Availability, stock-outs and warehouse facilities of essential medicines at regional medical supplies divisions in Sri Lanka: A multicentre, cross-sectional study

Essential medicines (EMs) shortages impact clinical, economic, and humanistic outcomes. Good supply chain management practices of EMs are a vital factor that ensures availability and access to medicines. This study aimed to investigate the availability, record keeping, expired medicines, stock-outs, and conservation levels of EMs at Regional Medical Supplies Divisions (RMSDs), which serve as the backbone of the pharmaceutical supply chain of Sri Lanka. Ten RMSDs out of 26, representing all 9 provinces in Sri Lanka, were included in the study. The ethical approval was received from the Ethics Review Committee of the Open University of Sri Lanka (FH/ERC/033). The data were collected from 1st May to 31st October 2023. Twelve out of 50 dosage forms were available at all the RMSDs. RMSD-S and RMSD-C reported the high levels of availability of EMs (94%), which is in keeping with the WHO benchmark of 80%, while RMSD-E reported the least availability (52%). All the RMSDs reported 100% for the record keeping of pharmaceuticals. No RMSD reported having expired drugs on shelves. The highest average number of stock-out days reported by an RMSD was reported by RMSD-E (233.5 days), while RMSD-S reported the lowest average number of stock-out days (99.0 days). All the RMSDs had proper conditions to ensure the control of temperature, areas were free from moisture, had proper cold storage, regularly filled temperature charts for the cold storage, no evidence of pests in the area, and medicines were stored first-expiry-first out (FEFO). The average score for conservation conditions was reported as 94%. The average availability of EMs among the studied RMSDs was higher than the WHO benchmark of 80%. All RMSDs maintained 100% record keeping, and no expired medicines were reported. All RMSDs maintained fairly good conservation of medicines and required stocks of EMs to maintain an uninterrupted supply of EMs.