R 4 : R E S U L T S AN D D I S C U S S I O N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 6
iv
4.1.1 Staff member responsible for drug supply
management.................. ........................................46
v
4.3.4 Ventilation and temperature control
within facilities.................................................. ....74
vi
C H AP T E R 5 : S U M M AR Y O F R E S U L T S AN D C O N C L U S I O N . . . . . . . 1 0 4
vii
5.4.3 Availability of tracer and non -tracer
items............................ .......................................115
C H AP T E R 6 : K E Y R E C O M M E N D AT I O N S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 4
viii
6.3 MEDICINE MANAGEMENT AND PROCESSES..........128
ix
LIST OF FIGURES
(N=25)........................................ ...................53
(Clinic C)....................................................... 58
x
Figure 4.10: No protection from sunlight, no electricity in store
(Clinic E).......................................................6 4
(N=25)........................................................... 86
(N=25)...........................................................90
xi
Figure 4.24: Lead time between request and receipt of drugs
(N=25).................................. .........................97
xii
LIST OF TABLES
(N=21).................................. .............................51
officers (N=4)..................................................... 67
(N=25)................................................................ 74
xiii
LIST OF APPENDICES
APPENDIX 3: Q U E S T I O N N AI R E - T R AN S P O R T O F F I C E R . . . . . . . 1 5 0
APPENDIX 4: Q U E S T I O N N AI R E -
S T O R E M AN AG E R / F AC I L I T Y M AN A G E R . . . . . . . . . . 1 5 1
APPENDIX 5: R E S E AR C H E R C H E C K L I S T . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 5 6
APPENDIX 6: T R AC E R M E D I C I N E L I S T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 5 8
APPENDIX 7: G L O S S AR Y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 5 9
APPENDIX 9: E T H I C AL C L E AR A N C E C E R T I F I C AT E . . . . . . . . . . . . . . 1 7 6
A P P E N D I X 1 0 : S T O C K C AR D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 7 7
A P P E N D I X 1 1 : D A T A S H E E T – S E C T I O N A:
F A C I L I T Y M AN AG E R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 7 8
xiv
L I S T O F AB B R E V I AT I O N S
ARV Anti-retroviral
FIFO First-in/first-out
FM Facility Manager
xv
NCS National Core Standards
PA Pharmacist Assistant
TB Tuberculosis
xvi
AB S T R A C T
in the district.
responses. Bin cards and primary health care order files were
xvii
There was a 100% response with all primary health care centres
district pharmacy.
Nineteen clinics claimed that the storage area was not large
enough to store all the stock for a month’s supply and only one
checked and the driver’s note was then signed, and stock
xviii
clinics, 20% admitted that the re-order level had not been
and the Essential Drugs List were also not available at all
keeping.
pharmacists did not manage to visit all the clinics each month.
care level.
xix
C H AP T E R 1
1.1 INTRODUCTION
essential drugs are those drugs which the nation must have in
and maintain health, for too many people throughout the world
figure rising to over half in the poorest parts of Africa and Asia
1
According to Dukes and colleagues, the following factors may
drugs
supply
storage
2
1.2 B AC K G R O U N D
2005a).
3
can be prevented, treated or at least alleviated with cost
benefits on people all over the world (NDOH, 1996). They have
2003).
4
Despite all these benefits, drugs have not been available to all
South Africans. This has been the case even after the NDP and
5
may vary from district to district. Therefore, this study aims to
1.4 R E S E AR C H Q U E S T I O N
a weekly basis (an out of stock item results, when the demand
6
countries have acquired considerable experience in managing
include that:
supply,
performance and,
7
Unless changes in drug supply systems are based on careful
8
related study has never been previously conducted in the
Sedibeng district.
1 . 5 . 1 Ai m o f t h e S t u d y
requirements,
Province.
9
1.6 THE SIGNIFICANCE OF THE STUDY
within the Sedibeng district. The results from the study will also
assist in:
level in DSM,
DSM not only at a local level but which are generic to the
10
This chapter summarised the importance of the availability of
procurement processes.
11
CHAPTER 2
LITERATURE REVIEW
2.1 INTRODUCTION
1997).
12
policies for the entire organisation (Booyens, 1997). One such
1997).
The success of the DSM cycle will depend upon the ability to
all levels of the health system (Mohammad & Raja, 2004). The
treatment.
13
Medical health drug supply chains are different because they
Raja, 2004).
delivery.
14
control. DSM tools help managers with the process of
2004).
Availability
of
medication Updated bin
cards
Re-order levels
Sedibeng district.
15
The procurement of drugs involves various steps including
within the supply and where they are located thus allowing the
items are being used correctly and not diverted and misused .
Raja, 2004).
16
In health care, ensuring that there are adequate drugs and
individual patient and the public at large (Jha & Roy, 2005).
ordination.
17
Partner with manufacturers in providing timely forecasts
warehouses.
the system.
2004).
18
storage, reliable transport systems and reinforcing reporting
19
and abuse by patients who collect treatment even if they are not
2005b).
20
countries. Transport is either difficult to p lan and manage, or is
compliance. All these losses that occur in the supply chain add
21
It has also been established that in certain areas a significant
centres have been found in the open drug markets. This matter
22
Factors influencing these drug stock outs included: financial
to the NDOH Strategic plan for 2009/2011 and the 10-point plan
2011).
23
The conference also introduced the NCS and explored the
discussed:
strengths appraised,
24
Self-assessments (audits) in pharmacies,
medicines,
25
2.2 AV AI L AB I L I T Y AN D ACCESSIBILITY OF AF F O R D AB L E
Q U AL I T Y E S S E N T I AL M E D I C I N E S
2 . 3 AV AI L AB I L I T Y O F A S U F F I C I E N T N U M B E R O F Q U AL I F I E D
H U M AN R E S O U R C E S
26
process of task-shifting has taken place. In African countries
Nursing Act 1978 which has now been amended to section 56A
2007).
27
The scope of practice of the two categories of PA’s is
viz.
Post-basic PA’s.
DUTIES OF A LEARNER
BASIC ASSISTANT Untrained-
Packing of shelves, assist in
dispatching of orders, filing in
Learner basic administative
bin cards, compiling orders, duties
under supervision
28
The scope of practice determines the activities, responsibilities
Raja, 2004):
logistical functions,
29
2 . 4 AV AI L A B I L I T Y O F AD E Q U AT E I N F R AS T R U C T U R E AC C O R D I N G
these patients are only given two active agents due to 'poor
30
a rapid assessment of the use and management of ARV ’s in
Forty four percent (44%) of the facilities did not have adequate
stock balance of these three ARV’s and eight (8) facilities had
Expired ARV’s were found in 64% of the facilities with the loss
was generally satisfactory in all the cent res as 84% and 92%
31
The goal of an ARV program, which is to provide uninterrupted
2003).
Therefore,
budgeted for,
supervision,
trained and equipped to carry out the very basic but very
32
essential service of managing drugs and monitoring supply
It is therefore critical that any health care system must take the
33
addition, it is here that the expectation of the people to take
2008).
The above information dealt with DSM and the reasons for drug
NDOH, Gauteng.
