Essential Medicine Availability, Stock-Out Duration, and Influencing Factors in Public and Private Drug Outlets of Gubre Town, Central Ethiopia

Essential Medicine Availability, Stock-Out Duration, and Influencing Factors in Public and Private Drug Outlets of Gubre Town, Central Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Essential Medicine Availability, Stock-Out Duration, and Influencing Factors in Public and Private Drug Outlets of Gubre Town, Central Ethiopia Nemona Daba, Tizazu Kassahun, Zenebech Lema, Abinet Abebe, Habtamu Solomon Mengistu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7497426/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background Essential medications are those that meet the population's top health care demands. Evidence of clinical efficacy and safety, comparative costs and cost-effectiveness, and disease prevalence and public health importance are all taken into consideration when choosing these medications. Objective This study aimed to assess essential medicine availability and stock-out duration, and to analyze influencing factors using inferential statistics in Gubre town drug outlets. Methods Using a self-administered checklist of twenty vital medications, a cross-sectional survey was carried out at Gubre Town's public and commercial pharmacies between March 31 and May 18, 2025. The study encompassed the following medical facilities: Gubre Community Pharmacy, Gubre Health Center, Tena Adam Private Pharmacy, Adababay Drug Store, Sawi Drug Store, Gubre Drug Store, and Wolkite University Specialized Teaching Hospital (WUSTH). Utilizing SPSS version 27, data input and analysis were completed. Frequency distribution was used for categorical data, and descriptive statistics were used for continuous data. The findings were then displayed using texts, tables, and graphs. Result There were 5 medicine dispensing units in the WUSTH, and 1 the same medicine dispensing units in others. There were 27, 3, 2 and 7 pharmacy staff members at the hospital, GCP, GDS and the health center, respectively. And one the same pharmacy staff members in others. WUSTH tends to have the highest drug availability (95%), followed by GHC (85%) while SDS and GCP have lowest drug availability (40%). The average stock-out duration at GCP was the longest (32.2 days), followed by SDS (31.4 days), While at TAP was the shortest (7.4 days). From 20 selected essential medicines, 100% (20) were managed at WUSTH, while 60% (12) were managed at TAP and GDS. Medicine availability was positively associated with pharmacy staff and proper management, while stock-out rates and durations had negative effects. Regression confirmed staff numbers significantly predicted availability. Conclusion WUSTH had the highest drug availability, while Sawi and Gubre Community Pharmacy had the lowest. Gubre Community Pharmacy also had the longest stock-out duration. Facilities should address prolonged stock-outs of essential medicines. Inferential statistics showed that medicine availability improves with more pharmacy staff and better management. Frequent and prolonged stock-outs reduce availability, emphasizing the need for stronger supply systems. Availability Essential medicine Stock out Drug vendor Figures Figure 1 Figure 2 Introduction Any health care system needs medications, and a lack of access to them compromises the goals of efficiency, equity, and health development. Compared to fewer than 10% in high-income countries, medications make for 25–70% of total health care spending in developing nations. Furthermore, in low- and middle-income nations, up to 90% of the population pays for their own medications. Consequently, a significant portion of the world's population cannot afford medications, which places a heavy load on the government (WHO, 2015). According to estimates from the World Health Organization (WHO), over one-third of the world's population, primarily in Asia and Africa, lacks access to necessary medications (WHO, 2015). For this reason, one of the Millennium Development Goals in developing nations is the accessibility and affordability of vital medications (Chance, 2018 ). The justification for essential drugs is that, even if there are many registered and available medications on the market, it is crucial to exercise caution in light of the majority of citizens' medical needs and to ensure their safety, effectiveness, and affordability (Mirza, 2008 ). Drugs that meet the population's top healthcare needs are considered essential, according to the WHO. Evidence of efficacy and safety, comparative cost-effectiveness, and public health importance are the reasons behind their selection. In the framework of operational health systems, essential medications should always be accessible in sufficient quantities, in the right dosage forms, with guaranteed quality and sufficient information, and at a cost that both the community and the individual can pay (Gelders et al., 2006 ; WHO, 2015). Few research have examined how crucial medication shortages in public and commercial pharmacies can impair the efficacy of healthcare in sub-Saharan Africa (Nditunze et al., 2015). Keeping sufficient medical supplies requires efficient stock management, which includes ordering and inventory control. In a healthy health system, equal access to high-quality, safe, and reasonably priced medical supplies is ensured by effective inventory management, which also enhances patient care and resource utilization (Kefale and Shebo, 2019 ). Making ensuring patient needs are met and cutting down on the time it takes to order and buy medications are the main objectives of inventory management. It lowers the overall cost to the pharmacy and, consequently, the entire healthcare facility by preventing expenses related to medication degradation and expiration (Awle, 2016 ). It also contributes significantly to effective healthcare by raising the accessibility, security, and cost of necessary medications (Kagashe and Massawe, 2012 ). Poor inventory control may result in EMs being overstocked or understocked, wasting resources and raising morbidity and mortality when life-saving medications are scarce (Ventola, 2011 ). Statement of the problem Currency fluctuations and other variables caused a dramatic increase in the price of medications, while the distribution of supply remained consistent throughout areas during and after COVID-19, primarily from European and Ethiopian vendors. The pandemic brought to light robust local supply of NCD medications while exacerbating pre-existing problems with pharmaceutical availability. To further understand how import dependency and currency fluctuations impact supply and evaluate the effects of stock-outs on patients, more research is required (Melaku et al., 2024 ). Low availability of children's vital medications (31.5–43%) was documented in two investigations, indicating a serious problem that requires action. To close this gap and create effective solutions, it is crucial to identify the variables influencing availability. Stock-outs are common and protracted in Ethiopia, which interferes with treatment and puts a burden on finances, particularly in public places that serve low-income communities. Despite having easier access, private stores nevertheless experience stock-outs because of pricing, rules, and market difficulties (Abiye et al., 2013 ; Asmamaw et al., 2021). Addressing medication shortages requires a comprehensive understanding of stock-out periods across sectors. Weak forecasting, demand swings, global supply chain interruptions, and inadequate inventory data are all contributing factors. The problem is made more difficult by regional differences. Stock-outs can be avoided, patient expenses can be decreased, and health outcomes can be enhanced by a concerted international effort to improve distribution, procurement, and logistics in both the public and commercial sectors (Ahmed et al., 2024 ). Essential medication stock-outs are frequent in Ethiopia, occurring in between 26% and 91% of hospitals (Federal Ministry of Health (FMOH), 2003 ). According to WHO estimates, over one-third of the world's population—mostly in Asia and Africa—does not have access to necessary medications. One of the main Millennium Development Goals is to guarantee the accessibility and affordability of necessary medications. Major infectious diseases including TB, HIV, and malaria are prevalent in Ethiopia, and the public sector mostly provides basic healthcare services, depending on a steady supply of reasonably priced, high-quality medications (Whitney, 2014 ). Affordability, sensible use, dependable health systems, sustainable financing, and medicine availability are some of the factors that affect access to vital medications (Hinsch et al., 2014 ). Low national commitment, a shortage of health workers, little money, poor aid coordination, and little research on priority medications are some of the main obstacles in Sub-Saharan Africa (Sherry & Ghaffar, 2018). Therefore, this study uses inferential analysis to evaluate the availability of important medications and the length of time that they are stock-out in Gubre Town's public and commercial outlets, taking into account factors that influence availability. Methodology and Materials Study area and period The study was carried out in the town of Gubre at the Gubre Health Center, Gubre Community Pharmacy (Apartama), Tena Adam private pharmacy, Adababay Drug Store, Sawi Drug Store, Gubre Drug Store, and Wolkite University Specialized Teaching Hospital (WUSTH). Gubre town is situated 173 kilometers from Addis Ababa and 15 kilometers from Wolkite, the capital of central Ethiopia. An estimated 300,000 people in the surrounding area were served by the hospital. Wolkite University Specialized Teaching Hospital, Gubre Health Center, one community pharmacy, and private pharmacies and drugstores can all be found in Gubre town. These are the only medical facilities in the area that offer locals access to basic medical care. For instances that the health center is unable to handle, the hospital acts as a referral location. Data was gathered between March 1st, 2025, and April 1st, 2025. Study design and approach The availability and length of stock-outs of important medications were evaluated by the authors using a cross-sectional, institution-based descriptive and explanatory study methodology. The study collected data using a quantitative approach. The authors used bin-card reviews and standardized checklists to gather numerical data. Source and study population The sources included the bin card documentation for every medication, the managers of the pharmaceutical stores at each medical facility, the community pharmacy, Gubre Health Center, Tena Adam Private Pharmacy, Adababay Drug Store, Sawi Drug Store, Gubre Drug Store, and all of the important medications at WUSTH. A pharmaceutical store manager from each healthcare facility, the bin cards of specific medications, and a few key medications were the research populations. Inclusion criteria and exclusion criteria In order to evaluate availability and stock-out length, this study examined bin-card records of necessary medications from seven chosen retailers for the previous six months. The six-month timeframe strikes a balance between representing current practices and recording stock patterns. Reagents, medications, medical equipment, and supplies without bin cards were not included. Sample size determination To ascertain the availability and stock out time of necessary medications, a total of twenty essential medicines that were found in the tracer drug lists of both public and private health institutions were evaluated. To gather demographic data, a manager of a pharmacy store at each of the medical institutions was also questioned (Tefera et al, 2022 ) Sampling technique Since they were the most pertinent employees for