Inventory Management Practices and Supply Chain Performance of Antiretroviral Medicines in Public Hospitals in Nyamira County, Kenya.

Background: Unreliable supply systems have plagued the provision of an uninterrupted supply of life-saving medicines in many developing countries, with antiretroviral (ARV) medicines having the worst repercussions. Objective: To identify the inventory management practices used, evaluate the supply chain performance, and determine the challenges affecting inventory management of ARV medicines in public hospitals. Methods: The study used a descriptive cross-sectional design, gathering snapshot data on inventory management practices happening in all the 8 public hospitals across Nyamira County. Data collection was done using structured questionnaires, key informant interviews, checklists and data from the national health information system. Results: The response rate was 97.3% for the questionnaires and 100% for the key informant interviews. The prevailing inventory management practices were: use of scheduled inventory control model (80.95%), forecasting demand using previous consumption data (100%), keeping accurate and updated stock records for each commodity (92.31%), having essential logistical data in reports (100%), including safety stock (61.54%) when ordering and keeping ARV medicines in dedicated stores (75%). With the exception of order lead time (17.98 days), the other supply chain performance metrics namely stock out rate (52.12%), stock wastage rate (43.2%), and reporting rates (70.84%) were found to be deficient. The challenges mostly affecting inventory management included inadequate staff and training, lack of proper storage, and unreliable supply of medicines. Conclusion: Inventory management practices were according to the recommended best approaches despite various challenges. The supply chain performance metrics evaluated, with the exception of order lead time, were all found to be unsatisfactory owing to the high stock out rates, below par reporting rates and high stock wastage rate due to expiries discovered. Adoption of an electronic inventory system, use of data for decision making, dedicated storage of ARV medicines, and inclusion of buffer stock, are some strategies to improve inventory management.