34
C H AP T E R 3
M E T HO DO LO G Y
3.2 SETTING
35
Region B consists of the Ekurhuleni and Sedibeng districts,
3 . 4 S T U D Y P O P U L AT I O N
36
3 . 5 S AM P L E S I Z E
clinics and the four CHC’s. CHC’s were included in this study,
namely, Lesedi and Midvaal and included two PHC clinics from
37
The aim of the pilot study was to identify any problems that the
(Stead & Struwig, 2001). The data collected from the p ilot
3 . 7 D AT A C O L L E C T I O N
eight clinics each, whilst one data collector was allocated to the
38
period of two months commencing on 20 June 2011 until 20
August 2011.
(Appendix 3),
(Appendix 4),
the facilities,
39
questionnaire which was administered to FM and store
months. The stock cards and order files were evaluated by the
40
cards and order files. The checklist also assisted in verifying
establish:
41
director of the clinic. Questions from this current monitoring
PHC clinics where there was no store manager, the person who
42
3.9 STATISTICAL AN ALYSIS
facility name. This was for the purposes of the researcher only,
and was not indicated in the research report. The same process
43
applied to the transport officer. Anonymity and confidentiality
& Struwig, 2001). Validity was tested during the pilot study
3 . 1 2 B I AS
PHC and CHC clinics, and data collection was done during this
of bias.
44
3.13 LIMITATIONS OF THE STUDY
The study also has its limitations in terms of feedback from the
this study and the impact of drug out of s tocks in the district
clinics.
administered
45
CHAPTER 4
of these results.
SECTION A
46
There was specific individual/s, in all 25 clinics that were
clinics.
clinics interviewed.
of assistants.
had part time PA’s, which resulted in drugs not being checked
47
resources necessitates the need to look at mid-level workers
level.
in both the public and the private sectors since the late 1980’s
48
However, training of pharmacy technicians is planned for and
From the results obtained, only one clinic had no trained nurses
in dispensing.
49
member per clinic (Blaauw, Chabikuli, Gilson & Schneider,
2005).
medicines. The registered nurse may only prescribe the speci fic
50
medication but were not trained in PHC and had not c ompleted
dispensing
51
Fifty percent of the clinics had learner basic PA’s in
clinics).
52
4.1.5 Training in Drug Supply Management
25
20
Number of clinics
15
10
0
0 1 2
Number of nurses trained in DSM
(N=25).
53
to prescribe or order medications. The health facility also
SECTION B
measures.
medicines:
requirements).
54
medicine store provided it complies with GPP practice
requirements).
store,
rooms.
55
In 16 clinics, it was admitted that medicines were not the
56
A previous study stated that store rooms are needed in every
facility to store drugs and medical supplies safely and that the
some clinics consist of two rooms and drugs are stored on the
57
Figure 4.5: Cracks in medicine store wall at a clinic
(Clinic C).
58
Figure 4.6: Broken ceiling panel (Clinic D).
59
Only one clinic (4%) claimed that there was a secure
conditions.
60
Figure 4.8: Blinds protect medication from direct sunlight
(Clinic B).
(Clinic E).
61
The lack of electricity in the store room can result in:
No temperature control,
62
housekeeping and a pest-free environment. This can result in
charge.
Nine of the clinics had a security door and eight clinics had
63
Figure 4.12: Lack of security-medicines easily accessible
(Clinic E).
SECTION C
Taking into account that one clinic did not fill in the data, it was
specific procedures:
64
1. The number of boxes is checked and the driver’s
Pharmacist 0
Nurse 8
Store manager 0
Security 0
Facility Manager 10
receipt.
65
One of the key elements in DSM is to ensure th at medication
immediately.
60
50
40
Percentage (%)
30
20
10
0
Same day Within 24 hours Within a week
When is stock checked after receipt
66
Furthermore, not checking stock as soon as possible after
expired stock.
Always 1
Never 1
Sometimes 2
67
The results obtained from the four transport officers as
asked to FM’s).
Store manager 2
Facility manager 2
Security 3
PA 1
Nurse 1
Note that all four transport officers stated that there was
the clinic.
68
Three transport officers reported that the number of boxes
at the clinic.
69
the district pharmacy to ensure that t he signed delivery
medication delivered.
70
There are three common forms of theft and leakage:
robbery may involve people both inside and outside the drug
71
The discrepancies between the responses of PHC personnel and
consulting room
room.
consulting room.
72
In a previous study conducted by Dukes et al., (1997), it
The cost of expired stock in one clinic in this study was as high
incremental- the higher the stock levels, the higher the costs of
1997).
73
4.3.4 Ventilation and Temperature control within facilities
Airbricks 1
Air-conditioner (functional) 11
Air-conditioner (non-functional) 6
None 4
Missing data 2
74
checklist, the following was noted in terms of temperature
control:
75
Updated + available
Updated + available
Available
Available
potency of medication.
76
changes can damage some items thus affecting the potency and
% of
% of
clinics
clinics
according
according
to
to facility
researcher
manager
checklist
Only medicines stored in all 96% 96%
medication fridges
fridge
between 2-8°C
a power failure
77
*Note: Data is not available as all the questions posed to the
maintained.
78
In the Sedibeng district, cold chain items usually consist of
one cooler box and the transport officer takes it into the
From the results of the study, it is clear that cold chain is not
as outlined below.
exposure to heat and cold as they pass through the cold chain.
79
and distributors of vaccines. Foodstuff must not be stored in the
80
and the primary protection aga inst theft and corruption. The
physically witnessed.
medicine store and one clinic for tracer items in the consulting
rooms.
not been calculated for all tra cer items in the store.
these regularly.
months.
82
a.
30
20
No. of clinics
15
10
0
Medicine store Consulting room
Evidence of re-order levels of tracer items
b.
3 clinics
7 clinics
15 clinics
(b) (N=25).
83
In a study conducted on DSM in the Mopani district, none of the
the lack of review of ROL’s can be linked to the find ings of the
84
4.4.6 Quantity and period of stock out at clinics
not vital, the reasons for out of stocks and the number of
(GDOH, 2009). In order to meet this target, both tracer and non
researcher checklist.
85
According to the researcher checklist:
86
Figure 4.19: Medication out of stock (Clinic B).
of the facilities ,
absence of a PA.
responsibility.
months.
87
The estimated monetary value of the items expired varied
expiry dates.
88
a.
b.
89
4.4.9 Stock take
25
15
10
0
Medicine store Consulting room
Evidence of stock take
b.
(N=25).
90
In one clinic stock take was last conducted in 2010.
2011.
stock take and only two facilities before every EDL order
91
cards should be used to control all the stock dispensed from
consultation rooms.
It was thus difficult for clinics who did not maintain stock cards
92
Figure 4.23: Unopened stock stored on the floor ( Clinic B).
The boxes are still sealed implying that stock has not been
seals these. Thus a sealed box may contain mixed items, which
93
and when it is utilised (as was established in the study),
from the store room and leave notes for the assistant to
of stock.
94
overworked in the Sedibeng district with little or no time
for DSM.
a.
b.
