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MANAGEMENT AND CONTROL OF INVENTORIES (DRUGS) IN GOVERNMENT HEALTH - INSTITUTIONS

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Inventories occupy the most strategic position in structure of working capital of most business enterprises. It constitutes the largest component of current asset in most business enterprises. In the sphere of working capital, the efficient control and management of inventory has paired the most serious problem to the health institutions. The turnover of working capital is largely governed by the turnover of inventory, that is the rate of working capital is largely governed by the amount of inventory which is largely provided by the government. It is therefore quite natural that inventory which helps to maximize profit occupies the most significant place among current and profit assets.
The American usage of the word ‘inventory’ is synonymous with the British use of the word ‘stock’, this synonym is evident in the definitions of inventory and stock by the Oxford Dictionary. The Oxford English Dictionary defined inventory as follows:
1. A list, catalogue, detailed account
2. A lot or stock of goods, etc which are or may be made the subject of an inventory.
3. The aggregate of goods and some specified kind of goods which a trader has on hand as provision for the possible future requirement of customers.

Many understand the word inventory as a stock of goods, but the generally accepted meaning of the word ‘goods’ in the accounting language is the stock of finished goods only. In a manufacturing organization, however, in addition to the stock of finished goods, there will be stock of partly finished goods; there will be stock of partly finished goods, raw materials and stores. The collective name of these entire items is ‘inventory’.
Inventory management is aimed at maintaining a minimum investment in operations to maximize profitable operations. To maintain a large stock of investment to ensure a smooth and efficient operation of the firm.

The effect of inventory management on government health institutions like UNTH Enugu cannot be over emphasized; this is because asset of many institutions represents considerable percentage of the total invested capital. The control, accounting and management of an efficient inventory management system is of a special interest to both management, suppliers and other users of accounting information.
Therefore, poor inventory management leads to expiration of drugs, loss of quality sequel to poor storage system with resultant reduction in efficacy of the drug. This might even lead to death of some patients. There may be stock out and lot more effect of poor inventory control and management.
Inventory control is concerned with the acquisition, control, handling and use of inventories so as to ensure the availability of inventory whenever needed, providing adequate provision for contingencies, deriving maximum economy and minimizing wastages and losses.
Hence, inventory control refers to a system, which ensures the supply of required quantity and quality of inventory at the required time. Inventory control can make or break a company. This explains the usual saying that inventories are the grave yard of business.

The aim of a sound inventory control system is to ensure the best balance between two much and too little. Too much inventory carries financial rises and too little reacts adversely on continuity of sequence.
In health institutions such as UNTH Enugu, inventory control is more than just procurement and usage. The proper controls and processes can save millions in health care cost by enabling health institutions to efficiently order and store just the right amount of supplies needed for patient care while tackling cost, tier pricing and patient charges associated with supplies.
Inventory management and control helps facilities identify, control and manage their inventories by keeping accurate records of all inflow, outflow and movement of inventory (drugs) in a user friendly environment. The proper tracking data allows for accuracy in patient charges and on audit trail to identify cist charges.
The intention of this research work therefore aimed at studying the management and control of inventories (drugs) in government health institutions with special reference to University of Nigeria Teaching Hospital, Enugu.

1.2 STATEMENT OF THE PROBLEM

A large proportion of the government health institutions are faced with similar problems. These problems hinder the growth and development of institutions in this country. The problems include
1. Unsatisfied clients/patients arising from poor qualify drugs.
2. High rate of obsolescence, wastages and theft of drugs.
3. Poor quality of inventory control leading to out of stock of essential drugs in the hospital.

1.3 OBJECTIVES OF THE STUDY

1. To ensure an effective and efficient management and control of inventory (drugs) in government health institution leading to effective service delivery.
2. To reduce obsolescence and wastages of drugs.
3. To reduce out of stock syndrome prevalent in government hospitals.

1.4 RESEARCH QUESTIONS

1. To what extent has effective management and control of inventory aid in effective and efficient service delivery of hospitals?
2. How far do effective inventory management reduce obsolescence and wastages of drugs experienced in hospitals?
3. To what extent do good inventory management help in reducing out of stock syndrome prevalent in government hospitals?

1.5 FORMULATION OF HYPOTHESES

Ho: proper management and control of inventory does not have a significant effect on effective and efficient service delivery of hospitals.
Hi: Proper management and control of inventory has a significant effect on effective and efficient service delivery on hospitals.
Ho: Proper management and control of inventory does not reduce obsolescence and wastages experienced in hospitals.
Hi: Proper management and control of inventory reduce obsolescence and wastages experienced in hospitals.
Ho: There is no relationship between inventory control and stock out experienced n hospitals.
Hi: There is relationship between inventory control and stock out experienced n hospitals.

