The pharmaceutical management cycle and the availability of essential medicines at public health facilities in Limpopo province, South Africa: A qualitative study

One of the pilot districts for the National Health Insurance pilot scheme in South Africa since 2014 is the Vhembe District, which aims to provide universal health coverage. However, medicine shortages and inefficiencies associated with the pharmaceutical management cycle (PMC) processes such as selection, procurement, including funding, storage, distribution, and the rational use of medicines have hindered the achievement of universal health coverage. This study explored the challenges related to the PMC framework and the availability of essential medicines at public health facilities. A qualitative research design using convenience sampling was employed to select participants. Data were collected through an interview guide, and data saturation was reached after interviewing thirteen professional nurses. The collected data were analyzed using thematic content analysis, with emergent themes and sub-themes summarized. The results revealed issues such as inappropriate selection processes, inefficient procurement practices, transportation and communication challenges, and irrational use of medicines by patients. A comprehensive understanding of the challenges associated with the PMC and effective planning of these processes are critical for ensuring a steady availability of essential medicines at public health facilities. Recommendations were made to policymakers and health planners to reduce stock-outs and shortages of essential medicines in public health systems.