95
According to transport officers:
officers (N=4)
% of transport officers
vehicle
medication.
All four of the transport officers admitted that they are not
96
driver to deliver medication is one of the contributing
medication (N=25).
97
4.4.12 Feedback from district pharmacy
of to-follow orders.
The district pharmacy was not included in this study and hence
to by the clinics.
98
to be conducted to establish factors influencing the
needs of the clinics and this would affect the ROL’s of the
pharmacy.
present),
the facility.
99
The findings of this study are consistent with challenges
(Matse, 2005b).
contain stock which has not been checked and packed due to
the box since the district pharmacy supplies mixed items in the
stock or stock could expire in the boxes if these boxes are not
unpacked.
100
The unavailability of a constant dedicated person to order
and theft.
FEFO principles.
101
4.4.15 Standard operating procedures and reference material
SOP (N=25)
102
All clinics (i.e. 100%) had access to the EDL/STG for PHC
list.
conclusions.
103
CHAPTER 5
SECTION A
nobody was responsible for DSM in the absence of the PA. The
104
items in the stores and to efficiently and effectively manage,
nurses has lagged behind in growth and the need for health
et al., 2005).
From the results of the study, it became clear that there was a
study sample.
105
or authorisation. This was a direct contravention of both
supervision by a pharmacist.
Both leaner basic and post basic assistants were not based
supply.
This objective was met by the results indicated above and it was
found that the Sedibeng district did not have sufficient dedicated
106
SECTION B:
patient care.
storage space,
107
5.3.2 Condition of medicine store
(SAPC, 2010).
sunlight.
108
According to the GPP, light conditions and temperature
clinic.
109
of the PA, the key was hung in the key cupboard, allowing
However, from the results it was established that the district did
2010).
SECTION C:
110
Stock was checked immediately or within 24 hours of
receipt, as expected.
delivery of medication.
24 clinics.
111
Some clinics claimed that transport did not maintain the
PHC level except for one clinic. This can be addressed with the
consulting room
112
The district complied in 20 clinics in cold chain
The study found that facilities either did not have bin
113
According to a study conducted by Gray and Suleman, (2009), if
114
The lack of utilisation of proper ordering systems further
contributed to drug stock outs and the district once again failed
systems.
receiving medication.
115
5.4.5 Responsibility for ordering of medication
116
medication has been cited by many studies as one of the
must play their part and work together to improve supply chain
117
The fourth objective of the study was:
above.
118
experienced in DSM which were excluded from the supervisory
tool.
tool:
supply,
distribution process,
medication delivery,
delivery vehicle,
119
There are definitely gaps between policy and practice in primary
in all areas of the community and the health care sector. There
define SOP’s.
process.
120
The DOH continues to add new services to PHC without the
and to track loopholes along the way. The role of the Provincial
problem-solving is important.
121
appraised. It needs to provide a national framework to certify
The introduction of the NCS is one such frame work. The NCS
Due to the fact that this study did not include DSM at the
pharmacy.
122
requirement at all times. None of the clinics were found to be
123
CHAPTER 6
KEY RECOMMENDATIONS
SECTION A
6.1.1 Training
124
DSM and quarterly performance evaluations should include DSM
evaluations.
licence.
SECTION B
125
6.2.2 Temperature control in the medicine store and
consulting room
regularly maintained.
necessary.
All clinics need to ensure that the key for the medicine
medication.
being used.
126
6.2.5 Delivery and receipt of medication
127
situations at clinics as medication will not be delivered on
time to clinics.
supply chain.
needs to be implemented.
SECTION C
128
6.3.2 Availability of bin cards
cards) for the medicine store along with the maintenance and
129
research needs to be conducted to establish whether there
stock take.
procedures until such time that each clinic has a dedicated staff
130
6.3.7 Expired stock
131
service pharmacists could also assist by completing their
study. Currently, the tool does not address the issue of human
132
should be mandatory at least once a month for each clinic and
situations:
adequate
followed
133
evaluation should be accompanied by an action list attaching
134
LIST OF REFERENCES
Bakarich A., Finucane P., Harris J., Healy D., 2006. Problems
www.hst.org.za/uploads/files/sahr05_ chapter8.pdf.
Bradley H., Johnson Y., Von Zeil M., 2011. “Improving the
135
Carol D., 2002. Pharmacist’s Assistant Training, and the real
3-6.
www.who.int/medicines/publications/WHO_PSM_PAR_2007.2.pdf -
KTree-doc_request-docid-1294.phtml.
136
Department of Health, 2006. Nursing Act no. 33 of 2005,
Available at www.info.gov.za/view/DownloadFileActi .
www.doh.gov.za/docs/tenders/NCS%20for%20 Health%20FINA
L_1.
137
Circular minute 118 of 2009, Directorate Clinical Support
Gray A., Gengiah T., and Naidoo P., 2005. The Pharmacist’s
http://www.hst.org.za/uploads/files/sahr05chapter12.pdf .
Gray A., McCoy D., and Suleman F., 1988. Technical report
Available on
wiredspace.wits.ac.za/bitstream/handle/10539/1623/06References.pdf?...9.
A v a i l a b l e a t www.who.int/entity/alliance-hpsr/alliancehpsr_annualreport09.pdf -
138
Hall W., 2003. Staffing Norms for PHC. Health Systems Trust,
management-lessons-learnt-isds-east... - Cached.
Available at
nihfw.org/pdf/RAHI-II%20Reports/DARBHANGA.pdf .
139
Kruger S., 2009. “Position Paper on Dispensing Licences ”.
www.sasohn.org.za/images/PositionPaperDispensingLicense.p
v.6; 2008.
(online) Available at
wiredspace.wits.ac.za/bitstream/handle/10539/1623/01 Chapte
r1.pdf?
140
Matse P.M., 2005b. Essential drugs at PHC, Chapter 4.
(online) Available at
wiredspace.wits.ac.za/bitstream/handle/10539/1623/01 Chapte
r4.pdf?
handbook-on-supply-chain-management-f..
Pretoria.
141
http://www.doh.gov.za/docs/factsheets/ guidelines/dhp/index.
html - 14k -
www.epnetwork.org.http://wcccoe.org/wcc/news/contact.html.
nigeriahttp://www.ngnhc.org/docs/NHC2009/papers/Making
Essential Dr…
142
South African Pharmacy Council, 2010. Good Pharmacy
Pretoria.
doc.
Town.
www.theglobalfund.org/
143
Weber R.J., Skleda S.J., Sirianni C.R., Frank S., Yourich B.,
http://cat.inist.fr/?aModele=afficneN&cpsidt=16348289 .
Available at:
www.safecare.org/.../SafeCare%20standards%20for%20Clinic
s%20and%20health%
www.who.int/medicines/publications/essentialmedicines/en/.
144
World Health Organisation, 2003. How to investigate the use
http://www.who.int/medicinedocs/collect/edmweb/pdf/whozip08e/whozip08e.pdf
collections.infocollections.org/whocountry/collect/.../s6864e.p
145
APPENDIX 1:
Name of Study:
“Problems affecting drug supply management at primary health care level in the
Sedibeng district”
I have read the information the aims and objectives of the proposed study and was
provided the opportunity to ask questions and given adequate time to rethink the issue.