1.6 SIGNIFICANCE OF THE STUDY

The significance of the study is mainly attributed to the need for measuring result of inventory operations for a particular period such as month of year. This study will point out the importance of inventory control and management in government health institutions.

This study will also create an opportunity for existing and prospective employers and employees to benefit from the use of modern inventory control and management techniques that will be recommended. To students, it will improve their theoretical and practical knowledge of inventory management and control in government health institutions.

1.7 SCOPE OF THE STUDY

The management and control of inventories cover physical control, accounting control and management policies and procedures relating to inventory. This study is based on government health institutions but due to time, the school system and financial constraints, this research has selected a sample from eth population of health instructions.

The study sample selected for this study is University of Nigeria Teaching Hospital (UNTH) in Enugu, and the study shall cover their ordering method, procurement method, storage and issue of drugs including the cold chain system and the inventory management and control techniques that aid in the achievement of the organizational goal.

1.8 LIMITATION OF THE STUDY

The absence of any previous empirical study on the management and control of inventories drugs in the program of UNTH is a significant limitation to this study.

These absences of an existing body of study on this area in the institution posses a special problem of the absence of previous reference or primary data from the scratch through questionnaire administration and designed to supplement available secondary data. However, financial constraints are expected to present a very serious limitation to the study since it would limit the researcher’s data material and the presentation of existing evidence.

1.9 DEFINITION OF OPERATIONAL TERMS

Inventory – Stock of materials or product. In this, inventory refers to drugs.
Inventory Management – The official system designed by the management of a company to monitor control and manage the stock of inventories and assets under its possession.
Inventory Control – Supervision of the supply and storage and accessibility of items in order to incur on adequate supply without excessive supply.
Cold Chain System – A popular term for continuous maintenance of low temperature required for biological example vaccines from the time of manufacture to shipping, warehouse and storing before administration.

1.10 HISTORY OF UNTH

The UNTH Ituku Ozalla, Enugu, has come a long way. The hospital began in the 20th century as a standard hospital for Africans built by the colonial administrators. It later metamorphosed into a general hospital on attainment of Nigeria’s independence in 1960.

However, at the end of the Nigerian civil war in 1970, the then government of east central state transformed it into a specialist hospital with effect from July 1, 1970.

At this time, the hospital has a total of 50 doctors, 10 wards and 300 beds and a chest bay of 60 beds. There are also 350 nurses working in the hospital. Today, the situation has changed drastically. The bed capacity of the hospital in the permanent is over 500 beds and the number of its personnel both professional and non professional has increased tremendously.

By decree number of 23 of 1974, the Federal Ministry Government took over the hospital, but left the management in the hands of the council of the University of Nigeria Nsukka. The University of Nigeria Teaching Hospital became independent in July 1976 with the appointment of autonomous management board.
The physical constraints of the old site of the hospital made it impossible for needed expansion to be implemented. It was also appreciated that the old site was developed and used as a general hospital, and therefore, could not longer cope with the challenges of a teaching hospital.

Consequently, the approval of the then Federal Ministry Government for the construction of a new complex for the teaching hospital was ought and it came as welcome relief. Today, this site, which is the permanent site of the UNTH at Ituku Ozalla is permanent and fully functional. It is located 21 kilometers from Enugu capital city along Enugu, Port-Harcourt Express way.

All services rendered at the old site has now been moved into the permanent site with effect from 8the January, 2007. The hospital covers an area of about 200, acres while the entire parcel of land about 306 hectares (747 acres).

There is now a room for expansion and this is hoped to assist in solving the accommodation needs of the hospital once and for all.

The new hospital complex is also better equipped under the Federal Government assisted by VAMED engineering equipment programme which has elevated it and some other teaching hospitals in the country to an international standard.

The UNTH has broad objectives of services, teaching and research. The hospital tries to achieve these through provision of inpatient and outpatient services to its clients through her highly trained staffs, provision of adequate clinical materials for service and training as well as equipment of research, provision of teaching facilities for training her students and other persons in the health delivery team and conduct and promotion of research in all matters pertaining to health.

Altogether, there are 41 main departments in the hospital with three outpost. They are:
– Comprehensive Health Centers at Obukpa near Nsukka Enugu State
– Abagana in Njikoka Local Government Area of Anambra State.
– Isuochi in Abia State.

There are 9 training school/programmes in the hospital they have school of nursing, midwifery, medical laboratory science, nurse anesthetists, community health, post ophthalmic nursing, perioperative nursing, cardiothoracic nursing and medical records. These schools operate currently at the old site but plans are already on the ground to provide structure for them in the new site as soon as possible.

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