Assessing User Perspectives and Debottlenecking of Supply Chain Management for E-Aushadhi and FPLMIS in the Gaya District of Bihar- A Cross-Sectional Study

Abstract

Background: The supply chain is the network or process through which goods, equipment, and commodities are delivered from the manufacturer to the end users, i.e., customers. In Bihar, all health-related commodities except vaccines & family planning commodities are procured by BMSICL i.e., Bihar Medical Services & Infrastructure Corporation Limited. The BMSICL procured medications and commodities using an open bidding mechanism on a quarterly basis. The Bihar government's LMIS system comprises DVDMS (E-Aushadhi) & FP-LMIS.

Study Objective: To assess & understand the Field Level Workers’ user perspectives on E-Aushadhi and FPLMIS and their challenges in the Gaya region of Bihar. Also, to understand & identify supply chain bottlenecks and potential alternatives. Methods: It is a cross-sectional mixed method study conducted in the 7 randomly selected blocks in the Gaya district of Bihar. The sample size of the quantitative interview is calculated to be 100 and more over 8 In-Depth interviews with the Pharmacist at block and district level facilities and warehouse. The data analysis was done by the statistical software like SAS, Atlas.Ti and MS Excel.

Results: The utilization rate of the E-Aushadhi and FPLMIS was found to be 79% and 10% respectively among the ANMs. They encounter many challenges like lack of basic and comprehensive trainings, availability of transportation and dual system entry of the drugs. There are the various challenges faced by the pharmacist at facility level which include getting the late supply of the drugs, receiving counterfeit medicines, unavailability of storage units and many more. The 3 measure gaps were identified which includes the infrastructural gaps, system level gaps and skill gaps (both basic and comprehensive skills).

Conclusion: The end users were satisfied with the introduction of this system but on the other hands they encounter various challenges in the same. To overcome these challenges, the government should focus on capacity building and maintaining system strictness along with the proper training and availability of the trained staff.