the study, all seven drug outlets were included, and all of the pharmacists, druggists, and managers of pharmaceutical stores were specifically selected from each drug outlet. Additionally, all of the necessary medications identified in each health facility's tracer drug lists—a total of twenty medications were identified in each list—were chosen for assessment. Health facilities should create their own tracer drug lists by consulting the Ethiopian Federal Ministry of Health's (EFMOH) tracer drug listings. Based on their effectiveness in treating or identifying the most prevalent illnesses, tracer medications were chosen. One bin-card was chosen for each chosen medication in order to examine its availability (a total of 20 bin-cards). The Essential medicines evaluated in this study listed in the Table 1 below: Table 1 List of essential medicine evaluated in this study Amoxicillin 500 mg capsule, Artemether + lumefantrine 20mg + 120mg, Ceftriaxone 1gm injection, Cotrimoxazole 240mg/5 ml suspension, Ferrous salt + folic acid 150mg + 0.5mg tablet, Gentamycin 40mg/5 ml injection, Hydralazine injection, Magnesium Sulphate injection, Oral Rehydrate Salt (ORS), Oxytocin injection, Pentavalent vaccine, Rifampicin/Isoniazid/Ethambutol/Pyrazinamide fixed-dose combination, Med Roxy progesterone injection, Tetracycline 1%, and Tenofovir + Lamuvidine + Efaverenz Adult dose, Amitriptyline 25mg tablet, Amlodipine 5mg or 10mg tab, Metformin 500mg or 850mg tablet, Metronidazole 250mg or 500mg caps, and Omeprazole 20mg or 40 mg capsule. (Tefera et al, 2022 ). Data collection tool and procedure To collect data, a structured questionnaire was prepared in English. The questionnaires utilized in this study were originally developed and published by USAID DELIVER (2008) in the Logistics Indicators Assessment Tool (LIAT). Moreover, the authors reviewed the bin-card records of each selected medicine for the past 6 months to measure its availability and stock-out duration. These data were collected by pharmacy personnel with expertise in medicines management. Data processing and analysis The data was evaluated for completeness and analyzed by using SPSS version 27. The authors computed descriptive statistics (frequency and percentage) and summarized the results with texts, tables, charts, graphs and tables. The authors analyzed and presented the data separately for each health facility. Moreover, an inferential statistical analysis consisting of correlation and regression analysis was conducted. Results and Discussion Results General characteristics of the health facilities The health facilities included in the study were a WUSTH, Gubre community pharmacy (GCP), Gubre health center (GHC), Tena Adam pharmacy (TAP), Adababay drug store (ADS), Sawi drug store (SDS), and Gubre drug store (GDS). There were 5 medicine dispensing units in the WUSTH, and 1 the same medicine dispensing units in others. Majority of medicine store managers were Druggist. ( Table 2 ) Table 2 General characteristics of health facilities S/No. Characteristics WUSTH GCP GHC TAP ADS SDS GDS 1 Type of health facilities Specialized hospital pharmacy Community pharmacy Health center Private pharmacy Drug store Drug store drug store 2 Number of medicines dispensing units 5 1 1 1 1 1 1 3 Number of pharmacy staff 28 3 7 1 1 1 2 4 Numbers of medicines store manager 1 1 1 1 1 1 1 6 Academic status of medicine store manager Pharmacist Pharmacist Druggist Pharmacist Druggist Druggist Druggist Availability, Manageability and Stock out of essential medicines in each health facility On the day of the survey, only 95% (19), 85% (17), 55% (11) of the 20 essential medicines were available at WUSTH, Gubre health center and Adababay drug store, respectively. While 40% (8) were available at Gubre community Pharmacy and Sawi drug store and 60% (12) were available at Tena Adam pharmacy and Gubre drug store. ( Table 3 ) Table 3 Availability of essential medicines on the day of the survey Health facility On the day of the survey Frequency (20) Percent (%) WUSTH Pharmacy Not Available 1 5 Available 19 95 Gubre Community Pharmacy Not Available 12 60 Available 8 40 GHC Pharmacy Not Available 3 15 Available 17 85 Tena Adam Pharmacy Not available 8 40 Available 12 60 Adababay drug store Not Available 9 45 Available 11 55 Sawi drug store Not Available 12 60 Available 8 40 Gubre drug store Not Available 8 40 Available 12 60 On the day of survey, WUSTH had the highest Percentage availability (95%), while SDS and GCP had the lowest (40%). (Fig. 1 ) From 20 selected essential medicines, 100% (20), 95% (19), 70% (14) were managed at WUSTH, Gubre health center and Adababay drug store, respectively. While 65% (13) were managed at Gubre community pharmacy and Sawi drug store and 60% (12) were managed at Tena Adam pharmacy and Gubre drug store. ( Table 4 ) Table 4 Manageability of essential medicines in each health facility Health institution Manageability Frequency (20) Percent (%) WUSTH Pharmacy Not Managed 0 0 Managed 20 100 Gubre Community Pharmacy Not Managed 7 35 Managed 13 65 GHC Pharmacy Not Managed 1 5 Managed 19 95 Tena Adam Pharmacy Not Managed 8 40 Managed 12 60 Adababay drug store Not Managed 6 30 Managed 14 70 Sawi drug store Not Managed 7 35 Managed 13 65 Gubre drug store Not Managed 8 40 Managed 12 60 During the last six months, 60% (12), 50% (10), 30% (6) of essential medicines were stocked out at Gubre health center, Sawi drug store, and Adababay drug store, respectively. While 35% (7) were stock out at WUSTH and Gubre community pharmacy and 25% (5) were stock out at Tena Adam pharmacy and Gubre drug store. ( Table 5 ) Table 5 Stock out at least once in the last 6 months before data collection Health Institution Stock out at least once in the last 6 months before data collection Frequency (20) Percent (%) WUSTH Pharmacy Not stockout 13 65 Stock out 7 35 Not managed 0 0 Gubre Community Pharmacy Not stock out 6 30 Stock out 7 35 Not managed 7 35 GHC Pharmacy Not stock out 8 40 Stock out 12 60 Not managed 0 0 Tena Adam Pharmacy Not stock out 7 35 Stock out 5 25 Not managed 8 40 Adababay drug store Not stock out 8 40 Stock out 6 30 Not managed 6 30 Sawi drug store Not stock out 3 15 Stock out 10 50 Not managed 7 35 Gubre drug store Not stock out 7 35 Stock out 5 25 Not managed 8 40 Availability of essential medicines in each health facility On the days of the survey, WUSTH demonstrated the highest availability of essential medicines, with 19 out of 20 of the surveyed medicines were available. In contrast, the lowest availability was observed at Gubre Community Pharmacy (GCP) and Sawi Drug Store (SDS), each with only 8 out of 20 of the medicines available. Several essential medicines had limited available in only two of the seven health facilities. These included; Hydralazine injection, Magnesium sulfate (MgSO₄) injection, TDF + 3TC + EFV adult dose, Medroxyprogesterone injection, RHZE fixed-dose combination, Pentavalent vaccine, and Oxytocin injection, all of which were exclusively available at WUSTH and Gubre Health Center (GHC). On the other hand, some medicines showed universal availability across all surveyed facilities. These included Amoxicillin 500 mg capsule, Ceftriaxone 1 gm injection, Amitriptyline 25 mg tablet, Amlodipine 5 mg or 10 mg tablet, Metronidazole 250 mg or 500 mg capsule, and Omeprazole 20 or 40 mg capsule. ( Table 6 ) Table 6 Availability of each medicine in each health Facility S/No Essential Medicine WUSTH GCP GHC TAP ADS SDS GDS Available(1) Not Available(0) Available(1) Not Available(0) Available(1) Not Available(0) Available(1) Not Available(0) Available(1) Not Available(0) Available(1) Not Available(0) Available(1) Not Available(0) 1 Amoxicillin 500mg Capsule 1 1 1 1 1 1 1 2 Artemether + lumefantrin20mg + 120mg tab 1 0 1 1 0 0 1 3 Ceftriaxone 1gm injection 1 1 1 1 1 1 1 4 Cotrimoxazole 240mg/5ml susp 1 1 1 1 1 0 1 5 Ferrous salt + folic acid 150mg + 0.5mg tab 1 0 0 1 1 0 1 6 Gentamycin 40mg/5ml injection 1 0 1 0 0 0 0 7 Hydralazine injection 1 0 0 1 0 0 0 8 Mgso4 injection 1 0 0 0 0 0 0 9 ORS 1 1 1 1 1 0 1 10 Oxytocin injection 1 0 1 0 0 0 0 11 Pentavalent vaccine 1 0 1 0 0 0 0 12 RHZE Fixed combination 1 0 1 0 0 0 0 13 Med Roxy progesterone injection 1 0 1 0 0 0 0 14 Tetracycline 1% 0 0 1 1 1 1 1 15 TDF + 3TC + EFV adult dose 1 0 1 0 0 0 0 16 Amitriptyline 25mg tablet 1 1 1 1 1 1 1 17 Amlodipine 5mg or 10mg tablet 1 1 1 1 1 1 1 18 Metformin 500mg tablet 1 0 1 1 1 1 1 19 Metronidazole 250mg or 500mg caps 1 1 1 1 1 1 1 20 Omeprazole 20 or 40 mg capsule 1 1 1 1 1 1 1 Stock-out duration of essential medicines in each health facility The average number of stock-out days at WUSTH was 10.2 days. Over the last six months, Tetracycline 1% was the medicine with the most stocked out days (61 days) while in Gubre health center average stock out days was 20.1 days and Hydralazine injection was the medicine with the most stocked out days (125 days) in the last six month, followed by Metformin 500mg tablet with 41 days. The average number of stock-out days at Gubre community pharmacy, Tena Adam pharmacy, Adababay drug store, Sawi drug store and Gubre drug store were 32.2, 7.4, 15.5, 31.4 and 7.6 days, respectively. Gentamycin 40mg/5ml injection (109 days), Amitriptyline 25mg tablet (45 days), Artemether + lumefantrine 20mg + 120mg Table (50 days) was the medicine with the most stocked out days in the last six month in Gubre community pharmacy, Tena Adam pharmacy, and Gubre drug store, respectively. While Hydralazine injection was the medicine with the most stocked out days at Adababay drug store and Sawi drug store with 116 days and 163 days, respectively. ( Table 7 ) Table 7 Stock-out duration of essential medicines in the last 6-months in each health facility S/N o. Essential Medicines Stock out Duration in days WUSTH pharmacy Gubre community pharmacy Gubre health center Tena adam Pharmacy Adababay drug store Sawi drug store Gubre drug store 1 Amoxicillin 500mg Capsule 0 0 20 0 0 21 0 2 Artemether + lumefantrine 20mg + 120mg tab 0 25 41 30 50 3 Ceftriaxone 1gm injection 0 0 27 0 0 5 0 4 Cotrimoxazole 240mg/5ml susp 26 107 4 0 0 28 0 5 Ferrous salt + folic acid 150mg + 0.5mg tab 0 100 14 29 37 100 32 6 Gentamycin 40mg/5ml injection 6 109 0 60 142 7 Hydralazine injection 11 97 125 116 163 8 Mgso4 injection 0 30 9 ORS 0 0 0 0 0 29 0 10 Oxytocin injection 0 0 11 Pentavalent vaccine 0 0 12 RHZE Fixed combination 0 0 13 Med Roxy progesterone injection 0 0 14 Tetracycline 1% 61 105 11 0 0 0 0 15 TDF + 3TC + EFV adult dose 23 0 16 Amitriptyline 25mg tablet 0 0 39 45 0 42 29 17 Amlodipine 5mg or 10mg tablet 32 54 37 0 41 71 19 18 Metformin 500mg tablet 0 73 41 16 27 27 23 19 Metronidazole 250mg or 500mg caps 0 0 0 25 0 0 0 20 Omeprazole 20 or 40 mg capsule 51 0 28 0 0 0 0 The Factors affect availability and stock out of essential medicine At all facilities that the authors have studied, (100%) reported that there are no local suppliers or Ethiopian pharmaceutical supply service (EPSS) hubs in the area, indicating complete reliance on external sources. all of them receive supplies from sources more than 31 km away, which likely contributes to delays and logistical challenges. Only a small portion (14.3%) receive supplies weekly and most (71.5%) receive medicines every 2 weeks to 3 months, which can lead to gaps in stock availability. Supervision occurs mostly every six months (57.1%) or every two months (28.6%), with very little frequent oversight, possibly impacting inventory management and accountability. More than half (57.1%) reported a 2–7 day gap between ordering and receiving medicines, while others experience delays of up to two weeks. The majority (57.1%) depend solely on private suppliers, while only 14.3% rely solely on EPSS. This shows a weak presence of public supply chains. Transportation is split between suppliers (42.9%) and the outlets' own means (42.9%), with minimal shared