The aim and objectives of the study are sufficiently clear to me. I have not been
I understand that participation in this Study is completely voluntary and that I may
I know that this Study has been approved by the Medunsa Research Ethics Committee
aware that the results of this study will be used for scientific purposes and may be
............................................................ .................................................
______________________________________________________________________
146
Statement by the Researcher
I agree to answer any future questions concerning the Study as best as I am able to.
147
APPENDIX 2:
I hereby confirm that I have been informed by the researcher, Ms Shamima Tayob
“Problems affecting drug supply management at primary health care level in the
Sedibeng district”
I have also received, read and understood the above written information (Participant
I am aware that the results of the study will be anonymously processed into a study
report.
In view of the requirements of this research, I agree that the data collected during this
or on their behalf.
I may, at any stage, without prejudice, withdraw my consent and participation in the
study.
I have had sufficient opportunity to ask questions and (of my own free will) declare
148
PARTICIPANT
I, Shamima Tayob, herewith confirm that the above participant has been fully informed
RESEARCHER
149
APPENDIX 3
QUESTIONNAIRE TO TRANSPORT OFFICER
6. Do you have a schedule which you follow to deliver medicine from district Yes No
pharmacy to the PHC clinic?
7. Are you always able to adhere to the delivery schedule ? Yes No
8. Are security personnel always available to count the number of Always Sometimes Never
boxes?
9.items which
Is there are loaded
a dedicated into the
person vehicle?
to receive the order when it delivered to the clinic? Yes No
10. Who is the person receiving the order at Store manager Facility Security Other
the clinic? Manager
11. Are the number of the boxes checked immediately when Sometimes Always Never
the delivery is received at the clinic?
12. Please explain what happens if the what procedure is followed if the order is not checked immediately.
16. Is the delivery note signed by the person receiving the order? Yes No
17. Do you return a copy of the signed delivery note to the pharmacy? Yes No
18. In your experience, have there been discrepancies in terms of delivery of Yes No
medication?
19. Is the cold chain maintained when delivering Sometimes Always Never
medication?
20. If the cold chain is not maintained, who do you report Do not PHC clinic District
this to? report Pharmacy
150
APPENDIX 4: QUESTIONNAIRE TO FACILITY MANAGER AND /OR STORE MANAGER
HUMAN RESOURCES
TRAINING DETAILS
Please indicate number of staff who have been trained in dispensing.
Additional Comments:
management over the last 12 months
151
ants)?
17. Available
Security
Systems a. CCTV b. Alarm c. Guard d. Burglar bars e. Security door
18. Which of the following Check number of boxes Check stock received Other No procedure
receiving procedure/s apply at this and sign driver’s note against invoice
facility?
19. Who is responsible for Pharmacist Pharmacist Nurse Store Security Other
receiving drugs in the facility? assistant manager
20. Within what period of time is stock Immediately The same day Within 24 hours Later
checked after receipt ?
22. Are there any drugs stored in direct contact with the floor? Yes No
23. Which option describes the Medicine Pharmacy Consulting M/R P C/R M/R P C/R
ventilation process / temperature Room (P) room (CR )
control of the Pharmacy/Medicine (M/R )
store best?
Air Conditioner (functional) Fans Air bricks
24. Is the room temperature recorded twice daily? Yes No
Additional comments:
25a. Is only medicines stored in all the designated medication fridges and refrigerator (no food, Yes No
no drinks)?
b. Is there sufficient space in the refrigerator/cold room to store medication and provide adequate Yes No
flow?
c. Is there a thermometer in the fridge? Yes No
of cool air?
152
d. Is the temperature of the refrigerator(s) maintained between 2C and 8C? Yes No
f. Are fridges defrosted and cleaned twice a month or when the ice is more than 5mm? Yes No
g. When there is a power failure, is there a backup generator in case of a power failure? Yes No
h. Is the cold chain maintained when receiving stock from the district pharmacy? Yes No
Additional comments:
153
SECTION C- FACILITY MANAGER/STORE MANAGER
28. Which of the following is reflected on Max stock level Average Monthly Reorder
the stock card/computer? Consumption level/factor
29. Has the ROL been calculated for all tracer items in the Yes No
store?
30. Are the re-order levels of tracer items reviewed? Yes No If yes how often
31. What was the average stock out period of tracer items? 1-3 days 4-7 days 8 days or more
32. Are there any items out of stock currently Yes No No of items=
according to the tracer list tracer list?
33. Who is responsible for ordering Pharmacist Pharmacist Nurse Store manager Other
of medication in the facility? Assistant
34. Did any drugs expire over the last 12 months? Yes No
35. If yes what was the estimated monetary value of the items R Don’t Know
expired?
36. How does the supply system track expiry date? Please explain
38. What is your lead time between request and No of day’s: Don’t Know
receipt of drugs?
39. Do you receive your order on time from the district Yes No Sometimes Most of the time
pharmacy?
40. What action is taken if orders Contact Contact Other
are not received on time? pharmacy Transport
41. Do you report on stock out Yes No For All For Tracer To Whom-
situation? Medicines Medicines
42. If the facility is out of stock of medication, what do you do? Please choose the most appropriate
answer/s below
do you:
a. Do you send patients to other clinics? Yes No
154
e. Do you give patient a small supply and ask them to come back? Yes No
f. Do you tell the patient that there is no medication at clinics and you are not Yes No
sure when you will receive medication?
43. Do you receive feedback Expected Out of stock in Status of to follow orders
regarding the status of your orders? delivery pharmacy
Yes No Yes No Yes No
44. Are all procurement and receipt documents filed? Yes No
b.
c.
47. Has the facility been visited by the district pharmacist in the last month? Yes No
155
APPENDIX 5 : RESEARCHER CHECK LIST
Reference (Unique 1.Completion Date: Name of facility
No.):
2. Check area’s where
medicines are stored a. Pharmacy b. Dispensary c. Bulk Store d. Nurse Consulting room
3. Is only medicine stored in areas identified in Question 2. Yes No
11. Check the number of items out of stock Tracer items Non tracer Items
No= No=
12. Check the value of expired stock for the last three Value
months
Yes No Yes No
13. Check that there are no supplies stored in direct contact Medicine store Consulting room
with the floor Yes No Yes No
14. Check for evidence of stock take in facility Medicine room Consulting room Frequency=
Yes No Yes No
15. Check if bin cards for tracer items are Medicine Room Consulting room Updated regularly
available and updated Yes No Yes No Yes No
16. Check if each tracer item has a Medicine Room Consulting Reviewed three monthly
re-order level room
Yes No Yes No Yes No
17. Check if only medicines are stored in the refrigerator (No food, no drinks) Yes No
a. Check if the temperature of the refrigerator(s) is between 2C and 8 Yes No
b. Check if fridges are clean and ice is less than 5mm thick Yes No
c. Check if a temperature chart is available and up Chart available Chart updated twice daily
to date Yes No Yes No
Record available Ice less than 5mm thick
d. Check if cleaning records are available Yes No Yes No
for fridge
18. Check documents for procurement and receipt of medication Available Not available Filed
Yes No
19. Check order files to determine if stock is Stock counted for all Re-order level recorded for each item
counted prior to ordering and re-order levels items
indicated of each item on order file Yes No Yes No
156
STANDARD OPPERATING PROCEDURES AND REFERENCE MATERIAL
20. Check if the following SOP’s are available in the facility ( Addendum 1 of Circular 4 of 2007 )
21. Check if the pharmacy/facility has copies of, or electronic access to: Yes No
a. EDL/STG - Adult Standard Treatment Guidelines for Hospital Edition/
date
b. EDL/STG - Paediatric Standard Treatment Guidelines for Yes No
Hospital
c .EDL/STG - Primary Health Care Standard Treatment Guidelines Yes No
d. A Provincial Formulary/Code List Yes No
No
157
APPENDIX 6: TRACER MEDICINES MONITORING – Primary Health Care
3. Sub District:
2. Name of Facility:
1 Adrenalin 1mg/ml IM
Amp
158
APPENDIX 7:
GLOSS ARY
consumption.
