<p>Median number of MTC members by level of care.</p>

World health organization estimates that of all medicines used globally, about 50% are used irrationally. This is mostly attributed to overuse of antibiotics and indiscriminate use of injectables, among other things. Globally, medicines and therapeutic committees (MTCs) play a significant role in combating inappropriate medicines use problems. This study explored the extent of the functionality of MTCs in health facilities in Uganda and the associated factors. This was a longitudinal assessment that utilised a semistructured questionnaire that was administered through face-to-face interviews. Panel data analysis techniques were used to compare results between the two waves. This study utilised the ordered logistic regression model and random effects techniques to determine the factors influencing the functionality of MTCs. Overall, the percentage of health facilities with a functional MTC significantly increased from 8.3% (22/264) in wave one to 20.8% (55/265) in wave two (p-value = 0.000). The percentage of MTCs that are partially functioning increased from 15.2% (40/264) in wave one to 29.1% (77/265) in wave two. The percentage of HFs with MTC structures increased from 2.6% to 42.6% in wave two. Health facilities without an MTC significantly reduced from 72% (190/264) in wave one to 7.6% (20/265) in wave two (p-value = 0.0000). The median number of MTC members significantly increased from 13 in wave one to 15 members in wave two (p-value = 0.0112). Level of care, availability of guidelines, availability of subcommittees, and MTC members being active were significantly associated with the performance of MTCs (p-value<0.05). The study established a significant improvement in the functionality of MTCs in health facilities attributed to interventions from national medical stores, Uganda’s ministry of health and implementing partners. The study, however, observed little improvement in the full functionality of MTC subcommittees. Continuous medical education interventions should be strengthened at all levels of care.世界卫生组织（World Health Organization）估计，全球使用的所有药物中，约有50%被不合理使用。这主要归因于抗生素的过度使用以及注射剂的滥用等诸多因素。全球范围内，药物与治疗委员会（Medicines and Therapeutic Committees, MTCs）在解决不合理用药问题方面发挥着重要作用。本研究探究了乌干达各卫生机构内药物与治疗委员会的功能发挥程度及其相关影响因素。本研究为纵向评估，采用半结构化问卷通过面对面访谈的方式开展调研。研究运用面板数据分析技术对两轮调研的结果进行对比，并采用有序logistic回归模型与随机效应分析法，以明确影响药物与治疗委员会功能发挥的相关因素。总体而言，拥有功能完善的药物与治疗委员会的卫生机构占比从第一轮调研的8.3%（22/264）显著提升至第二轮调研的20.8%（55/265）（p值=0.000）。部分功能运转的药物与治疗委员会占比从第一轮的15.2%（40/264）升至第二轮的29.1%（77/265）。设立药物与治疗委员会架构的卫生机构占比从2.6%提升至第二轮的42.6%。未设立药物与治疗委员会的卫生机构占比从第一轮的72%（190/264）大幅降至第二轮的7.6%（20/265）（p值=0.0000）。药物与治疗委员会成员的中位数数量从第一轮的13人显著增至第二轮的15人（p值=0.0112）。照护层级、指南可及性、小组委员会设立情况以及药物与治疗委员会成员的活跃程度，均与药物与治疗委员会的履职表现存在显著关联（p值<0.05）。研究发现，得益于乌干达国家药品仓库、乌干达卫生部及合作实施方的干预措施，各卫生机构内药物与治疗委员会的功能运转得到了显著改善。但研究同时观察到，药物与治疗委员会下属小组委员会的完全运转情况改善甚微。应在各级照护体系中强化持续性医学教育干预措施。