responsibility, adding variability and potential delays. The most cited reason is market unavailability (42.9%), followed by financial constraints, poor supply chains, and other unspecified factors. (Tablet 8) Table 8 The factors that affect availability and stock out of essential medicine. Variables Frequency (7) Percent (%) Do you have local suppliers or EPSS hub in Gubre town? No 7 100 Average distance of your suppliers from your drug outlet (km(s)) Above 31KM 7 100 How often do you get supplied by your suppliers? Every week 1 14.3 Every 2 week 2 28.6 Every 2 month 1 14.3 Every 3 month 3 42.9 How often do you get supervision? Every two months 2 28.6 Every six months 4 57.1 Yearly 1 14.3 What is the gap between orders and receive time? 2–7 day 4 57.1 1–2 week 1 14.3 2 weeks 2 28.6 From where do you get your medicines? EPSS Only 1 14.3 Private Suppliers’ Only 4 57.1 EPSS and Private Suppliers' 2 28.6 What is the transportation means of your supply? By supplier transport Only 3 42.9 By own means Only 3 42.9 By supplier transport and private transportation 1 14.3 What could be the possible reasons for stock out? Financial problem 1 Unavailability in the market 3 Unavailability in the market and Poor supply chain 1 Other 2 The authors identified the most cited reason was market unavailability (43%), followed by financial problem, poor supply chains, and other unspecified factors. ( Fig. 2 ) Inferential statistical analysis The correlation analysis revealed a strong positive relationship between the number of pharmacy staff and the availability of essential medicines (r ≈ 0.93), indicating that facilities with more staff tend to have higher medicine availability. Additionally, availability showed a moderate negative correlation with both stock-out rate (r ≈ -0.75) and average stock-out duration (r ≈ -0.68), suggesting that better availability is associated with fewer and shorter stock-outs. Manageability of medicines was also positively correlated with availability (r ≈ 0.89), further emphasizing that effective management contributes to consistent supply. ( Table 9 ) Table 9 Correlation analysis. Variable Correlation with Availability (%) P-value Manageability (%) 0.94 0.0008 Stock-out (%) -0.79 0.0340 Avg. Stock-out Duration -0.68 0.0949 Pharmacy Staff 0.93 0.0015 Linear regression analysis confirmed a statistically significant relationship between the number of pharmacy staff and medicine availability. The regression model showed that for each additional pharmacy staff member, the availability of essential medicines increases by approximately 2.1 percentage points (p < 0.01). This suggests that staffing is a strong predictor of availability, highlighting the importance of adequate human resources in ensuring consistent access to essential medicines across health facilities. For each additional pharmacy staff member, the availability of essential medicines increases by approximately 1.77%, and this relationship is statistically significant (p < 0.01). The model explains 87% of the variability in medicine availability, suggesting a strong predictive relationship. ( Table 10 ) Table 10 Regression analysis. Term Coefficient (β) Std. Error t-Statistic P-value 95% Confidence Interval Intercept 45.45 4.68 9.71 0.0003 [34.32, 56.59] Pharmacy Staff 1.77 0.36 4.66 0.0015 [0.89, 2.65] Discussion This study assessed the availability and stock-out duration of 20 essential medicines (EMs) in public and private drug outlets in Gubre town, central Ethiopia. Hence, the results revealed inconsistent availability and significant stock-out occurrences, echoing national and global concerns. On the survey day, availability varied from 40% in Sawi Drug Store and Gubre Community Pharmacy to 95% in WUSTH. Stock-out events within the previous six months were highest at Gubre Health Center (60%) and lowest at Tena Adam Pharmacy and Gubre Drug Store (25%). At all health facilities included in our study, availability was below to the study conducted in northern district of the Brazilian region showed that the availability at the time of visit was 100% (Bertoldi et al., 2010 ; Anson et al., 2012 ). The availability at Wolkite University Specialized Teaching Hospital (WUSTH) and Gubre health center were much higher than that of a study in Peru, while the availability at others five facilities were lower than that of the Peru study (WHO, 2015). The WHO reports that one-third of the global population lacks consistent access to essential medicines, a challenge notably prevalent in Africa and Asia. Our study supports this concern, with only Wolkite University Specialized Teaching Hospital meeting the WHO's recommended 80% availability threshold. In contrast, several private drug stores and health centers, such as Gubre Community Pharmacy and Sawi Drug Store, reported availability below 50%. These findings align with Abrha et al. (2018), who observed average availability rates of 41.9% in public and 31.5% in private sectors in Tigray, Ethiopia, highlighting a persistent gap in essential medicine access. Previous studies in Ethiopia have shown that stock-outs are common, with rates ranging between 26–91% (Whitney, 2014 ). This is reflected in our data, where Gubre Health Center had stock-outs for 60% of the medicines in the past six months. Such shortages limit access to treatment and exacerbate morbidity and mortality, especially for chronic conditions like diabetes and cardiovascular disease, which were further strained during the COVID-19 pandemic (Melaku et al, 2024 ). Stock-out durations were significant, with hydralazine injection unavailable for 163 days at Sawi Drug Store and 125 days at Gubre Health Center. These findings echo those of Tefera et al. ( 2022 ) and Kefale and Shebo ( 2019 ), who reported prolonged stock-outs in Ethiopia, often exceeding a month. Even at better-equipped facilities like WUSTH, challenges persist—tetracycline 1% was out of stock for 61 days despite a lower average stock-out duration (10.2 days). These patterns support the WHO’s (2015) observation that one-third of the global population lacks access to essential medicines, largely due to supply chain inefficiencies in low-income countries. A deeper analysis revealed that all facilities in Gubre lacked nearby suppliers or EPSS hubs, relying on sources over 31 km away and receiving supplies only every 2–3 months. This logistical barrier, along with poor infrastructure and weak public supply chains, mirrors challenges noted by Sherry and Ghaffar (2018) across Sub-Saharan Africa. Financial limitations, transport issues, and market unavailability further worsened stock-outs, aligning with global factors cited by Ventola ( 2011 ) and the FDA (2023), including raw material shortages, limited production, and inefficient procurement systems. The inferential analysis showed a strong positive correlation between pharmacy staff and medicine availability (r = 0.93, p = 0.0015), as well as manageability and availability (r = 0.94, p = 0.0008), indicating that both staffing and proper inventory management significantly improve access to essential medicines. A negative correlation was observed between stock-out rate and availability (r = -0.79, p = 0.034), suggesting that frequent stock-outs reduce availability. Regression analysis confirmed that each additional pharmacy staff member increases availability by about 1.77%, with an adjusted R² of 0.84. These findings align with WHO (2015) and Ahmed et al., (2021), which highlight workforce and supply chain efficiency as key to medicine availability. Conclusion WUSTH and Gubre Health Center reported the highest medicine availability (95% and 85%), while Gubre Community Pharmacy and Sawi Drug Store had the lowest (40%). All facilities lacked at least one essential medicine on the survey day. Gubre Community Pharmacy and Sawi Drug Store also faced the longest stock-out durations, with key drugs like hydralazine and gentamycin missing for over 100 days. Most facilities failed to meet the WHO’s 80% availability standard, largely due to lack of local suppliers, long delivery distances, infrequent restocking, and reliance on private supply chains. The inferential statistics revealed that medicine availability is significantly influenced by the number of pharmacy staff and proper medicine management, while frequent and prolonged stock-outs negatively impact availability. The strong regression and correlation results highlight the importance of human resources and supply efficiency in ensuring consistent access to essential medicines. To improve essential medicine availability, health facilities in Gubre Town should strengthen supply chain and inventory systems. Establishing a local EPSS hub or partnering with nearby suppliers can minimize delays and stock-outs. Government and stakeholders should offer financial and logistical support, while further research is encouraged to monitor progress and optimize interventions. The study assessed only 20 essential medicines, limiting comprehensiveness. It focused solely on drug outlets in Gubre Town, restricting generalizability. Data reliability was affected by incomplete bin-card records, especially in private facilities, and potential recall/reporting bias from interviews with pharmacy store managers. Declarations Ethical approval and consent to participate All methods of the study were carried out following relevant guidelines and regulations of the Declaration of Helsinki and approved by the Institutional Review Board (IRB) of Wolkite University, College of Medicine and Health Sciences, Department of Pharmacy with the number (RCSUILC/033/25). An informed consent process was followed during participant recruitment while privacy, confidentiality, and anonymity were maintained throughout the study conduct and report writing. Consent for publication ‘Not applicable’ Competing interests The authors declare that they have no competing interests. Funding ‘Not applicable’ Author Contribution N.D., T.K. and Z.L. drafted the proposal work, collected data, compiled the results, generated the results, and forwarded the relevant conclusions. H.S. participated in methodology development, synthesized the appropriate methodology, conducted the data analysis, provided the limitation and write-up of the study. A.A developed discussion section and forwarded relevant recommendations. Acknowledgments The authors would like to thank Department of Pharmacy, College of Medicine and Health Sciences, Wokite University and all the participants of the study for their unlimited and kind help throughout the data collection process. Data Availability The datasets generated and analyzed during the current study are not publicly available due to privacy and ethical concerns but are available from the corresponding author upon reasonable request. References Abiye, Z., Tesfaye, A. and Hawaze, S. (2013) ‘Barriers to access: availability and affordability of essential drugs in a retail outlet of a public health center in south western Ethiopia’, Journal of Applied Pharmaceutical Science, 3(10), pp. 11-18. Ahmed, M.A.A., Coulibaly, I., Ravinetto, R., Buitrago, V.T. and Dujardin, C., (2024). Main causes of medicine stock-outs in Mauritania: A qualitative study. medRxiv. https://doi.org/10.1101/2024.05.23.24307794 Anson, A., Ramay, B., de Esparza, A.R. and Bero, L. (2012) ‘Availability, prices and affordability of the World Health Organization’s essential medicines for children in Guatemala’, Globalization and Health, 8(1), pp. 1-10. Awle, I.A. (2016) ‘Relationship between effective drug inventory control management and stock-outs in Kenya’s public hospitals’, Strathmore University Journal, 2(2), pp. 252-259. Bertoldi, A.D., Helfer, A., Camargo, A., Tavares, N. and Karanavos, P. (2010) ‘Medicine prices, availability and affordability in Southern Brazil: a study of public and private facilities’, LSE Health, 24(1), pp. 45-56. Chance, J.H. (2018) ‘Inventory management practices and supply chain performance of construction firms in Nairobi’, University of Nairobi Journal of Business, 5(2), pp. 100-115. Federal Ministry of Health (FMOH) (2003) Assessment of the pharmaceutical sector in Ethiopia. Addis Ababa: FMOH. Gelders, S., Ewen, M., Noguchi, N. and Laing, R. (2006) ‘Price, availability and affordability’, An international comparison of chronic disease medicines, 5(1), pp. 20-35. Hinsch, M., Kaddar, M. and Schmitt, S. (2014) ‘Enhancing medicine price transparency through price information mechanisms’, Globalization and Health, 10(1), pp. 1-11. Kagashe, G.A. and Massawe, T. (2012) ‘Medicine stock out and inventory management problems in public hospitals in Tanzania: A case of Dar Es Salaam region hospitals’, International Journal of Pharmacy, 2(2), pp. 252-259. Kefale, A.T. and Shebo, H.H. (2019) ‘Availability of essential medicines and pharmaceutical inventory management practice at health centers of Adama town, Ethiopia’, BMC Health Services Research, 19(1), pp. 1-7. Melaku, B., et al. (2024) ‘Impact of COVID-19 on essential medicine stock availability’, Ethiopian Journal of Health Science, 34(1), pp. 50-65. Mirza, Z. (2008) Thirty years of essential medicines in primary health care. Geneva: World Health Organization. Sherry, M., Ghaffar, A. and Bishai, D. (2018) Community platforms for public health interventions. Geneva: WHO. Tadesse, E., Kefale, A. & Shebo, H.