159
the data collection. It often uses visual aids such as graphs and
health.
applicable, having bin cards with each item having the name,
recorded, stored off the floor in a lockable store room where the
160
General assistant - is one who works in the pharmacy but has
of the medicine.
PHC.
assigned to manage.
Maximum stock level - this level is the target level which is the
stock needed to satisfy demand until the next order after this
one is received.
the storage of bulk stocks of medi cines, which must comply with
161
practice rules published in terms of Section 35A of the
substances.
162
dispensing licence. The Director-General will only issue a
Council.
and
163
only if the medical practitioner is not personally available
license).
164
such organization, as the case may be, may in the course of
in any person;
conditions; or
such nurse may perform such act only whenever the services of
of 1981.]
165
Primary Health Care - A set of prescribed services, generally
pharmacist.
166
structured practical training programme provided by the SAPC
stock level.
investigator collects data from past records and does not follow
study.
167
environment, and in a way that maximi ses operation and
production requirement.
facility manager to manage the drug supply for the facility. The
rooms.
or hospitals).
168
who is authorised to transport medication to designated
facilities.
169
APPENDIX 8:
Name of Pharmacist:________________
PHC
FACILITY DATE
Specify:
Are working surfaces and shelves where medicines are kept finished with a smooth impermeable
material? Y N
:
Are there separate facilities for washing hands and cleaning equipment?
Y N
Are there tablet counting trays?
Y N
Are they cleaned after every use?
Y N
Is the access to the medicine storeroom controlled for unauthorized persons?
Y N
:
Are waste containers available (in line with the IPC policy)?
Y N
The medicine store is large enough to keep all supplies?
Y N
:
The medicine store is kept locked at all times when not in use
Y N
There are no cracks, holes or sign of water damage in the medicine store
Y N
:
There is a ceiling in the medicine store which is in good condition
Y N
The medicine store is appropriately air conditioned
Y N
The windows are painted in white (or have curtains) and are secured with grills
170
Y N
There are no signs of pest infestations in the medicine store (i.e. cockroaches, rats)
Y N
The medicine store is tidy; shelves are dusted, the floor is swept, and walls are clean
Y N
There are no supplies in direct contact with the floor (boxes are kept in pallets)
Y N
B. Selection
Are medicines prescribed by generic name?
Y N
Do you know how to calculate the Average Monthly Consumption (AMC) – ask one to calculate it Y N
then Check Formula
Do you take into consideration stock out period when calculating the AMC Y N
Do you calculate the Maximum Stock by multiplying the AMC by the Maximum Stock Factor Y N
Has the Maximum Stock been calculated for each item in the store Y N
Is the Maximum Stock recorded on each item’s stock card (in pencil) Y N
171
When was the last time that the Maximum Stock was reviewed?
Indicate:
Is a standard requisition form used? Y N
Are all orders placed in writing using the prescribed forms? Y N
Is the requisition book kept at the facility? Y N
D. Distribution
How are stock outs addressed when they occur?
Explain
What is the average length of time of stock out for critical items (tracer medicines)?
Indicate:
Explain:
Are quantities received checked against quantities ordered?
Y N
E. Storage
Supplies are systematically classified on the shelves (i.e. by dosage forms or therapeutic class)
Y N
Tablets and other dry medicines (e.g. ORS) are stored in airtight containers
Y N
Supplies such as surgical items, condoms and bandages are stored in the bottom shelves
Y N
172
Items are grouped in amounts that are easy to count
Y N
Medicines are utilised in terms of first expiry first out principle (FEFO)
Y N
Supplies with no expiry or manufacture date are stored in the order received (FIFO)
Y N
The disposal of medicines is recorded in a separate register and includes the date, time, witness,
value, quantities and reason(s) Y N
NarcotiPrimary health care facility supervisor and psychotropic medicines are in a separate
double-locked storage space Y N
Are items checked regularly for potential deterioration (i.e. bad odour or discoloured tablets)
Y N
F. Use Y N
Does the labelling of medicines meet the legal requirements? (Supervisor to take 3 random Y N
samples of prescriptions issued to 3 – 5 patients. Tick from the list: Name of patient, name of
medicine, strength and quantity, instructions on how to take the medicine, name of facility, exp
date and batch number)
173
Quality Control/ Patient Care
The health care worker checks for poor quality items, such as: -
o Discolouration of medicines,
Y N
o Sediments in medicines
Y N
o Broken and or leaking containers
Y N
o Spoiled labels on medicine containers
o Unsealed and unlabelled medicine containers
Y N
o Expired medicines on shelves
Y N
174
Out of stock medication
out of stock reasons intervention
175
APPENDIX 9:
176
APPENDIX 10:
SEDIBENG
DISTRICT
STOCK CONTROL CARD HEALTH
Note : For every discrepancy on running balance a reason must be supplied with
PHARMACIST signature !
V
A
1
1
FACILITY:...................................... Page no.
ITEM:…………………………….....
