Effect of implementing bottom-up quantification on availability of essential health commodities in Dodoma region, Tanzania: a pre- and post‑evaluation study

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Background: Proper quantification of health commodities has been a concern for the availability of these commodities at health facilities. This study aimed at assessing the impact of implementing bottom-up quantification (BUQ) approach on availability of health commodities in Dodoma Region, Tanzania. Methods: This mixed-methods, pre- and post-evaluation, quantitative design study was conducted from February to April 2024 in 194 health facilities in the Dodoma Region, Tanzania. Measures included information on HCW trained on BUQ, type of facilities, engagement of HCW on doing quantification, availability of health commodities, availability of essential quantification guidelines and delivery of health commodities by MSD were collected using designed questionnaire and validated into Excel then analysed using SPSS v27. The paired t-test statistic was used to compare the mean results before and after implementation at 95% confidence interval and p-value <0.05 was considered statistically significant. Results: The availability of health commodities increased from 68% (SD=16.40%) in 2019 to 78% (SD=12.85%) in 2023 respectively before and after the implementation of BUQ. Additionally, the study found that 69.59% of visited facilities reported having healthcare workers trained formally and 30.41% had received on-the job training to perform the quantification. Furthermore, the engagement of staff during quantification process was reported to be 77.84%. Conclusions: With the implementation of BUQ, availability of health commodities at the facilities increased, and there was prompt delivery of orders. Likewise, the training of the HCW on the BUQ approach was done in order to smoothen its implementation. As a result, health facilities were capable of doing the forecasting for the annual demands. There is however the need to resolve the challenges encountered by healthcare workers in the implementing BuQ.

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