ArticlePloS one2019
Stock-outs of antiretroviral and tuberculosis medicines in South Africa: A national cross-sectional survey.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed.
- A Continuous Quality Improvement Intervention to Improve Antenatal HIV Care Testing in Rural South Africa: Evaluation of Implementation in a Real-World Setting.International journal of health policy and management · 2022Trial
- Viral load care of HIV-1 infected children and adolescents: A longitudinal study in rural Zimbabwe.PloS one · 2021Trial
- Simplified dolutegravir dosing for children with HIV weighing 20 kg or more: pharmacokinetic and safety substudies of the multicentre, randomised ODYSSEY trial.The lancet. HIV · 2020Trial
- Drug stock-outs in HIV, tuberculosis, and malaria programs: a systematic review.EClinicalMedicine · 2026Review
- Challenges with drug management of children and adolescents living with human immunodeficiency virus on antiretroviral therapy: A narrative review.African journal of primary health care & family medicine · 2026Review
- Medicines governance and systemic constraints: A qualitative study among healthcare professionals in South Africa.African journal of primary health care & family medicine · 2026Article
- Tuberculosis in prisons: an integrated prevention and care cascade for a persistent structural epidemic.Frontiers in public health · 2026Review
- Determinants, Models, performances, and strategies of supply chain to address medicine stockouts in primary health care: a scoping review.Journal of pharmaceutical policy and practice · 2026Review
- Factors contributing to human and veterinary medicine shortages in developing countries: perspectives of suppliers and regulators in Namibia.Tropical medicine and health · 2025Article
- Preference for HIV testing among community residents in Yunnan Province, China: results from a discrete choice experiment.BMC health services research · 2025Article
- Community pharmacists' perceptions and experiences of medicine shortages in disruptive situations: a qualitative study.International journal of clinical pharmacy · 2025Article
- Assessing the preparedness of primary healthcare facilities for the implementation of universal test and treat in uThukela District, South Africa: a cross-sectional study.BMJ public health · 2025Article
- Engaging Councillors to Address Structural and Social Drivers of HIV Infections in Blantyre City: A Formative Study.International journal of health policy and management · 2025Article
- Low completion rate for the 6-months course of isoniazid preventive therapy among people living with HIV, North Eastern Uganda, 2015-2017.The Pan African medical journal · 2024Article
- Predictors of medicine redistribution at public healthcare facilities in King Cetshwayo District, KwaZulu-Natal, South Africa.BMC health services research · 2023Article
- Dolutegravir once daily with rifampicin for HIV and tuberculosis.The lancet. HIV · 2023Article
- Improving the distribution of antiretroviral medicines through centralised dispensing: perspectives of HIV+ patients and nurses at a chronic dispensing unit in Ekurhuleni, Gauteng Province, South Africa.The Pan African medical journal · 2023Article
- Article
- Patient-centred care: reality or rhetoric-patients' experiences at ARV clinics located in public hospitals in KwaZulu-Natal, South Africa.AIDS research and therapy · 2022Article
- Determinants of stock-outs of first line anti-tuberculosis drugs: the case of public health facilities of Addis Ababa city administration health bureau, Addis Ababa, Ethiopia.BMC health services research · 2022Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHIV and TB programs have rapidly scaled-up over the past decade in Sub-Saharan Africa and uninterrupted supplies of those medicines are critical to their success. However, estimates of stock-outs are largely unknown. This survey aimed to estimate the extent of stock-outs of antiretroviral and TB medicines in public health facilities across South Africa, which has the world's largest antiretroviral treatment (ART) program and a rising multidrug-resistant TB epidemic.
methodsWe conducted a cross-sectional telephonic survey (October-December 2015) of public health facilities. Facilities were asked about the prevalence of stock-outs on the day of the survey and in the preceding three months, their duration and impact.
resultsNationwide, of 3547 eligible health facilities, 79% (2804) could be reached telephonically. 88% (2463) participated and 4% (93) were excluded as they did not provide ART or TB treatment. Of the 2370 included facilities, 20% (485) reported a stock-out of at least 1 ARV and/or TB-related medicine on the day of contact and 36% (864) during the three months prior to contact, ranging from 74% (163/220) of health facilities in Mpumalanga to 12% (32/261) in the Western Cape province. These 864 facilities reported 1475 individual stock-outs, with one to fourteen different medicines out of stock per facility. Information on impact was provided in 98% (1449/1475) of stock-outs: 25% (366) resulted in a high impact outcome, where patients left the facility without medicine or were provided with an incomplete regimen. Of the 757 stock-outs that were resolved 70% (527) lasted longer than one month.
interpretationThere was a high prevalence of stock-outs nationwide. Large interprovincial differences in stock-out occurrence, duration, and impact suggest differences in provincial ability to prevent, mitigate and cope within the same framework. End-user monitoring of the supply chain by patients and civil society has the potential to increase transparency and complement public sector monitoring systems.
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