RE-
ORDER
STRENGTH :…………………… PACK SIZE:………………. LEVEL:
177
APPENDIX 11:
SHAMIMA TAYOB: 2011 10:45 Wednesday, October 5, 2011 19
PROGRAM FILE SHAMIMA.sas *** DATA FILE DATA Shamima data.xlsx
SECTION A: FACILITY MANAGER
PRINTOUT NUMBER 1
facility
Cumulative Cumulative
facility Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
Beverly Hills 1 4.00 1 4.00
Boipatong 1 4.00 2 8.00
Boitumelo 1 4.00 3 12.00
Bophelong 1 4.00 4 16.00
Driehoek 1 4.00 5 20.00
EMPILISWENI 1 4.00 6 24.00
Evaton Main 1 4.00 7 28.00
Helga Kuhn 1 4.00 8 32.00
Johan Deo 1 4.00 9 36.00
Johan Heyns 1 4.00 10 40.00
Le Vai Mbatha 1 4.00 11 44.00
Market Ave 1 4.00 12 48.00
Meyerton 1 4.00 13 52.00
Mpumelelo 1 4.00 14 56.00
Osisweni 1 4.00 15 60.00
Pontshong 1 4.00 16 64.00
Retswelapele 1 4.00 17 68.00
Rustervaal 1 4.00 18 72.00
Sharpville 1 4.00 19 76.00
Thlokomelong 1 4.00 20 80.00
Tshepiso 1 4.00 21 84.00
Zone 11 1 4.00 22 88.00
Zone 12 1 4.00 23 92.00
Zone 17 1 4.00 24 96.00
Zone 3 1 4.00 25 100.00
District
Cumulative Cumulative
District Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
Sedibeng 25 100.00 25 100.00
Sub_district
*********************************************************************************
*********************
Facility_type
178
*********************************************************************************
*********************
SECTION A: HUMAN RESOURCES
The FREQ Procedure
q3
Cumulative Cumulative
q3 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
yes 25 100.00 25 100.00
Designations
Cumulative Cumulative
Designations Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
Facility manager 1 4.17 1 4.17
assistant 9 37.50 10 41.67
nurse 1 4.17 11 45.83
pharmacist assistant 11 45.83 22 91.67
sister in charge 2 8.33 24 100.00
Frequency Missing = 1
q4
Cumulative Cumulative
q4 Frequency Percent
Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
Part time pharmacist assistant 1 5.26
1 5.26
assistant once a week 6 31.58
7 36.84
assistant twice a week 3 15.79
10 52.63
assistant twice a week or facility manager 1 5.26
11 57.89
full time assistant 4 21.05
15 78.95
pharmacist assistant available on weekly basis 1 5.26
16 84.21
pharmacist assistant twice a week 2 10.53
18 94.74
proffessional nurse 1 5.26
19 100.00
Frequency Missing = 6
*********************************************************************************
*********************
179
SECTION A: TRAINING DETAILS
PRINTOUT NUMBER 3.1
nurses_trained
Cumulative Cumulative
nurses_trained Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
0 1 4.00 1 4.00
1 2 8.00 3 12.00
2 9 36.00 12 48.00
3 2 8.00 14 56.00
4 6 24.00 20 80.00
6 1 4.00 21 84.00
7 1 4.00 22 88.00
9 1 4.00 23 92.00
10 1 4.00 24 96.00
12 1 4.00 25 100.00
nurses_in_training
nurses_untrained
Cumulative Cumulative
nurses_untrained Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
0 1 4.00 1 4.00
1 7 28.00 8 32.00
2 7 28.00 15 60.00
3 5 20.00 20 80.00
5 1 4.00 21 84.00
8 1 4.00 22 88.00
9 1 4.00 23 92.00
12 1 4.00 24 96.00
23 1 4.00 25 100.00
*********************************************************************************
*********************
180
pa_trained
Cumulative Cumulative
pa_trained Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
0 13 52.00 13 52.00
1 12 48.00 25 100.00
pa_in_training
Cumulative Cumulative
pa_in_training Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
0 16 64.00 16 64.00
1 9 36.00 25 100.00
pa_untrained
Cumulative Cumulative
pa_untrained Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
0 25 100.00 25 100.00
q6
Cumulative Cumulative
q6 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
0 22 88.00 22 88.00
1 2 8.00 24 96.00
2 1 4.00 25 100.00
q6_specify
Cumulative Cumulative
q6_specify Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
pharmasist assistant 1 100.00 1 100.00
Frequency Missing = 24
181
APPENDIX 12:
q7_1
Cumulative Cumulative
q7_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
medicine store 21 100.00 21 100.00
Frequency Missing = 4
q7_2
Cumulative Cumulative
q7_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
nurses consulting room 25 100.00 25 100.00
q8
Cumulative Cumulative
q8 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 19 76.00 19 76.00
yes 6 24.00 25 100.00
q9
Cumulative Cumulative
q9 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 8 33.33 8 33.33
yes 16 66.67 24 100.00
Frequency Missing = 1
q10
Cumulative Cumulative
q10 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 23 92.00 23 92.00
yes 2 8.00 25 100.00
*********************************************************************************
*********************
182
q11
Cumulative Cumulative
q11 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 1 4.00 1 4.00
yes 24 96.00 25 100.00
q12
Cumulative Cumulative
q12 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 24 96.00 24 96.00
yes 1 4.00 25 100.00
q13
Cumulative Cumulative
q13 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
blinds 8 57.14 8 57.14
none 5 35.71 13 92.86
paint 1 7.14 14 100.00
Frequency Missing = 11
q13_other
Cumulative Cumulative
q13_other Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no store room 1 9.09 1 9.09
no sun inside room 1 9.09 2 18.18
no windows 9 81.82 11 100.00
Frequency Missing = 14
*********************************************************************************
*********************
q14
Cumulative Cumulative
q14 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 2 8.33 2 8.33
yes 22 91.67 24 100.00
Frequency Missing = 1
q15
Cumulative Cumulative
q15 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 2 9.09 2 9.09
yes 20 90.91 22 100.00
Frequency Missing = 3
183
*********************************************************************************
*********************
Cumulative Cumulative
q16 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
No store room 1 2.38 1 2.38
nurse 1 2.38 2 4.76
other nurses 3 7.14 5 11.90
pharmasist assistant 16 38.10 21 50.00
sister in charge 21 50.00 42 100.00
Frequency Missing = 33
Cumulative Cumulative
q17 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
alarm 2 5.71 2 5.71
burglar bars 11 31.43 13 37.14
guard 6 17.14 19 54.29
locks on cupboards 2 5.71 21 60.00
normal door 2 5.71 23 65.71
security door 12 34.29 35 100.00
Frequency Missing = 40
184
APPENDIX 13:
SHAMIMA TAYOB: 2011 10:45 Wednesday, October 5, 2011 71
PROGRAM FILE SHAMIMA.sas *** DATA FILE DATA Shamima data.xlsx
SECTION C: STORAGE AND CONTROL PROCESSES
PRINTOUT NUMBER 5
q18_1
Cumulative Cumulative
q18_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
x 24 100.00 24 100.00
Frequency Missing = 1
q18_2
Cumulative Cumulative
q18_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
x 24 100.00 24 100.00
Frequency Missing = 1
q19_1
Cumulative Cumulative
q19_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
pharmasist assistant 21 100.00 21 100.00
Frequency Missing = 4
q19_2
Cumulative Cumulative
q19_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
nurse 8 100.00 8 100.00
Frequency Missing = 17
q19_other
Cumulative Cumulative
q19_other Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
sister in charge 10 100.00 10 100.00
Frequency Missing = 15
185
q20
Cumulative Cumulative
q20 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
once a week 1 4.00 1 4.00
the same day 14 56.00 15 60.00
within 24 hrs 10 40.00 25 100.00
q21
Cumulative Cumulative
q21 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 2 8.33 2 8.33
yes 22 91.67 24 100.00
Frequency Missing = 1
q22
Cumulative Cumulative
q22 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 12 48.00 12 48.00
yes 13 52.00 25 100.00
