Publications
HST provides free electronic access to over 500 health systems research related reports, publications and papers. Close to 300 of these are publications that have been commissioned and funded by the Trust. Topics include among others district systems development, drug supply management, human resource development, informatics, legislation, finance, environmental health, mental health, lessons learnt, nutrition and sexually transmitted diseases / HIV/AIDS. The main publication of the HST is the annual South African Health Review. From 2005 all HST publications will be available in low resolution only. To explore the range of publications HST offers use the Advanced search to search using a variety of criteria.

Introduction

Drugs play an important role in the health system and many patients view access to drugs as an indication of good health care management.

Drugs also consume about 10% of the total recurrent expenditure on health in the public sector, and substantial savings can be made if drugs are efficiently managed. There are four components to the provision and use of drugs in health facilities. These are:

1. Selection choosing the drugs for use in the health service in the correct quantities. Selection is carried out at the national and provincial levels to ensure maximum discounts on bulk buying
2. Procurement using available funds to buy the drugs from a supplier
3. Distribution and stock management receiving the drugs from the supplier, storing them, issuing them to health facilities and health services, and ensuring stock control.
4. Use prescribing and dispensing drugs to patients, and encouraging compliance with the therapy.

The Initiative for Sub-District Support (ISDS) has been working with health workers in several districts across the country to improve their drug supply and distribution system. This document summarises some of the key lessons that have been learnt in those health districts. It focusses mainly on the third component described above, and aims to describe the characteristics of a well-managed drug distribution system.

In order to illustrate some of these lessons, the experiences from three ISDS sites (Mount Frere district in the Eastern Cape, Impendle-Pholela-Underberg district in KwaZulu-Natal and the Kalahari region of the Northern Cape) are described.