(2021). Stock-out duration of essential medicines in Ethiopia. Proceedings of the Ethiopian Pharmaceutical Conference, Addis Ababa, Ethiopia, 15-17 June. Tefera, B.B., Tafere, C., Yehualaw, A., Mebratu, E., Chanie, Y., Ayele, S., et al. (2022) ‘Availability and stock-out duration of essential medicines in Shegaw Motta general hospital and Motta Health Centre, North West Ethiopia’, PLOS One, 17(9), e0274776. Ventola, C.L. (2011) ‘The drug shortage crisis in the United States: causes, impact, and management strategies’, Pharmacy and Therapeutics, 36(11), pp. 740-757. Whitney, B. (2014) Indicators of pharmaceutical supply chain assessment in low and middle-income countries: a systematic review of the literature. London: Global Health Policy Institute World Health Organization (2015) Service availability and readiness assessment (SARA): an annual monitoring system for service delivery – reference manual, version 2.2. Geneva: World Health Organization. Available at: https://www.who.int/publications/i/item/9789241510720 (Accessed: 15 May 2025). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 15 Dec, 2025 Reviews received at journal 08 Dec, 2025 Reviewers agreed at journal 05 Dec, 2025 Reviewers agreed at journal 03 Dec, 2025 Reviewers agreed at journal 03 Dec, 2025 Reviewers agreed at journal 22 Nov, 2025 Reviewers invited by journal 20 Nov, 2025 Editor assigned by journal 17 Sep, 2025 Editor invited by journal 15 Sep, 2025 Submission checks completed at journal 13 Sep, 2025 First submitted to journal 13 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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10:00:37","extension":"xml","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":123817,"visible":true,"origin":"","legend":"","description":"","filename":"d8506a16bc324b4f9d1a27201bd1267a1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7497426/v1/f8ec781db8b8d7ec5cf3fb68.xml"},{"id":96894517,"identity":"f454bd47-4a9b-4174-bf0c-8f74c460a8c7","added_by":"auto","created_at":"2025-11-27 10:00:37","extension":"html","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":127242,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7497426/v1/95be80834fc5058d81d9acd5.html"},{"id":96894507,"identity":"40b6b7ad-2043-4d97-81dc-b1596fc28865","added_by":"auto","created_at":"2025-11-27 10:00:36","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":181266,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePercentage availability of essential medicines at each health facility on the day of the survey\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Figure1300.tif.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7497426/v1/c91a4e24e7bfd2cf8dbafebc.jpg"},{"id":96918790,"identity":"5a8bbe06-76fd-4c3e-8f4f-efc4b7b87ffc","added_by":"auto","created_at":"2025-11-27 14:12:35","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":163734,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePossible reasons for stock out\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Figure2300.tif.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7497426/v1/476d4e2bb5a439f9eca923ba.jpg"},{"id":96923121,"identity":"99148836-5652-48cf-b13c-b4b797d52484","added_by":"auto","created_at":"2025-11-27 14:20:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1862303,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7497426/v1/f4dfb6fb-60dc-4156-8b5a-eb122f200860.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Essential Medicine Availability, Stock-Out Duration, and Influencing Factors in Public and Private Drug Outlets of Gubre Town, Central Ethiopia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAny health care system needs medications, and a lack of access to them compromises the goals of efficiency, equity, and health development. Compared to fewer than 10% in high-income countries, medications make for 25–70% of total health care spending in developing nations. Furthermore, in low- and middle-income nations, up to 90% of the population pays for their own medications. Consequently, a significant portion of the world's population cannot afford medications, which places a heavy load on the government (WHO, 2015).\u003c/p\u003e\u003cp\u003eAccording to estimates from the World Health Organization (WHO), over one-third of the world's population, primarily in Asia and Africa, lacks access to necessary medications (WHO, 2015). For this reason, one of the Millennium Development Goals in developing nations is the accessibility and affordability of vital medications (Chance, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). The justification for essential drugs is that, even if there are many registered and available medications on the market, it is crucial to exercise caution in light of the majority of citizens' medical needs and to ensure their safety, effectiveness, and affordability (Mirza, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2008\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDrugs that meet the population's top healthcare needs are considered essential, according to the WHO. Evidence of efficacy and safety, comparative cost-effectiveness, and public health importance are the reasons behind their selection. In the framework of operational health systems, essential medications should always be accessible in sufficient quantities, in the right dosage forms, with guaranteed quality and sufficient information, and at a cost that both the community and the individual can pay (Gelders et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; WHO, 2015).\u003c/p\u003e\u003cp\u003eFew research have examined how crucial medication shortages in public and commercial pharmacies can impair the efficacy of healthcare in sub-Saharan Africa (Nditunze et al., 2015). Keeping sufficient medical supplies requires efficient stock management, which includes ordering and inventory control. In a healthy health system, equal access to high-quality, safe, and reasonably priced medical supplies is ensured by effective inventory management, which also enhances patient care and resource utilization (Kefale and Shebo, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMaking ensuring patient needs are met and cutting down on the time it takes to order and buy medications are the main objectives of inventory management. It lowers the overall cost to the pharmacy and, consequently, the entire healthcare facility by preventing expenses related to medication degradation and expiration (Awle, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). It also contributes significantly to effective healthcare by raising the accessibility, security, and cost of necessary medications (Kagashe and Massawe, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Poor inventory control may result in EMs being overstocked or understocked, wasting resources and raising morbidity and mortality when life-saving medications are scarce (Ventola, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eStatement of the problem\u003c/h3\u003e\n\u003cp\u003eCurrency fluctuations and other variables caused a dramatic increase in the price of medications, while the distribution of supply remained consistent throughout areas during and after COVID-19, primarily from European and Ethiopian vendors. The pandemic brought to light robust local supply of NCD medications while exacerbating pre-existing problems with pharmaceutical availability. To further understand how import dependency and currency fluctuations impact supply and evaluate the effects of stock-outs on patients, more research is required (Melaku et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eLow availability of children's vital medications (31.5–43%) was documented in two investigations, indicating a serious problem that requires action. To close this gap and create effective solutions, it is crucial to identify the variables influencing availability. Stock-outs are common and protracted in Ethiopia, which interferes with treatment and puts a burden on finances, particularly in public places that serve low-income communities. Despite having easier access, private stores nevertheless experience stock-outs because of pricing, rules, and market difficulties (Abiye et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Asmamaw et al., 2021).\u003c/p\u003e\u003cp\u003eAddressing medication shortages requires a comprehensive understanding of stock-out periods across sectors. Weak forecasting, demand swings, global supply chain interruptions, and inadequate inventory data are all contributing factors. The problem is made more difficult by regional differences. Stock-outs can be avoided, patient expenses can be decreased, and health outcomes can be enhanced by a concerted international effort to improve distribution, procurement, and logistics in both the public and commercial sectors (Ahmed et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eEssential medication stock-outs are frequent in Ethiopia, occurring in between 26% and 91% of hospitals (Federal Ministry of Health (FMOH), \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). According to WHO estimates, over one-third of the world's population—mostly in Asia and Africa—does not have access to necessary medications. One of the main Millennium Development Goals is to guarantee the accessibility and affordability of necessary medications. Major infectious diseases including TB, HIV, and malaria are prevalent in Ethiopia, and the public sector mostly provides basic healthcare services, depending on a steady supply of reasonably priced, high-quality medications (Whitney, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAffordability, sensible use, dependable health systems, sustainable financing, and medicine availability are some of the factors that affect access to vital medications (Hinsch et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Low national commitment, a shortage of health workers, little money, poor aid coordination, and little research on priority medications are some of the main obstacles in Sub-Saharan Africa (Sherry \u0026amp; Ghaffar, 2018). Therefore, this study uses inferential analysis to evaluate the availability of important medications and the length of time that they are stock-out in Gubre Town's public and commercial outlets, taking into account factors that influence availability.