Sociodemographic characteristics

The sociodemographic characteristics are summarised in Table 1. The average age of the respondents was 33.48 (SD ± 6.6) years and the range was 24 to 58 years. The overall participants’ mean work experience was 6.8 (SD ± 5.95) years, and in their respective health facilities was 3.53 (SD ± 3.02) years. The majority of the respondents were male (41, 68.33%), and nurses predominated (43,71.67%). Most (47,78.3%) of the participants were diploma holders.

Table 1 Sociodemographic characteristics (n = 60)Availability of tracer health commodities

The mean availability of the tracer commodities was 68.73% with a standard deviation of 14.41 and a range of 27% to 94.6%. Fifty-seven (95%) facilities had stock control cards in place (Table 2). Fifty-four (90%) were using the stock cards and 40 (66.67%) had them updated. The average lead time was 39 days with a standard deviation of 10.7 days and a range of 22 to 90 days. The fill rate was at 56.8% and the range of 30% to 70% while the standard deviation was 10.3 days. All the facilities in the county used the manual system of commodity management.

Table 2 Availability of tracer health commodities (n = 60)Factors affecting the availability of tracer health commoditiesHuman resource factors

The findings revealed that 27 (45%) respondents had trained in commodity management in the last 6 months while 36 (60%) had trained in commodity management since employment (Table 3). Half of the participants acknowledged that the training was very relevant. Twenty-nine (48.3%) of them had been trained 3–4 times and 22 (61.1%) had stayed for 3–4 years since they were last trained at the time of the study. The majority (53, 88.33%) of those who dispensed health commodities were community health volunteers.

Table 3 Human resource factors influencing the availability of tracer commoditiesFinancing-related factors

Different categories of the level of care influenced the amount of money received for purchases of tracer commodities. As indicated in table 4, fifty-three (88.33%) facilities were Level Two which are also called Dispensaries while four (6.67%) were Level 3 also known as Health centres. In addition, two (3.33%) were level 4 facilities also called sub-county hospitals and there was one (1.67%) level 5 also known as the County Referral Hospital. The average amount allocated to each facility for the purchase of commodities was Ksh 679,592. The range was from Ksh 211,230 to Ksh 2,867,794. The standard deviation was Ksh 663,874 which shows a wide variation in the amount allocated to these health facilities. No facility received an adequate budgetary allocation for the purchase of health commodities and the disbursement was done half yearly. Out of the facilities that participated in the study 55 (91.7%) received a budgetary allocation out of which only 5 (8.33%) indicated it was adequate.

Table 4 Finance-related factors influencing the availability of tracer commoditiesPredictors of the availability of tracer commodities

Inferential statistics was employed to establish the relationship between availability of tracer commodities as the dependent variable. The independent variables were human and financing related factors. Linear regression was used because the dependent variable is continuous. The level of significance was set at 0.05.

Analysis was conducted to investigate the association between the human resource variables and the availability of medicines. Availability of tracer commodities was 4.56 times higher in facilities that had personnel trained in commodity management since employment (β = 4.56, 95%CI 2.29–11.21, p = 0.012). The findings also revealed that facilities that had pharmaceutical technicians dispensing commodities had 2.85 times increase in the availability of tracer commodities (β = 2.85, 95%CI 1.29–5.21, p = 0.005) compared to those without.

The relationship between finance factors and availability of tracer commodities showed that county and sub-county-level health facilities had higher availability of tracer commodities (β = 19.11, 95%CI 7.39–30.83, p = 0.002) compared to the lower-level facilities. The availability of tracer health commodities was found to be 12.08 times more in those facilities that had disbursement of budgetary allocation on time (β = 12.08, 95%CI 3.11–23.57, p = 0.002).

The variables that were found to be statistically significant at the bivariate level were subjected to multiple linear regression analysis to determine the independent predictors of the availability of tracer commodities. Training in commodity management since employment and level of health facilities were found to be the significant factors. The availability of tracer health commodities was 3.22 more in facilities that had dispensing personnel who had been trained in commodity management since employment (β = 3.22, 95%CI 1.45–11.61, p = 0.002). Higher level health facilities had higher availability of tracer commodities (β = 20.52, 95%CI 4.25–36.79, p = 0.014) compared to lower levels.