Impact of the COVID-19 pandemic on the quality of medical products in Zimbabwe: a qualitative study based on key informant interviews with health system stakeholders

{ 'indexed': {'date-parts': [[2023, 6, 9]], 'date-time': '2023-06-09T04:31:21Z', 'timestamp': 1686285081173}, 'reference-count': 44, 'publisher': 'BMJ', 'issue': '6', 'license': [ { 'start': { 'date-parts': [[2023, 6, 8]], 'date-time': '2023-06-08T00:00:00Z', 'timestamp': 1686182400000}, 'content-version': 'unspecified', 'delay-in-days': 7, 'URL': 'http://creativecommons.org/licenses/by-nc/4.0/'}], 'funder': [ { 'DOI': '10.13039/100010269', 'name': 'Wellcome Trust', 'doi-asserted-by': 'publisher', 'award': ['206316_Z_17_Z']}, {'name': 'US Pharmacopeial Convention', 'award': ['N/A']}], 'content-domain': {'domain': ['bmj.com'], 'crossmark-restriction': True}, 'published-print': {'date-parts': [[2023, 6]]}, 'abstract': '<jats:sec><jats:title>Objective</jats:title><jats:p>To explore the impact of the Coronavirus ' 'disease 2019 (COVID-19) pandemic on the quality of medical products in Zimbabwe, including ' 'market risks for substandard and falsified products and impacts on quality assurance ' 'activities.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Qualitative ' 'study based on in-depth key informant ' 'interviews.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Health ' 'system stakeholders across the medical product supply chain in ' 'Zimbabwe.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>36 key ' 'informants were interviewed between April and June ' '2021.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We found that the ' 'COVID-19 pandemic disrupted quality assurance and regulatory activities of medical products ' 'in Zimbabwe, resulted in observations of poor-quality personal protective equipment (PPE) and ' 'other COVID-19-related products and led to increased risks to quality. Risks to quality due ' 'to COVID-19-related disruptions included increased layers of agents in the supply chain and ' 'an influx of non-traditional suppliers. COVID-19-related movement restrictions reduced access ' 'to health facilities and thus may have increased the usage of the informal market where ' 'smuggled and unregistered medical products are sold with less oversight by the regulator. ' 'Most reports of poor-quality medical products were for PPE, such as masks and infrared ' 'thermometers, used for the COVID-19 response. Besides these reports, many participants stated ' 'that the quality of essential medicines in the formal sector, not related to COVID-19, had ' 'largely been maintained during the pandemic due to the regulator’s stringent quality ' 'assurance process. Incentives for suppliers to maintain quality to retain large donor-funded ' 'contracts, and the need for local wholesalers and distributors to comply with quality-related ' 'aspects of distribution agreements with global manufacturers of brand-name medical products, ' 'mitigated threats to ' 'quality.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The ' 'COVID-19 pandemic presented opportunities and market risks for circulation of substandard and ' 'falsified medical products in Zimbabwe. There is a need for policymakers to invest in ' 'measures to safeguard the quality of medical products during emergencies and to build ' 'resiliency against future supply chain shocks.</jats:p></jats:sec>', 'DOI': '10.1136/bmjopen-2022-068923', 'type': 'journal-article', 'created': {'date-parts': [[2023, 6, 8]], 'date-time': '2023-06-08T17:27:17Z', 'timestamp': 1686245237000}, 'page': 'e068923', 'update-policy': 'http://dx.doi.org/10.1136/crossmarkpolicy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Impact of the COVID-19 pandemic on the quality of medical products in Zimbabwe: a qualitative ' 'study based on key informant interviews with health system stakeholders', 'prefix': '10.1136', 'volume': '13', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-1489-627X', 'authenticated-orcid': False, 'given': 'Tatenda T', 'family': 'Yemeke', 'sequence': 'first', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-3305-5836', 'authenticated-orcid': False, 'given': 'Farouk A', 'family': 'Umaru', 'sequence': 'additional', 'affiliation': []}, {'given': 'Rashida A', 'family': 'Ferrand', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-7608-9038', 'authenticated-orcid': False, 'given': 'Sachiko', 'family': 'Ozawa', 'sequence': 'additional', 'affiliation': []}], 'member': '239', 'published-online': {'date-parts': [[2023, 6, 8]]}, 'reference': [ { 'key': '2023060810252180000_13.6.e068923.1', 'first-page': '157', 'article-title': 'WHO declares COVID-19 a pandemic', 'volume': '91', 'author': 'Cucinotta', 'year': '2020', 'journal-title': 'Acta Biomed'}, { 'key': '2023060810252180000_13.6.e068923.2', 'unstructured': 'United Nations office on drugs and crime . 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