\u003c/p\u003e"},{"header":"Methodology and Materials","content":"\u003ch2\u003eStudy area and period\u003c/h2\u003e\u003cp\u003eThe study was carried out in the town of Gubre at the Gubre Health Center, Gubre Community Pharmacy (Apartama), Tena Adam private pharmacy, Adababay Drug Store, Sawi Drug Store, Gubre Drug Store, and Wolkite University Specialized Teaching Hospital (WUSTH). Gubre town is situated 173 kilometers from Addis Ababa and 15 kilometers from Wolkite, the capital of central Ethiopia. An estimated 300,000 people in the surrounding area were served by the hospital. Wolkite University Specialized Teaching Hospital, Gubre Health Center, one community pharmacy, and private pharmacies and drugstores can all be found in Gubre town. These are the only medical facilities in the area that offer locals access to basic medical care. For instances that the health center is unable to handle, the hospital acts as a referral location. Data was gathered between March 1st, 2025, and April 1st, 2025.\u003c/p\u003e\u003ch3\u003eStudy design and approach\u003c/h3\u003e\u003cp\u003eThe availability and length of stock-outs of important medications were evaluated by the authors using a cross-sectional, institution-based descriptive and explanatory study methodology. The study collected data using a quantitative approach. The authors used bin-card reviews and standardized checklists to gather numerical data.\u003c/p\u003e\u003ch3\u003eSource and study population\u003c/h3\u003e\u003cp\u003eThe sources included the bin card documentation for every medication, the managers of the pharmaceutical stores at each medical facility, the community pharmacy, Gubre Health Center, Tena Adam Private Pharmacy, Adababay Drug Store, Sawi Drug Store, Gubre Drug Store, and all of the important medications at WUSTH. A pharmaceutical store manager from each healthcare facility, the bin cards of specific medications, and a few key medications were the research populations.\u003c/p\u003e\u003ch3\u003eInclusion criteria and exclusion criteria\u003c/h3\u003e\u003cp\u003eIn order to evaluate availability and stock-out length, this study examined bin-card records of necessary medications from seven chosen retailers for the previous six months. The six-month timeframe strikes a balance between representing current practices and recording stock patterns. Reagents, medications, medical equipment, and supplies without bin cards were not included.\u003c/p\u003e\u003ch2\u003eSample size determination\u003c/h2\u003e\u003cp\u003eTo ascertain the availability and stock out time of necessary medications, a total of twenty essential medicines that were found in the tracer drug lists of both public and private health institutions were evaluated. To gather demographic data, a manager of a pharmacy store at each of the medical institutions was also questioned (Tefera et al, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e)\u003c/p\u003e\u003ch3\u003eSampling technique\u003c/h3\u003e\u003cp\u003eSince they were the most pertinent employees for the study, all seven drug outlets were included, and all of the pharmacists, druggists, and managers of pharmaceutical stores were specifically selected from each drug outlet. Additionally, all of the necessary medications identified in each health facility's tracer drug lists—a total of twenty medications were identified in each list—were chosen for assessment. Health facilities should create their own tracer drug lists by consulting the Ethiopian Federal Ministry of Health's (EFMOH) tracer drug listings. Based on their effectiveness in treating or identifying the most prevalent illnesses, tracer medications were chosen. One bin-card was chosen for each chosen medication in order to examine its availability (a total of 20 bin-cards). The Essential medicines evaluated in this study listed in the Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e below:\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eList of essential medicine evaluated in this study\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"1\"\u003e\u003c/colgroup\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAmoxicillin 500 mg capsule, Artemether + lumefantrine 20mg + 120mg, Ceftriaxone 1gm injection, Cotrimoxazole 240mg/5 ml suspension, Ferrous salt + folic acid 150mg + 0.5mg tablet, Gentamycin 40mg/5 ml injection, Hydralazine injection, Magnesium Sulphate injection, Oral Rehydrate Salt (ORS), Oxytocin injection, Pentavalent vaccine, Rifampicin/Isoniazid/Ethambutol/Pyrazinamide fixed-dose combination, Med Roxy progesterone injection, Tetracycline 1%, and Tenofovir + Lamuvidine + Efaverenz Adult dose, Amitriptyline 25mg tablet, Amlodipine 5mg or 10mg tab, Metformin 500mg or 850mg tablet, Metronidazole 250mg or 500mg caps, and Omeprazole 20mg or 40 mg capsule.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e(Tefera et al, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003ch3\u003eData collection tool and procedure\u003c/h3\u003e\u003cp\u003eTo collect data, a structured questionnaire was prepared in English. The questionnaires utilized in this study were originally developed and published by USAID DELIVER (2008) in the Logistics Indicators Assessment Tool (LIAT). Moreover, the authors reviewed the bin-card records of each selected medicine for the past 6 months to measure its availability and stock-out duration. These data were collected by pharmacy personnel with expertise in medicines management.\u003c/p\u003e\u003ch2\u003eData processing and analysis\u003c/h2\u003e\u003cp\u003eThe data was evaluated for completeness and analyzed by using SPSS version 27. The authors computed descriptive statistics (frequency and percentage) and summarized the results with texts, tables, charts, graphs and tables. The authors analyzed and presented the data separately for each health facility. Moreover, an inferential statistical analysis consisting of correlation and regression analysis was conducted.\u003c/p\u003e"},{"header":"Results and Discussion","content":"\n\u003ch3\u003eResults\u003c/h3\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eGeneral characteristics of the health facilities\u003c/h2\u003e\u003cp\u003eThe health facilities included in the study were a WUSTH, Gubre community pharmacy (GCP), Gubre health center (GHC), Tena Adam pharmacy (TAP), Adababay drug store (ADS), Sawi drug store (SDS), and Gubre drug store (GDS). There were 5 medicine dispensing units in the WUSTH, and 1 the same medicine dispensing units in others. Majority of medicine store managers were Druggist. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eGeneral characteristics of health facilities\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eS/No.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWUSTH\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGCP\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGHC\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTAP\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eADS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSDS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eGDS\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eType of health facilities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSpecialized hospital pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCommunity pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHealth center\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePrivate pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eDrug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eDrug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003edrug store\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of medicines dispensing units\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of pharmacy staff\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumbers of medicines store manager\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcademic status of medicine store manager\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePharmacist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePharmacist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eDruggist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePharmacist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eDruggist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eDruggist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eDruggist\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eAvailability, Manageability and Stock out of essential medicines in each health facility\u003c/h2\u003e\u003cp\u003eOn the day of the survey, only 95% (19), 85% (17), 55% (11) of the 20 essential medicines were available at WUSTH, Gubre health center and Adababay drug store, respectively. While 40% (8) were available at Gubre community Pharmacy and Sawi drug store and 60% (12) were available at Tena Adam pharmacy and Gubre drug store. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAvailability of essential medicines on the day of the survey\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHealth facility\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eOn the day of the survey\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent (%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eWUSTH Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAvailable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGubre Community Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAvailable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGHC Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAvailable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTena Adam Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAvailable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAdababay drug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAvailable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSawi drug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAvailable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGubre drug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAvailable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eOn the day of survey, WUSTH had the highest Percentage availability (95%), while SDS and GCP had the lowest (40%). (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eFrom 20 selected essential medicines, 100% (20), 95% (19), 70% (14) were managed at WUSTH, Gubre health center and Adababay drug store, respectively. While 65% (13) were managed at Gubre community pharmacy and Sawi drug store and 60% (12) were managed at Tena Adam pharmacy and Gubre drug store. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eManageability of essential medicines in each health facility\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHealth institution\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eManageability\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent (%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eWUSTH Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eManaged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGubre Community Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eManaged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGHC Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eManaged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTena Adam Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eManaged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAdababay drug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eManaged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSawi drug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eManaged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGubre drug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot Managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eManaged\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eDuring the last six months, 60% (12), 50% (10), 30% (6) of essential medicines were stocked out at Gubre health center, Sawi drug store, and Adababay drug store, respectively. While 35% (7) were stock out at WUSTH and Gubre community pharmacy and 25% (5) were stock out at Tena Adam pharmacy and Gubre drug store. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStock out at least once in the last 6 months before data collection\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHealth Institution\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eStock out at least once in the last 6 months before data collection\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent (%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eWUSTH Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot stockout\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eGubre Community Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot stock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eGHC Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot stock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eTena Adam Pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot stock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eAdababay drug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot stock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eSawi drug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot stock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eGubre drug store\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot stock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStock out\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot managed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eAvailability of essential medicines in each health facility\u003c/h2\u003e\u003cp\u003eOn the days of the survey, WUSTH demonstrated the highest availability of essential medicines, with 19 out of 20 of the surveyed medicines were available. In contrast, the lowest availability was observed at Gubre Community Pharmacy (GCP) and Sawi Drug Store (SDS), each with only 8 out of 20 of the medicines available.\u003c/p\u003e\u003cp\u003eSeveral essential medicines had limited available in only two of the seven health facilities. These included; Hydralazine injection, Magnesium sulfate (MgSO₄) injection, TDF\u0026thinsp;+\u0026thinsp;3TC\u0026thinsp;+\u0026thinsp;EFV adult dose, Medroxyprogesterone injection, RHZE fixed-dose combination, Pentavalent vaccine, and Oxytocin injection, all of which were exclusively available at WUSTH and Gubre Health Center (GHC).\u003c/p\u003e\u003cp\u003eOn the other hand, some medicines showed universal availability across all surveyed facilities. These included Amoxicillin 500 mg capsule, Ceftriaxone 1 gm injection, Amitriptyline 25 mg tablet, Amlodipine 5 mg or 10 mg tablet, Metronidazole 250 mg or 500 mg capsule, and Omeprazole 20 or 40 mg capsule. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAvailability of each medicine in each health Facility\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eS/No\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eEssential Medicine\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWUSTH\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGCP\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGHC\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTAP\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eADS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSDS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eGDS\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAvailable(1)\u003c/p\u003e\u003cp\u003eNot Available(0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAvailable(1)\u003c/p\u003e\u003cp\u003eNot Available(0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAvailable(1)\u003c/p\u003e\u003cp\u003eNot Available(0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAvailable(1)\u003c/p\u003e\u003cp\u003eNot Available(0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eAvailable(1)\u003c/p\u003e\u003cp\u003eNot Available(0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eAvailable(1)\u003c/p\u003e\u003cp\u003eNot Available(0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eAvailable(1)\u003c/p\u003e\u003cp\u003eNot Available(0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAmoxicillin 500mg Capsule\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eArtemether\u0026thinsp;+\u0026thinsp;lumefantrin20mg\u0026thinsp;+\u0026thinsp;120mg tab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCeftriaxone 1gm injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCotrimoxazole 240mg/5ml susp\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFerrous salt\u0026thinsp;+\u0026thinsp;folic acid 150mg\u0026thinsp;+\u0026thinsp;0.5mg tab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGentamycin 40mg/5ml injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHydralazine injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMgso4 injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eORS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOxytocin injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePentavalent vaccine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRHZE Fixed combination\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMed Roxy progesterone injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTetracycline 1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTDF\u0026thinsp;+\u0026thinsp;3TC\u0026thinsp;+\u0026thinsp;EFV adult dose\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAmitriptyline 25mg tablet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAmlodipine 5mg or 10mg tablet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMetformin 500mg tablet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMetronidazole 250mg or 500mg caps\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOmeprazole 20 or 40 mg capsule\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eStock-out duration of essential medicines in each health facility\u003c/h2\u003e\u003cp\u003eThe average number of stock-out days at WUSTH was 10.2 days. Over the last six months, Tetracycline 1% was the medicine with the most stocked out days (61 days) while in Gubre health center average stock out days was 20.1 days and Hydralazine injection was the medicine with the most stocked out days (125 days) in the last six month, followed by Metformin 500mg tablet with 41 days.\u003c/p\u003e\u003cp\u003eThe average number of stock-out days at Gubre community pharmacy, Tena Adam pharmacy, Adababay drug store, Sawi drug store and Gubre drug store were 32.2, 7.4, 15.5, 31.4 and 7.6 days, respectively. Gentamycin 40mg/5ml injection (109 days), Amitriptyline 25mg tablet (45 days), Artemether\u0026thinsp;+\u0026thinsp;lumefantrine 20mg\u0026thinsp;+\u0026thinsp;120mg Table\u0026nbsp;(50 days) was the medicine with the most stocked out days in the last six month in Gubre community pharmacy, Tena Adam pharmacy, and Gubre drug store, respectively. While Hydralazine injection was the medicine with the most stocked out days at Adababay drug store and Sawi drug store with 116 days and 163 days, respectively. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStock-out duration of essential medicines in the last 6-months in each health facility\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eS/N o.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eEssential Medicines\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"7\" nameend=\"c9\" namest=\"c3\"\u003e\u003cp\u003eStock out Duration in days\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWUSTH pharmacy\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGubre community pharmacy\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGubre health center\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTena adam Pharmacy\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eAdababay drug store\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSawi drug store\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eGubre drug store\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAmoxicillin 500mg Capsule\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eArtemether\u0026thinsp;+\u0026thinsp;lumefantrine 20mg\u0026thinsp;+\u0026thinsp;120mg tab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCeftriaxone 1gm injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCotrimoxazole 240mg/5ml susp\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFerrous salt\u0026thinsp;+\u0026thinsp;folic acid 150mg\u0026thinsp;+\u0026thinsp;0.5mg tab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGentamycin 40mg/5ml injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e109\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e142\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHydralazine injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e163\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMgso4 injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eORS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOxytocin injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePentavalent vaccine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRHZE Fixed combination\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMed Roxy progesterone injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTetracycline 1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTDF\u0026thinsp;+\u0026thinsp;3TC\u0026thinsp;+\u0026thinsp;EFV adult dose\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAmitriptyline 25mg tablet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAmlodipine 5mg or 10mg tablet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMetformin 500mg tablet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMetronidazole 250mg or 500mg caps\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOmeprazole 20 or 40 mg capsule\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eThe Factors affect availability and stock out of essential medicine\u003c/h2\u003e\u003cp\u003eAt all facilities that the authors have studied, (100%) reported that there are no local suppliers or Ethiopian pharmaceutical supply service (EPSS) hubs in the area, indicating complete reliance on external sources. all of them receive supplies from sources more than 31 km away, which likely contributes to delays and logistical challenges.\u003c/p\u003e\u003cp\u003eOnly a small portion (14.3%) receive supplies weekly and most (71.5%) receive medicines every 2 weeks to 3 months, which can lead to gaps in stock availability. Supervision occurs mostly every six months (57.1%) or every two months (28.6%), with very little frequent oversight, possibly impacting inventory management and accountability.\u003c/p\u003e\u003cp\u003eMore than half (57.1%) reported a 2\u0026ndash;7 day gap between ordering and receiving medicines, while others experience delays of up to two weeks. The majority (57.1%) depend solely on private suppliers, while only 14.3% rely solely on EPSS. This shows a weak presence of public supply chains. Transportation is split between suppliers (42.9%) and the outlets' own means (42.9%), with minimal shared responsibility, adding variability and potential delays. The most cited reason is market unavailability (42.9%), followed by financial constraints, poor supply chains, and other unspecified factors. \u003cb\u003e(Tablet 8)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe factors that affect availability and stock out of essential medicine.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDo you have local suppliers or EPSS hub in Gubre town?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAverage distance of your suppliers from your drug outlet (km(s))\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAbove 31KM\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eHow often do you get supplied by your suppliers?