Assessment of consumption patterns for essential medicines: a study of the Nyeri county referral hospital

Juliana W. Murigi, Henry Ng'ethe, Douglas Nderitu, Veronica Murigi


Background: Nyeri is one of the pilot Universal Health Coverage roll-out counties aimed at guaranteeing healthcare service access to all households in the region by 2022. The aim of the study was to provide management insights into ways of optimizing pharmaceutical management to ensure essential medicine are consumed by majority of population in need by 2022.

Methods: A mixed-methods approach was used, combining quantitative and qualitative data collection techniques.

Results: Amoxicillin had the highest (751,000) consumption over the study period. Other essential medicines with high consumption include paracetamol (432,000), metformin (280,264) and enalapril (111,800). The most cited reason for stock-outs was limited allocation of budget for medicines, a point that was mentioned by eight of the ten respondents.

Conclusions: The study concludes that the stock-out frequency for essential medicines at the Nyeri County Referral Hospital is high. The frequent and persistent stock-out frequency for essential medicines is a problem considering the high consumption for essential medicines.


Stock out, Essential medicines, Affordable, Consumption

Full Text:



WHO (2016). Medicines shortages. WHO Drug Information, 30 (2). Available at: https://www. Accessed on 17 April 2021.

Murray CJ, Frenk J. A framework for assessing the performance of health systems. Bull World Health Organ. 2000;78(6):717-31.

WHO. Monitoring The Building Blocks Of Health Systems: A Handbook Of Indicators And Their Measurement Strategies, 20210. Available at: Accessed on 17 April 2021.

WHO. SDG 3: Ensure Healthy Lives And Promote Wellbeing For All At All Ages, 2017. Available at: Accessed on 17 April 2021.

WHO. HIV/AIDS Fact Sheet, 2017. Available at: Accessed on 17 April 2021.

Victor Z. Organizational practices influencing availability of essential medicines at hospitals in Nairobi county. Semantic Scholar. 2016.

Castillo CHM, Garrafa V, Cunha T, Hellmann F. Access to health care as a human right in international policy: critical reflections and contemporary challenges. Cien Saude Colet. 2017;22(7):2151-60.

Chuma J, Maina T, Ataguba J. Does the distribution of health care benefits in Kenya meet the principles of universal coverage? BMC Public Health. 2012;12:20.

Guan X, Hu H, Man C, Shi L. A survey of availability, price and affordability of essential medicines from 2011 to 2016 in Chinese secondary and tertiary hospitals. Int J Equity Health. 2018;17(1):158.

Mujinja PG, Mackintosh M, Justin TM, Wuyts M. Local production of pharmaceuticals in Africa and access to essential medicines: 'urban bias' in access to imported medicines in Tanzania and its policy implications. Global Health. 2014;10:12.

Vialle VCE, Serumaga B, Wagner AK, Ross DD. Evidence on access to medicines for chronic diseases from household surveys in five low- and middle-income countries. Health Policy Plan. 2015;30(8):1044-52.

Ganle JK, Parker M, Fitzpatrick R, Otupiri E. A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition. BMC Pregnancy Childbirth. 2014;14:425.

Muiruri CW, Mugambi MM. Factors influencing availability of essential medicines in public health facilities in Kenya: A case of Embu County. Int Academic J Information Sci Project Manag. 2017;2(2):43-57.

Kant S, Haldar P, Singh A, Kankaria A, Partha M. Inventory Management of Drugs at a Secondary Level Hospital Associated with Ballabgarh HDSS-An Experience from North India. J Young Pharmacist. 2015;7.

Kumar D, Kumar D. Managing the essential medicines stock at rural healthcare systems in India. Int J Health Care Qual Assur. 2018;31(8):950-65.

Kokilam MB, Joshi HG, Kamath VG. Assessment of Pharmaceutical Store and Inventory Management in Rural Public Health Facilities–A study with reference to Udupi District, Karnataka. Pharm Methods. 2015;6(2):53-9.

Munedzimwe FE. Medicine stock Management at Primary Health Care facilities in one South African Province, 2017. Available at: https://open.uct. Accessed on 17 April 2021.

Orubu ES, Okwelogu C, Opanuga O, Nunn T, Tuleu C. Access to age-appropriate essential medicines: a retrospective survey of compounding of medicines for children in hospitals in Nigeria and implications for policy development. Health Policy Plan. 2017;32(2):225-35.

Gallien JJ, Leung NHZ, Yadav P. Inventory Policies for Public Pharmaceutical Distribution in Zambia: Improving Availability and Geographic Access Equity for Essential Medicines. SSRN Electronic J. 2017.

Mungu SS. Supply Chain Management Practices and Stock Levels of Essential Drugs in Public Health Facilities in Bungoma East Sub-County, Kenya, 2013. Available at: Accessed on 17 April 2021.

Kamau LN, Mbaabu MP, Mbaria JM, Karuri GP, Kiama SG. Knowledge and demand for medicinal plants used in the treatment and management of diabetes in Nyeri County, Kenya. J Ethnopharmacol. 2016;189:218-29.

Ministry Of Health. Kenya Health Policy 2014-2030, Kenya Health Policy 2014-2030, 2014. Available at: Accessed on 17 April 2021.

Ministry of Health Kenya (2018).Kenya health policy 2014-2030, Ministry of Health, Nairobi. Available at: http://publications.universalhealth Accessed on 17 April 2021.

WHO. WHO Guideline On Country Pharmaceutical Pricing Policies, 2015. Available at: Accessed on 17 April 2021.

Lopez I, Cowley P, Kasale H, Mbuya C, Reid G, de Savigny D. Essential medicines in Tanzania: does the new delivery system improve supply and accountability?. Health Syst. 2014;3(1):74-81.

Fredrick MW, Muturi W. Factors Influencing Frequent Stock-Outs Of Essential Medicines In Public Health Facilities In Kisii County, Kenya. IOSR J Business and Management. 2016;18:63-75.

Kivoto PM, Mulaku M, Ouma C, Ferrario A, Kurdi A, Godman B, et al. Clinical and Financial Implications of Medicine Consumption Patterns at a Leading Referral Hospital in Kenya to Guide Future Planning of Care. Front Pharmacol. 2018;9:1348.