q23_1
Cumulative Cumulative
q23_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
C/R FAN & WINDOWS 1 4.35 1 4.35
C/R airbricks 1 4.35 2 8.70
M/R aircon 10 43.48 12 52.17
M/R aircon/not working 6 26.09 18 78.26
NONE 4 17.39 22 95.65
aircon 1 4.35 23 100.00
Frequency Missing = 2
q23_2
Cumulative Cumulative
q23_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
fans 2 66.67 2 66.67
pharmacy AIRCON 1 33.33 3 100.00
Frequency Missing = 22
q23_3
Cumulative Cumulative
q23_3 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
air brick 2 100.00 2 100.00
Frequency Missing = 23
186
q24
Cumulative Cumulative
q24 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 15 60.00 15 60.00
yes 10 40.00 25 100.00
******************************************************************************************************
q24_comments
Frequency Missing = 14
q25_1
Cumulative Cumulative
q25_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 1 4.00 1 4.00
yes 24 96.00 25 100.00
q25_2
Cumulative Cumulative
q25_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 8 32.00 8 32.00
yes 17 68.00 25 100.00
q25_3
Cumulative Cumulative
q25_3 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 1 4.00 1 4.00
yes 24 96.00 25 100.00
187
q25_4
Cumulative Cumulative
q25_4 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 1 4.17 1 4.17
yes 23 95.83 24 100.00
Frequency Missing = 1
q25_5
Cumulative Cumulative
q25_5 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 1 4.17 1 4.17
yes 23 95.83 24 100.00
Frequency Missing = 1
******************************************************************************************************
q25_6
Cumulative Cumulative
q25_6 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 12 48.00 12 48.00
yes 13 52.00 25 100.00
q25_7
Cumulative Cumulative
q25_7 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 19 79.17 19 79.17
yes 5 20.83 24 100.00
Frequency Missing = 1
q25_8
Cumulative Cumulative
q25_8 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
yes 24 100.00 24 100.00
Frequency Missing = 1
q25_comments
Frequency Missing = 22
******************************************************************************************************
188
SECTION C: MEDICINE MANAGEMENT AND PROCESSES
PRINTOUT NUMBER 7
q26
Cumulative Cumulative
q26 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
manual/paper base 25 100.00 25 100.00
q27_1
Cumulative Cumulative
q27_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
reorder level/factor 21 100.00 21 100.00
Frequency Missing = 4
q27_2
Cumulative Cumulative
q27_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
max stock level 2 100.00 2 100.00
Frequency Missing = 23
q27_3
Cumulative Cumulative
q27_3 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
average monthly consumption 1 100.00 1 100.00
Frequency Missing = 24
q28_1
Cumulative Cumulative
q28_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
phamasist assistant 20 100.00 20 100.00
Frequency Missing = 5
******************************************************************************************************
q28_2
Cumulative Cumulative
q28_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
nurse 4 100.00 4 100.00
Frequency Missing = 21
q28_other
189
Cumulative Cumulative
q28_other Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
facility manager 1 12.50 1 12.50
sister in charge 7 87.50 8 100.00
Frequency Missing = 17
q29
Cumulative Cumulative
q29 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
1 4 17.39 4 17.39
2 2 8.70 6 26.09
3 1 4.35 7 30.43
4 2 8.70 9 39.13
6 4 17.39 13 56.52
7 1 4.35 14 60.87
8 2 8.70 16 69.57
10 1 4.35 17 73.91
11 1 4.35 18 78.26
12 3 13.04 21 91.30
14 1 4.35 22 95.65
16 1 4.35 23 100.00
Frequency Missing = 2
******************************************************************************************************
q30
Cumulative Cumulative
q30 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
1 - 3 days 2 8.70 2 8.70
4 - 7 days 11 47.83 13 56.52
8 days or more 10 43.48 23 100.00
Frequency Missing = 2
q31
Cumulative Cumulative
q31 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 5 20.00 5 20.00
yes 20 80.00 25 100.00
q32
Cumulative Cumulative
q32 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 15 65.22 15 65.22
yes 8 34.78 23 100.00
Frequency Missing = 2
q32_often
190
Cumulative Cumulative
q32_often Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
3 monthly 6 85.71 6 85.71
monthly 1 14.29 7 100.00
Frequency Missing = 18
******************************************************************************************************
q33
Cumulative Cumulative
q33 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 1 4.00 1 4.00
yes 24 96.00 25 100.00
q34
Cumulative Cumulative
q34 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 9 36.00 9 36.00
yes 16 64.00 25 100.00
q35_1
Cumulative Cumulative
q35_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
R1202.27 1 7.14 1 7.14
R126203.00 1 7.14 2 14.29
R16846.63 1 7.14 3 21.43
R2020.92 1 7.14 4 28.57
R21242.45 1 7.14 5 35.71
R23818.41 1 7.14 6 42.86
R26150.97 1 7.14 7 50.00
R30.87 1 7.14 8 57.14
R3218.84 1 7.14 9 64.29
R3922.58 1 7.14 10 71.43
R648.58 1 7.14 11 78.57
R7212.70 1 7.14 12 85.71
R98.04 1 7.14 13 92.86
don't know 1 7.14 14 100.00
Frequency Missing = 11
******************************************************************************************************
q35_2
Cumulative Cumulative
q35_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
R220.08 1 33.33 1 33.33
R2843.79 1 33.33 2 66.67
R99.60 1 33.33 3 100.00
Frequency Missing = 22
191
q36
Frequency Missing = 14
******************************************************************************************************
q37
Cumulative Cumulative
q37 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
001010 1 5.88 1 5.88
040711 1 5.88 2 11.76
080511 1 5.88 3 17.65
130611 1 5.88 4 23.53
210711 1 5.88 5 29.41
220711 1 5.88 6 35.29
270511 1 5.88 7 41.18
270711 1 5.88 8 47.06
280311 2 11.76 10 58.82
300511 1 5.88 11 64.71
300611 1 5.88 12 70.59
no stock take 3 17.65 15 88.24
none 1 5.88 16 94.12
not conducted 1 5.88 17 100.00
Frequency Missing = 8
q38
Cumulative Cumulative
q38 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
14 days 22 88.00 22 88.00
2 - 3 weeks 1 4.00 23 92.00
7 - 14 days 1 4.00 24 96.00
7 days 1 4.00 25 100.00
q39
Cumulative Cumulative
q39 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
most of the time 5 20.00 5 20.00
sometimes 19 76.00 24 96.00
yes 1 4.00 25 100.00
******************************************************************************************************
192
q40
Cumulative Cumulative
q40 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
contact pharmacy 25 100.00 25 100.00
q41
Cumulative Cumulative
q41 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
yes 25 100.00 25 100.00
q41_specify1
Cumulative Cumulative
q41_specify1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
for all meds 20 100.00 20 100.00
Frequency Missing = 5
q41_specify2
Cumulative Cumulative
q41_specify2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
for tracer medicines 12 100.00 12 100.00
Frequency Missing = 13
q41_to_whom
Cumulative Cumulative
q41_to_whom Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
district pharmacy 4 17.39 4 17.39
pharmacist 12 52.17 16 69.57
pharmacy 4 17.39 20 86.96
supervising pharmacist 3 13.04 23 100.00
Frequency Missing = 2
******************************************************************************************************
q42_1
Cumulative Cumulative
q42_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 23 95.83 23 95.83