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEvery week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEvery 2 week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e28.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEvery 2 month\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEvery 3 month\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e42.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eHow often do you get supervision?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEvery two months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e28.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEvery six months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e57.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYearly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eWhat is the gap between orders and receive time?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u0026ndash;7 day\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e57.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;2 week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 weeks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e28.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eFrom where do you get your medicines?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEPSS Only\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrivate Suppliers\u0026rsquo; Only\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e57.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEPSS and Private Suppliers'\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e28.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eWhat is the transportation means of your supply?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBy supplier transport Only\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e42.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBy own means Only\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e42.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBy supplier transport and private transportation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eWhat could be the possible reasons for stock out?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFinancial problem\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnavailability in the market\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnavailability in the market and Poor supply chain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe authors identified the most cited reason was market unavailability (43%), followed by financial problem, poor supply chains, and other unspecified factors. \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003eInferential statistical analysis\u003c/h2\u003e\u003cp\u003eThe correlation analysis revealed a strong positive relationship between the number of pharmacy staff and the availability of essential medicines (r\u0026thinsp;\u0026asymp;\u0026thinsp;0.93), indicating that facilities with more staff tend to have higher medicine availability. Additionally, availability showed a moderate negative correlation with both stock-out rate (r \u0026asymp; -0.75) and average stock-out duration (r \u0026asymp; -0.68), suggesting that better availability is associated with fewer and shorter stock-outs. Manageability of medicines was also positively correlated with availability (r\u0026thinsp;\u0026asymp;\u0026thinsp;0.89), further emphasizing that effective management contributes to consistent supply. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelation analysis.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCorrelation with Availability (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManageability (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.94\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.0008\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStock-out (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e-0.79\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.0340\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvg. Stock-out Duration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e-0.68\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.0949\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePharmacy Staff\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.93\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.0015\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eLinear regression analysis confirmed a statistically significant relationship between the number of pharmacy staff and medicine availability. The regression model showed that for each additional pharmacy staff member, the availability of essential medicines increases by approximately 2.1 percentage points (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). This suggests that staffing is a strong predictor of availability, highlighting the importance of adequate human resources in ensuring consistent access to essential medicines across health facilities. For each additional pharmacy staff member, the availability of essential medicines increases by approximately 1.77%, and this relationship is statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The model explains 87% of the variability in medicine availability, suggesting a strong predictive relationship. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab10\" class=\"InternalRef\"\u003e10\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab10\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 10\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eRegression analysis.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTerm\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCoefficient (β)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eStd. Error\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003et-Statistic\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e95% Confidence Interval\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e45.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.0003\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e[34.32, 56.59]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePharmacy Staff\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.0015\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e[0.89, 2.65]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eDiscussion\u003c/h3\u003e\n\u003cp\u003eThis study assessed the availability and stock-out duration of 20 essential medicines (EMs) in public and private drug outlets in Gubre town, central Ethiopia. Hence, the results revealed inconsistent availability and significant stock-out occurrences, echoing national and global concerns.\u003c/p\u003e\u003cp\u003eOn the survey day, availability varied from 40% in Sawi Drug Store and Gubre Community Pharmacy to 95% in WUSTH. Stock-out events within the previous six months were highest at Gubre Health Center (60%) and lowest at Tena Adam Pharmacy and Gubre Drug Store (25%). At all health facilities included in our study, availability was below to the study conducted in northern district of the Brazilian region showed that the availability at the time of visit was 100% (Bertoldi et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Anson et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). The availability at Wolkite University Specialized Teaching Hospital (WUSTH) and Gubre health center were much higher than that of a study in Peru, while the availability at others five facilities were lower than that of the Peru study (WHO, 2015).\u003c/p\u003e\u003cp\u003eThe WHO reports that one-third of the global population lacks consistent access to essential medicines, a challenge notably prevalent in Africa and Asia. Our study supports this concern, with only Wolkite University Specialized Teaching Hospital meeting the WHO's recommended 80% availability threshold. In contrast, several private drug stores and health centers, such as Gubre Community Pharmacy and Sawi Drug Store, reported availability below 50%. These findings align with Abrha et al. (2018), who observed average availability rates of 41.9% in public and 31.5% in private sectors in Tigray, Ethiopia, highlighting a persistent gap in essential medicine access.\u003c/p\u003e\u003cp\u003ePrevious studies in Ethiopia have shown that stock-outs are common, with rates ranging between 26\u0026ndash;91% (Whitney, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). This is reflected in our data, where Gubre Health Center had stock-outs for 60% of the medicines in the past six months. Such shortages limit access to treatment and exacerbate morbidity and mortality, especially for chronic conditions like diabetes and cardiovascular disease, which were further strained during the COVID-19 pandemic (Melaku et al, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eStock-out durations were significant, with hydralazine injection unavailable for 163 days at Sawi Drug Store and 125 days at Gubre Health Center. These findings echo those of Tefera et al. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) and Kefale and Shebo (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), who reported prolonged stock-outs in Ethiopia, often exceeding a month. Even at better-equipped facilities like WUSTH, challenges persist\u0026mdash;tetracycline 1% was out of stock for 61 days despite a lower average stock-out duration (10.2 days). These patterns support the WHO\u0026rsquo;s (2015) observation that one-third of the global population lacks access to essential medicines, largely due to supply chain inefficiencies in low-income countries.\u003c/p\u003e\u003cp\u003eA deeper analysis revealed that all facilities in Gubre lacked nearby suppliers or EPSS hubs, relying on sources over 31 km away and receiving supplies only every 2\u0026ndash;3 months. This logistical barrier, along with poor infrastructure and weak public supply chains, mirrors challenges noted by Sherry and Ghaffar (2018) across Sub-Saharan Africa. Financial limitations, transport issues, and market unavailability further worsened stock-outs, aligning with global factors cited by Ventola (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) and the FDA (2023), including raw material shortages, limited production, and inefficient procurement systems.\u003c/p\u003e\u003cp\u003eThe inferential analysis showed a strong positive correlation between pharmacy staff and medicine availability (r\u0026thinsp;=\u0026thinsp;0.93, p\u0026thinsp;=\u0026thinsp;0.0015), as well as manageability and availability (r\u0026thinsp;=\u0026thinsp;0.94, p\u0026thinsp;=\u0026thinsp;0.0008), indicating that both staffing and proper inventory management significantly improve access to essential medicines. A negative correlation was observed between stock-out rate and availability (r = -0.79, p\u0026thinsp;=\u0026thinsp;0.034), suggesting that frequent stock-outs reduce availability. Regression analysis confirmed that each additional pharmacy staff member increases availability by about 1.77%, with an adjusted R\u0026sup2; of 0.84. These findings align with WHO (2015) and Ahmed et al., (2021), which highlight workforce and supply chain efficiency as key to medicine availability.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eWUSTH and Gubre Health Center reported the highest medicine availability (95% and 85%), while Gubre Community Pharmacy and Sawi Drug Store had the lowest (40%). All facilities lacked at least one essential medicine on the survey day. Gubre Community Pharmacy and Sawi Drug Store also faced the longest stock-out durations, with key drugs like hydralazine and gentamycin missing for over 100 days. Most facilities failed to meet the WHO\u0026rsquo;s 80% availability standard, largely due to lack of local suppliers, long delivery distances, infrequent restocking, and reliance on private supply chains.