Transformation of the Tanzania medical store department through global fund support: an impact assessment study.
Transformation of the Tanzania medical store department through global fund support: an impact assessment study.
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DOI：
10.1136/bmjopen-2020-040276
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发表时间：
2020-11-06
期刊：
影响因子：
2.9
通讯作者：
Achoki T
中科院分区：
文献类型：
--
作者：
Githendu P;Morrison L;Silaa R;Pothapregada S;Asiimwe S;Idris R;Peterson T;Davidson E;Lesego A;Mwale N;Mwakalobo SM;Bwanakunu LR;Achoki T
坦桑尼亚政府寻求全球抗击艾滋病、结核病和疟疾基金的支持，以改革其医药商店部门，目的是提高业绩。该研究旨在评估改革的影响，并记录所吸取的教训。采用定量和定性研究方法评估改革的影响。定量部分涉及审查改革实施前后的业务和财务数据。中断时间序列分析被用来确定卫生区基本卫生商品平均供应量的变化。通过对41名关键知情人的访谈收集了定性数据。通过利益攸关方摸底、有目的和滚雪球抽样技术确定了参与者，并通过专题内容分析对答复进行了分析。改革后，基本卫生商品的可获得性显著增加了12.6%（95%CI 9.6%至15.6%），并且与干预前的趋势相比，每月继续增加0.2%（95%CI 0.0%至0.3%）。于二零一四╱二零一五年至二零一七╱二零一八年期间，销售额增加56. 6%，而销售成本则增加88. 6%。2014/2015年度至2017/2018年度，由于租金及燃料开支减少，盈余收入增加56. 4%。研究参与者一致认为，改革有助于改善医药仓库部门的业绩。改革取得了积极成果。然而，尽管取得了进展，但仍存在风险，例如政府应收款增加可能危及收益的可持续性。因此，多方利益攸关方的努力对于取得进展和扩大公共卫生是必要的。
The Tanzania government sought support from The Global Fund to Fight AIDs, Tuberculosis and Malaria to reform its Medical Stores Department, with the aim of improving performance. The study sought to assess the impact of the reforms and document the lessons learnt. Quantitative and qualitative research methods were applied to assess the impact of the reforms. The quantitative part entailed a review of operational and financial data covering the period before and after the implementation of the reforms. Interrupted time series analysis was used to determine the change in average availability of essential health commodities at health zones. Qualitative data were collected through 41 key informant interviews. Participants were identified through stakeholder mapping, purposive and snowballing sampling techniques and responses were analysed through thematic content analysis. Availability of essential health commodities increased significantly by 12.6% (95% CI 9.6% to 15.6%) after the reforms and continued to increase on a monthly basis by 0.2% (95%CI 0.0% to 0.3%) relative to the preintervention trend. Sales increased by 56.6% while the cost of goods sold increased by 88.6% between 2014/2015 and 2017/2018. Surplus income increased by 56.4% between 2014/2015 and 2017/2018 with reductions in rent and fuel expenditure. There was consensus among study participants that the reforms were instrumental in improving performance of the Medical Stores Department. Positive results were realised through the reforms. However, despite the progress, there were risks such as the increasing government receivable that could jeopardise the sustainability of the gains. Therefore, multistakeholder efforts are necessary to make progress and expand public health.
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影响因子：
5.6
作者：
Meyer JC;Schellack N;Stokes J;Lancaster R;Zeeman H;Defty D;Godman B;Steel G
通讯作者：
Steel G
影响因子：
34.3
作者：
Gouda, Hebe N.;Charlson, Fiona;Whiteford, Harvey
通讯作者：
Whiteford, Harvey
影响因子：
7.9
作者：
Gereffi G
通讯作者：
Gereffi G
影响因子：
7.7
作者：
Bhaskaran K;Gasparrini A;Hajat S;Smeeth L;Armstrong B
通讯作者：
Armstrong B
影响因子：
168.9
作者：
Cameron, A.;Ewen, M.;Laing, R.
通讯作者：
Laing, R.