| Summary: | Research report submitted to the Faculty of Health Sciences, University of the
Witswatersrand, in partial fulfilment of the requirements for the degree of Master of
Public Health in the field of Hospital Management === Background:
Use of drugs in maternity unit plays a major role in maternal health service
delivery. Therefore, drug use during pregnancy requires close monitoring which
includes prescription of appropriate medication to their diagnosis, correct doses,
and adequate period of time. Drugs are also one of the major cost drivers in
health facilities. Although maternal health services are receiving increasing
attention in South Africa, very few systematic studies have been done to analyze
this important component (prescribing patterns and costs of drugs) of maternal
health care services in a district hospital setting.
Aims:
The overall aim of the study is to assess the drugs utilized in a maternity ward at
Pretoria West District Hospital (A district hospital in the Tshwane District in the
Gauteng Province) and the factors that might influence its use and their cost over
a period of one year.
Methodology:
Cross-section study design was used. Retrospective review of hospital records
was undertaken for 2087 maternal patient deliveries during one year study period
(01 January to December 2009) and no primary data was collected. Data was
extracted for variables used in the study (quantity and cost of drug used, profile
of patients). The study commenced after obtaining necessary approval from the
Gauteng Department of Health and Social Development and University of the
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Witwatersrand “Human Research Ethics Committee (Medical)’.
Results:
The study found that all the patients were prescribed iron supplements. The
second most commonly prescribed drugs are uterotonics. Besides these two
items other prescription drugs were prescribed to 7% of patients. Postnatal
contraceptives were seldom used. The most commonly used antibiotic was
Ceftriaxone. Bezylpenicillin was prescribed only for one RPR positive patient
during one month. Only 13% HIV positive received antiretrovirals which is too
low as compared to number of mothers delivered. The study found underprescription
of anti-hypertensive drugs. Low use of parenteral analgesics signifies
that probably patients were not given adequate pain relief during labour and this
policy should be reviewed. The quantity of biological vaccines (BCG and oral
polio) was prescribed routinely for all the newborn babies. However, the
antiretrovirals (Zidovudine and Nevirapine syrups) were prescribed for fewer
newborn babies (n= 51), in comparison to total number of babies born to a HIV
positive mothers (n=266) and of concern. Total cost for the drugs used during
one year study period was R 113,664.56. The average costs per mother and
newborn babies were R 39.40 and R 15.08 respectively. Routine availability of
affordable and effective drugs is one of the key indicators of quality health. The
study showed that affordable and effective drugs were readily available in the
Unit.
Conclusion:
This is probably the first study that documented the use of drugs in the maternity
unit in a district hospital. Further prospective study would be able to provide more
information in this important subject.
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