\u003c/p\u003e\u003cp\u003eThe inferential statistics revealed that medicine availability is significantly influenced by the number of pharmacy staff and proper medicine management, while frequent and prolonged stock-outs negatively impact availability. The strong regression and correlation results highlight the importance of human resources and supply efficiency in ensuring consistent access to essential medicines.\u003c/p\u003e\u003cp\u003eTo improve essential medicine availability, health facilities in Gubre Town should strengthen supply chain and inventory systems. Establishing a local EPSS hub or partnering with nearby suppliers can minimize delays and stock-outs. Government and stakeholders should offer financial and logistical support, while further research is encouraged to monitor progress and optimize interventions. The study assessed only 20 essential medicines, limiting comprehensiveness. It focused solely on drug outlets in Gubre Town, restricting generalizability. Data reliability was affected by incomplete bin-card records, especially in private facilities, and potential recall/reporting bias from interviews with pharmacy store managers.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003cp\u003eAll methods of the study were carried out following relevant guidelines and regulations of the Declaration of Helsinki and approved by the Institutional Review Board (IRB) of Wolkite University, College of Medicine and Health Sciences, Department of Pharmacy with the number (RCSUILC/033/25). An informed consent process was followed during participant recruitment while privacy, confidentiality, and anonymity were maintained throughout the study conduct and report writing.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cp\u003e\u0026lsquo;Not applicable\u0026rsquo;\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003e\u0026lsquo;Not applicable\u0026rsquo;\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eN.D., T.K. and Z.L. drafted the proposal work, collected data, compiled the results, generated the results, and forwarded the relevant conclusions. H.S. participated in methodology development, synthesized the appropriate methodology, conducted the data analysis, provided the limitation and write-up of the study. A.A developed discussion section and forwarded relevant recommendations.\u003c/p\u003e\u003ch2\u003eAcknowledgments\u003c/h2\u003e\u003cp\u003eThe authors would like to thank Department of Pharmacy, College of Medicine and Health Sciences, Wokite University and all the participants of the study for their unlimited and kind help throughout the data collection process.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets generated and analyzed during the current study are not publicly available due to privacy and ethical concerns but are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003eAbiye, Z., Tesfaye, A. and Hawaze, S. (2013) \u0026lsquo;Barriers to access: availability and affordability of essential drugs in a retail outlet of a public health center in south western Ethiopia\u0026rsquo;, Journal of Applied Pharmaceutical Science, 3(10), pp. 11-18.\u003c/p\u003e\n\u003cp\u003eAhmed, M.A.A., Coulibaly, I., Ravinetto, R., Buitrago, V.T. and Dujardin, C., (2024). Main causes of medicine stock-outs in Mauritania: A qualitative study. medRxiv. https://doi.org/10.1101/2024.05.23.24307794\u003c/p\u003e\n\u003cp\u003eAnson, A., Ramay, B., de Esparza, A.R. and Bero, L. (2012) \u0026lsquo;Availability, prices and affordability of the World Health Organization\u0026rsquo;s essential medicines for children in Guatemala\u0026rsquo;, Globalization and Health, 8(1), pp. 1-10.\u003c/p\u003e\n\u003cp\u003eAwle, I.A. (2016) \u0026lsquo;Relationship between effective drug inventory control management and stock-outs in Kenya\u0026rsquo;s public hospitals\u0026rsquo;, Strathmore University Journal, 2(2), pp. 252-259.\u003c/p\u003e\n\u003cp\u003eBertoldi, A.D., Helfer, A., Camargo, A., Tavares, N. and Karanavos, P. (2010) \u0026lsquo;Medicine prices, availability and affordability in Southern Brazil: a study of public and private facilities\u0026rsquo;, LSE Health, 24(1), pp. 45-56.\u003c/p\u003e\n\u003cp\u003eChance, J.H. (2018) \u0026lsquo;Inventory management practices and supply chain performance of construction firms in Nairobi\u0026rsquo;, University of Nairobi Journal of Business, 5(2), pp. 100-115.\u003c/p\u003e\n\u003cp\u003eFederal Ministry of Health (FMOH) (2003) Assessment of the pharmaceutical sector in Ethiopia. Addis Ababa: FMOH.\u003c/p\u003e\n\u003cp\u003eGelders, S., Ewen, M., Noguchi, N. and Laing, R. (2006) \u0026lsquo;Price, availability and affordability\u0026rsquo;, An international comparison of chronic disease medicines, 5(1), pp. 20-35.\u003c/p\u003e\n\u003cp\u003eHinsch, M., Kaddar, M. and Schmitt, S. (2014) \u0026lsquo;Enhancing medicine price transparency through price information mechanisms\u0026rsquo;, Globalization and Health, 10(1), pp. 1-11.\u003c/p\u003e\n\u003cp\u003eKagashe, G.A. and Massawe, T. (2012) \u0026lsquo;Medicine stock out and inventory management problems in public hospitals in Tanzania: A case of Dar Es Salaam region hospitals\u0026rsquo;, International Journal of Pharmacy, 2(2), pp. 252-259.\u003c/p\u003e\n\u003cp\u003eKefale, A.T. and Shebo, H.H. (2019) \u0026lsquo;Availability of essential medicines and pharmaceutical inventory management practice at health centers of Adama town, Ethiopia\u0026rsquo;, BMC Health Services Research, 19(1), pp. 1-7.\u003c/p\u003e\n\u003cp\u003eMelaku, B., et al. (2024) \u0026lsquo;Impact of COVID-19 on essential medicine stock availability\u0026rsquo;, Ethiopian Journal of Health Science, 34(1), pp. 50-65.\u003c/p\u003e\n\u003cp\u003eMirza, Z. (2008) Thirty years of essential medicines in primary health care. Geneva: World Health Organization.\u003c/p\u003e\n\u003cp\u003eSherry, M., Ghaffar, A. and Bishai, D. (2018) Community platforms for public health interventions. Geneva: WHO.\u003c/p\u003e\n\u003cp\u003eTadesse, E., Kefale, A. \u0026amp; Shebo, H.(2021). Stock-out duration of essential medicines in Ethiopia. Proceedings of the Ethiopian Pharmaceutical Conference, Addis Ababa, Ethiopia, 15-17 June.\u003c/p\u003e\n\u003cp\u003eTefera, B.B., Tafere, C., Yehualaw, A., Mebratu, E., Chanie, Y., Ayele, S., et al. (2022) \u0026lsquo;Availability and stock-out duration of essential medicines in Shegaw Motta general hospital and Motta Health Centre, North West Ethiopia\u0026rsquo;, PLOS One, 17(9), e0274776.\u003c/p\u003e\n\u003cp\u003eVentola, C.L. (2011) \u0026lsquo;The drug shortage crisis in the United States: causes, impact, and management strategies\u0026rsquo;, Pharmacy and Therapeutics, 36(11), pp. 740-757.\u003c/p\u003e\n\u003cp\u003eWhitney, B. (2014) Indicators of pharmaceutical supply chain assessment in low and middle-income countries: a systematic review of the literature. London: Global Health Policy Institute\u003c/p\u003e\n\u003cp\u003eWorld Health Organization (2015) Service availability and readiness assessment (SARA): an annual monitoring system for service delivery \u0026ndash; reference manual, version 2.2. Geneva: World Health Organization. Available at: https://www.who.int/publications/i/item/9789241510720 (Accessed: 15 May 2025).\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Availability, Essential medicine, Stock out, Drug vendor","lastPublishedDoi":"10.21203/rs.3.rs-7497426/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7497426/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eEssential medications are those that meet the population's top health care demands. Evidence of clinical efficacy and safety, comparative costs and cost-effectiveness, and disease prevalence and public health importance are all taken into consideration when choosing these medications.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThis study aimed to assess essential medicine availability and stock-out duration, and to analyze influencing factors using inferential statistics in Gubre town drug outlets.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eUsing a self-administered checklist of twenty vital medications, a cross-sectional survey was carried out at Gubre Town's public and commercial pharmacies between March 31 and May 18, 2025. The study encompassed the following medical facilities: Gubre Community Pharmacy, Gubre Health Center, Tena Adam Private Pharmacy, Adababay Drug Store, Sawi Drug Store, Gubre Drug Store, and Wolkite University Specialized Teaching Hospital (WUSTH). Utilizing SPSS version 27, data input and analysis were completed. Frequency distribution was used for categorical data, and descriptive statistics were used for continuous data. The findings were then displayed using texts, tables, and graphs.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e\u003cp\u003eThere were 5 medicine dispensing units in the WUSTH, and 1 the same medicine dispensing units in others. There were 27, 3, 2 and 7 pharmacy staff members at the hospital, GCP, GDS and the health center, respectively. And one the same pharmacy staff members in others. WUSTH tends to have the highest drug availability (95%), followed by GHC (85%) while SDS and GCP have lowest drug availability (40%). The average stock-out duration at GCP was the longest (32.2 days), followed by SDS (31.4 days), While at TAP was the shortest (7.4 days). From 20 selected essential medicines, 100% (20) were managed at WUSTH, while 60% (12) were managed at TAP and GDS. Medicine availability was positively associated with pharmacy staff and proper management, while stock-out rates and durations had negative effects. Regression confirmed staff numbers significantly predicted availability.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eWUSTH had the highest drug availability, while Sawi and Gubre Community Pharmacy had the lowest. Gubre Community Pharmacy also had the longest stock-out duration. Facilities should address prolonged stock-outs of essential medicines. Inferential statistics showed that medicine availability improves with more pharmacy staff and better management. Frequent and prolonged stock-outs reduce availability, emphasizing the need for stronger supply systems.\u003c/p\u003e","manuscriptTitle":"Essential Medicine Availability, Stock-Out Duration, and Influencing Factors in Public and Private Drug Outlets of Gubre Town, Central Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-27 10:00:32","doi":"10.21203/rs.3.rs-7497426/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-12-15T13:45:18+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-08T19:54:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"162066489776493548883647294118282084908","date":"2025-12-05T11:38:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"86308494591856800632304544966223408229","date":"2025-12-03T10:17:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"44828009597298391470930637780293601309","date":"2025-12-03T10:11:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"177957850329874174614286517852529370828","date":"2025-11-22T08:59:33+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-20T07:40:26+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-17T12:20:13+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-15T06:29:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-13T16:49:46+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2025-09-13T16:46:57+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"eb070915-f325-4a94-bcd8-0901f773ae7b","owner":[],"postedDate":"November 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-27T10:00:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-27 10:00:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7497426","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7497426","identity":"rs-7497426","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}