Evaluation of the Sustainable Drug Revolving Fund (SDRF) scheme at the Primary Health Care Centres (PHCs) in Lagos State Health District 1

Abstract

Background: The Sustainable Drug Revolving Fund (SDRF) scheme was introduced in Lagos State as a revised model of the Drug Revolving Fund (DRF) to ensure continuous availability and affordability of essential medicines in Primary Health Care Centres (PHCs). This study assessed the operational performance of the SDRF and examined factors influencing staff satisfaction with its implementation in Lagos State Health District 1.

Methods: A descriptive cross-sectional study was conducted across all 59 functional PHCs in Lagos Health District I between May and July 2024. The primary outcome was the SDRF's operational performance, measured by drug availability, stock-out rates, and procurement frequency. The secondary outcome was staff satisfaction with SDRF operations, assessed alongside patient perspectives on drug availability, pricing, and dispensing time. Data were collected using interviewer-administered questionnaires, prescription review checklists, and facility audits. Descriptive statistics summarized key indicators, while chi-square tests and binary logistic regression identified predictors of staff satisfaction at a 5% significance level.

Results: SDRF was operational in 96.6% of facilities, with 76.3% having functional SDRF committees. Essential drug availability was high (90%), though prices varied across facilities. About half of PHCs reported delays in fund disbursement, and about half (50.9%) of the staff were averagely satisfied, and the remaining were very satisfied (49.1%) with the facilities' operational factors. Patient feedback corroborated these findings, with over 50% strongly agreeing that drugs were regularly available, and more than 91% of prescriptions were mainly dispensed. Logistic regression revealed that delays in fund disbursement negatively affected staff satisfaction.

Conclusion: The SDRF has improved drug availability and efficiency in PHCs. Sustaining staff satisfaction and long-term performance requires timely disbursement of funds, strengthened governance, standardized procurement cycles, and adequate capitalization.