Availability and Stock Levels of Essential Medicines in Government Healthcare Institutions of Different Settings in a Rural District in Sri Lanka: a multicentre cross-sectional study

Background: The availability of essential medicines (EMs) is an important aspect of quality healthcare services. This study aimed to assess the availability, stock-out periods, record-keeping, presence of expired medicines, and conservation and handling of selected EMs across different levels of Government Healthcare Institutions (GHCIs) in Monaragala, one of the rural districts in Sri Lanka. Methods: A descriptive, cross-sectional study was conducted, with retrospective data collection methods where necessary. Six GHCIs representing four different levels of care were selected in Monaragala District, Sri Lanka. EMs for 23 diseases were selected from the National Essential Medicine List (EML) of Sri Lanka. Data was collected using survey forms adapted from the WHO operational package for assessing, monitoring, and evaluating country pharmaceutical situations (WHO-OP). Ethics review approval was obtained from the Ethics Review Committee, the Open University of Sri Lanka, and institutional permissions were obtained from the relevant authorities. Results: The average availability of selected EMs was fairly high (77.1%) in the Monaragala district, while the “highest” availability (80.49%) was recorded by divisional hospitals type B. The highest average stock-out days (66 days) were reported from the Divisional Hospital- Type C. Only Divisional Hospital- Type A reported having expired medicines on shelves (2.43%). All six GHCIs reported more than 80.49% for record-keeping on medicines. Divisional Hospital Type-A reported having the lowest score for warehouse management. Conclusions: The availability of EMs at the GHCIs of the Monaragala district was fairly high. Record keeping of EMs was high while the average number of stock-out days varied per institution. Conservation and handling practices of the store rooms and dispensing areas of the GHCIs in the Monaragala district should be further improved.