Time series study of the sales of non-subsidised contraceptives in Kenya at times of public sector shortage: implications for future sustainability.

This paper describes volume trends of non-subsidised contraceptive commodities (NSCC) in Kenya between 2016-2019. We hypothesise that if non-subsidised contraceptive commodities volumes increased at times of public sector shortage then then we might hope for a similar response should public sector supplies reduce in response to an expected decline in donor funding. We find that non-subsidised contraceptive commodities contribute only 2% of total volume, and that these volumes are dominated by emergency contraceptives (EC) and combined oral contraceptives (COC). EC and COC volumes increased significantly during the 2017 nurses' strike, but not during those periods when the Kenya Medical Supplies Authority (KEMSA) was out of stock. Increases in NSCC volumes were not of sufficient size, however, to compensate for the decline in public sector volumes. In short it appears that the market for NSCC is small and constrained. We recommend that further research is needed to understand why distributors of NSCCs are not able to take advantage of continuing public sector supply shortages.

Does feedback improve the quality of computerized medical records in primary care?

OBJECTIVE: The MediPlus database collects anonymized information from generalpractice computer systems in the United Kingdom, for research purposes. Data quality markers are collated and fed back to the participating general practitioners. The authors examined whether this feedback had a significant effect on data quality. METHODS: The data quality markers used since 1992 were examined. The authors determined whether the feedback of "useful" data quality markers led to a statistically significant improvement in these markers. Environmental influences on data quality from outside the scheme were controlled for by examination of the data quality scores of new entrants. RESULTS: Three quality markers improved significantly over the period of the study. These were the use of highly specific "lower-level" Read Codes (p=0.004) and the linkage of repeat prescriptions (p=0.03) and acute prescriptions (p=0.04) to diagnosis. Clinicians who fall below the target level for linkage of repeat prescriptions to diagnosis receive more detailed feedback; the effect of this was also statistically significant (p<0.01.) CONCLUSIONS: The feedback of four of the ten markers had a significant effect on data quality. The effect of more detailed feedback appears to have had a greater effect. The lessons learned from this approach may help improve the quality of electronic medical records in the United Kingdom and elsewhere.