yes 1 4.17 24 100.00
Frequency Missing = 1
q42_2
Cumulative Cumulative
q42_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 1 4.00 1 4.00
yes 24 96.00 25 100.00
193
q42_3
Cumulative Cumulative
q42_3 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 1 4.00 1 4.00
yes 24 96.00 25 100.00
q42_4
Cumulative Cumulative
q42_4 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 20 80.00 20 80.00
yes 5 20.00 25 100.00
q42_5
Cumulative Cumulative
q42_5 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 5 20.00 5 20.00
yes 20 80.00 25 100.00
******************************************************************************************************
q42_6
Cumulative Cumulative
q42_6 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 18 72.00 18 72.00
yes 7 28.00 25 100.00
q43_ed
Cumulative Cumulative
q43_ed Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 25 100.00 25 100.00
q43_os
Cumulative Cumulative
q43_os Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
yes 25 100.00 25 100.00
q43_sfo
Cumulative Cumulative
q43_sfo Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 25 100.00 25 100.00
194
q44
Cumulative Cumulative
q44 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 2 8.00 2 8.00
yes 23 92.00 25 100.00
******************************************************************************************************
q45_1
Cumulative Cumulative
q45_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
district out of stock 24 96.00 24 96.00
no proper reorder levels 1 4.00 25 100.00
q45_2
Cumulative Cumulative
q45_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
Not sufficient space 1 4.55 1 4.55
district stock out 1 4.55 2 9.09
don’t order enough 1 4.55 3 13.64
late submission of orders 1 4.55 4 18.18
missed ordering 1 4.55 5 22.73
more pt's new township opened 1 4.55 6 27.27
no bin cards 1 4.55 7 31.82
no reorder levels 4 18.18 11 50.00
no reviewing of reorder levels 1 4.55 12 54.55
not correct ROL 2 9.09 14 63.64
pt load INCREASED 1 4.55 15 68.18
pt referred from other clinics 6 27.27 21 95.45
reducing of order by district pharmacy 1 4.55 22 100.00
Frequency Missing = 3
******************************************************************************************************
q45_3
Cumulative Cumulative
q45_3 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
DO NOT ORDER TIMEOUSLY 1 5.88 1 5.88
don’t order in time 2 11.76 3 17.65
lack of space 2 11.76 5 29.41
no reorder levels 2 11.76 7 41.18
no stock count 1 5.88 8 47.06
not enough space to adhere to re-order level 1 5.88 9 52.94
nurses do not fill bin cards when assistant is not there 1 5.88 10 58.82
pt referred from other clinics 1 5.88 11 64.71
referral for meds to other clinics 1 5.88 12 70.59
reorder levels incorrect 1 5.88 13 76.47
seasonal changes 1 5.88 14 82.35
seasonal changes e.g antibiotic use increases in winter 1 5.88 15 88.24
storage not sufficient 1 5.88 16 94.12
unexspected pt load 1 5.88 17 100.00
Frequency Missing = 8
195
q46
Cumulative Cumulative
q46 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
yes 22 100.00 22 100.00
Frequency Missing = 3
q47
Cumulative Cumulative
q47 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 11 50.00 11 50.00
yes 11 50.00 22 100.00
Frequency Missing = 3
196
APPENDIX 14:
SHAMIMA TAYOB: 2011 10:45 Wednesday, October 5, 2011 130
PROGRAM FILE SHAMIMA.sas *** DATA FILE DATA Shamima data.xlsx
TRANSPORT OFFICER
PRINTOUT NUMBER 1
q1
Cumulative Cumulative
q1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 4 100.00 4 100.00
q2
Cumulative Cumulative
q2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 4 100.00 4 100.00
q3_1
Cumulative Cumulative
q3_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
close van 1 100.00 1 100.00
Frequency Missing = 3
q3_2
Cumulative Cumulative
q3_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
car 4 100.00 4 100.00
q3_other
Cumulative Cumulative
q3_other Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
Golf 1 100.00 1 100.00
Frequency Missing = 3
******************************************************************************************************
q4
Cumulative Cumulative
q4 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
orders has to be split 3 75.00 3 75.00
sometimes 1 25.00 4 100.00
197
q5
Cumulative Cumulative
q5 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
never 1 25.00 1 25.00
sometimes 3 75.00 4 100.00
q6
Cumulative Cumulative
q6 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
yes 4 100.00 4 100.00
q7
Cumulative Cumulative
q7 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 4 100.00 4 100.00
q8
Cumulative Cumulative
q8 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
always 1 25.00 1 25.00
never 1 25.00 2 50.00
sometimes 2 50.00 4 100.00
******************************************************************************************************
q9
Cumulative Cumulative
q9 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 4 100.00 4 100.00
q10_1
Cumulative Cumulative
q10_1 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
store manager 2 100.00 2 100.00
Frequency Missing = 2
q10_2
Cumulative Cumulative
q10_2 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
facility manager 2 100.00 2 100.00
Frequency Missing = 2
198
q10_3
Cumulative Cumulative
q10_3 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
security 3 100.00 3 100.00
Frequency Missing = 1
******************************************************************************************************
q10_other
Cumulative Cumulative
q10_other Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
Pharmacist assistant 1 33.33 1 33.33
depend on who is available 1 33.33 2 66.67
nurses 1 33.33 3 100.00
Frequency Missing = 1
q11
Cumulative Cumulative
q11 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
seldom 1 25.00 1 25.00
sometimes 3 75.00 4 100.00
q12
Cumulative
Cumulative
q12 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
boxes are left outside with security. If pharmacist 1 33.33 1 33.33
assistant iS available boxes are counted
boxes are seldom counted 1 33.33 2 66.67
depending on who is available, sometimes the number of 1 33.33 3 100.00
boxes are counted, At other times boxes are left outside
dorr at clinic without being checked
Frequency Missing = 1
q13
Cumulative Cumulative
q13 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
yes 4 100.00 4 100.00
******************************************************************************************************
199
SHAMIMA TAYOB: 2011 10:45 Wednesday, October 5, 2011 134
PROGRAM FILE SHAMIMA.sas *** DATA FILE DATA Shamima data.xlsx
TRANSPORT OFFICER
PRINTOUT NUMBER 1
q14
Cumulative Cumulative
q14 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 4 100.00 4 100.00
q15
Frequency Missing = 1
q16
Cumulative Cumulative
q16 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 3 75.00 3 75.00
sometimes 1 25.00 4 100.00
q17
Cumulative Cumulative
q17 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
no 2 50.00 2 50.00
sometimes 2 50.00 4 100.00
q18
Cumulative Cumulative
q18 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
NOT SURE 1 25.00 1 25.00
yes 3 75.00 4 100.00
******************************************************************************************************
q19
Cumulative Cumulative
q19 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
always 2 50.00 2 50.00
sometimes 2 50.00 4 100.00
200
q20
Cumulative Cumulative
q20 Frequency Percent Frequency Percent
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
N/A 1 50.00 1 50.00
do not report 1 50.00 2 100.00
Frequency Missing = 2
201