An Appraisal of the Zero-Capital Drug Revolving Funds (ZDRF) Scheme for Surgical, Oncology and Palliative Care Patients at Federal Medical Centre Makurdi (FMCM), North Central Nigeria

Abstract

Aim: This study evaluated the impact of the ZDRF scheme at FMCM on improving access to essential medicines for patients undergoing surgical, oncology, and palliative care. The results indicated that ZDRF effectively enhanced the sustainable availability of quality medicines. However, it did not demonstrate a significant impact on drugs’ prices or patient utilization. Despite these limitations, the ZDRF led to a substantial revenue increase of over 450% compared to the traditional DRF model, indicating its potential as a better alternative for healthcare provision. Method: The study was conducted at FMCM, through the administration of Open-ended questionnaires to 100 participants, 50 each of staff of FMCM and patients. Records of drug purchases, sales and revenue generated were extracted from the pharmacy and finance departments to compare the performances of both the traditional and ZDRF in terms of availability, cost, quality, and revenue generation. Study Design: This cross-sectional study that used Open-ended questionnaires’ survey, administered to 100 participants, 50 each of staff and patients through a simple random sampling. The questionnaires enquired about patients views on drug availability, cost, and quality etc. Answers were based on a rating scale of 1-5. An informed consent was obtained through a short communication on the cover page of the questionnaire. Sampling: simple random sampling was employed to eliminate bias and make the results more generalizable. A total of 50 respondents each of staff of FMCM and patients were recruited for the study. This was simple, fast and made the results more generalizable. Results: The study found that the zero capital drug revolving fund significantly improved the sustainable availability of essential medicines at FMCM, P=0.000. The study also demonstrated that ZDRF drugs were of high quality, P=0.001. However, it was noted that the ZDRF had no significant level of drug patronage in the hospital, P=0.44. Similarly, the ZDRF did not have significant influence on the price of drugs within the hospital, P=0.15. While the revenue in the traditional DRF over a six month period (July-December, 2012) was 10, 825,683.00 Nigerian Naira, the revenue for corresponding period ZDRF over the subsequent six months (January to June, 2022), was 55,933,212.00 Nigerian Naira, (over 450% increase). Conclusion: With heavy indebtedness, inefficient traditional DRF schemes, poor healthcare financing, unavailable startup funds (seed Money), and low health insurance coverage, the ZDRF becomes a better alternative to the sustainable provision of essential medicines that are affordable, safe and of high quality. It must not be a one cap fits all. Each state, community, and institution, should be able to identify a DRF model that gives the desired benefits to its people.