Patients and healthcare professionals' experiences of medicine stock-outs and shortages at a community healthcare centre in the Eastern Cape

Background: Medicine stock-outs and shortages are a global issue and a rising concern in South Africa. The World Health Organization has reported shortages of essential medicines in high-, middle- and low-income countries globally. However, there is currently no standard intervention as the causes of medicine stock-outs vary across countries. When medicine stock-outs happen, they have consequences for both patients and healthcare professionals working at the facilities. Hence the need to explore and understand the effect of medicine stock-outs and shortages on both patients and healthcare professionals. Objective: The main aim of this study was to explore and describe both patients and healthcare professionals' experiences of medicine stock-outs and shortages at a primary healthcare centre in the Nelson Mandela Metropole. Methods: A qualitative in-depth interview approach and thematic analysis of transcribed interviews were used to determine the experiences of participants. Eight patients and twelve healthcare professionals (including doctors, nurses, a pharmacist and pharmacy support personnel), were recruited to the study, using a convenience sampling method at a community healthcare centre in the Eastern Cape. Results: Major themes identified included the psychological impact on both patients and healthcare professionals, perceptions of the causes of stock-outs and shortages, and compensatory measures adopted to counteract the effect of stock-outs and shortages. Patient experiences included dissatisfaction, anger, frustration and a loss of confidence in the healthcare service. Moreover, medicine stock-outs resulted in stress and burn out in healthcare professionals who felt useless when they prescribed medicines that were not available for dispensing. Healthcare professionals also experienced violence and verbal abuse from patients because of medicine stock-outs. Inadequate administration and lack of communication were perceived as significant causes of stock-outs, which negatively influenced relationships between healthcare professionals and patients Conclusion: In this study, strained patient-professional and professional-professional relationships were identified as a consequence of medicine stock-outs and shortages. Also, the lack of inter-professionalism and communication were perceived as causes of medicine shortages. The results suggest that better communication and information flow throughout the medicine supply chain could result in better stock management and availability of medicines and improve the experience of healthcare professionals and patients.