Hospitals on the spot over expired drugs

About half of hospitals in Kenya do not regularly remove expired or unusable medicines from their shelves, a new survey by the Health ministry has shown.

The Kenya Harmonised Health Facility Assessment report for 2018/19 indicates that only 54 percent of health facilities, both public and private, have records and processes in place to ensure disposal of expired or unusable drugs that pose risks to patients.

Expired drugs are harmful to both the sick as well as to the environment, besides being less potent.

Hospitals are expected to document all the drugs that they procure and dispense and those not yet used. They are also required to record substandard medicines as well as those which trigger adverse reactions in patients.

Drug outlets in Nairobi, Nyeri, Migori and Garissa were the worst performing in keeping records of the volumes of pharmaceutical products received and dispensed, and the balances, meaning that they are unlikely to estimate the stocks available in the counties. They were also at a weaker position to gauge demand from patients or make projections.

However, almost three quarters of the 47 counties reported having proper inventory on pharmacy supplies, with Isiolo topping the rankings at 100 percent followed by Kisumu and Baringo at 98 percent each.

“All secondary and tertiary health facilities reported a good performance across all variables,” the report says.

The study took pharmaceutical data from 2,505 out of the 2,732 health facilities countrywide. “Pharmacy reporting systems were performing slightly below expected standards as all pharmacies are to have systems to manage drugs in terms of expiries and adverse events reporting,” the report says.

According to the World Health Organisation (WHO), a robust management system informs reliable drugs consumption data and demand forecasts. It also minimises the quantities of drugs that remain unused before they expire. “A well-managed commodity supply system ensures equity as all patients are able to access drugs, leading to better outcomes,” the report says.

The study shows that only 33 percent and 32 percent of the facilities across the country were found to have the poor quality medicinal products reporting form (pink form) and the yellow form for reporting suspected adverse drug reactions, respectively.

The forms provided by the Pharmacy and Poisons Board (PPB) are necessary in ensuring that potentially harmful drugs are not prescribed to the sick.

Hospitals are also expected to have updated registers of antibiotics and insulin as Kenya is aiming to end inappropriate dispensing of antibiotics by unscrupulous pharmacists. The malpractice has been blamed for fuelling antimicrobial resistance (AMR), a condition that makes antibiotics ineffective in patients who have used them incorrectly in the past.

According to the latest study, 78 percent of health institutions stored pharmaceutical commodities in inappropriate condition. Only 10 percent of the visited private facilities lived up to the storage conditions while secondary and tertiary hospitals met about 50 percent of the storage requirements.

About nine percent of all the facilities said were in the process of implementing systems that would help them make informed decisions, plan and control flow of stock and reports.