scholarly journals Availability, prices and affordability of essential medicines for children: a cross-sectional survey in Jiangsu Province, China

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e023646 ◽  
Author(s):  
Xiaoluan Sun ◽  
Jing Wei ◽  
Yuan Yao ◽  
Qiutong Chen ◽  
Daiting You ◽  
...  
Keyword(s):  
Public Sector ◽  
Jiangsu Province ◽  
Public Hospitals ◽  
Essential Medicines ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Public ◽  
Medicines For Children ◽  
Government Worker

ObjectiveChina has undertaken several initiatives to improve the accessibility of safe and effective medicines for children. The aim was to determine the availability, price and affordability of essential medicines for children.DesignCross-sectional survey.SettingSix cities of Jiangsu Province, China.Participants30 public hospitals and 30 retail pharmacies.Primary and secondary outcome measuresThe WHO/Health Action International standardised methodology was used to collect the availability and price data for 40 essential medicines for children. Availability was measured as the percentage of drug outlets per sector where the individual medicine was found on the day of data collection, and prices were measured as median price ratios (MPRs). Affordability was measured as the number of days’ wages required for the lowest paid unskilled government worker to purchase standard treatments for common conditions.ResultsThe mean availabilities of originator brands (OBs) and lowest priced generics (LPGs) were 7.5% and 34.2% in the public sector and 8.9% and 29.4% in the private sector. The median MPRs of LPGs in both sectors ranged from 1.41 to 2.12 and 1.10 to 2.24, respectively. However, the patient prices of OBs far exceeded the critical level in both sectors, with median MPRs ranging from 2.47 to 8.22. More than half of these LPGs were priced at 1.5 times their international reference prices in the public sector. Most LPGs were affordable for treatment of common conditions in both public and private sectors, as they each cost less than the daily wage for the lowest paid unskilled government worker.ConclusionsAccess to essential medicines for children is hampered by low availability. Further measures to enhance access to paediatric essential medicines should be taken, such as developing a national essential medicine list for children and mobilising the enthusiasm of pharmaceutical firms to develop and manufacture paediatric medicines.

scholarly journals Access to essential medicines for children: a cross-sectional survey measuring medicine prices, availability and affordability in Hanam province, Vietnam

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e051465
Author(s):  
Dai Xuan Dinh ◽  
Huong Thi Thanh Nguyen ◽  
Van Minh Nguyen
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Urban Areas ◽  
Essential Medicines ◽  
Secondary Outcome ◽  
National Study ◽  
Cross Sectional ◽  
The Public ◽  
The Mean ◽  
Medicines For Children

ObjectiveTo identify the availability, prices and affordability of essential medicines for children (cEMs) in Hanam province, Vietnam.DesignCross-sectional study.SettingOne city and five districts of Hanam province.Participants66 public health facilities and 66 private drugstores.Primary and secondary outcome measuresThe standardised methodology of the WHO and Health Action International was used to investigate 30 paediatric essential medicines. For each medicine, data were collected for two products: the lowest-priced medicine (LPM) and the highest-priced medicine (HPM). The availability of medicine was computed as the percentage of facilities in which this medicine was found on the day of data collection. Median prices of individual medicines were reported in local currency. Affordability was calculated as the number of days’ wages required for the lowest-paid unskilled government worker to purchase standard treatments for common diseases. Data were analysed using R software V.4.1.0.ResultsThe mean availability of LPMs in the private sector (33.2%, SD=38.0%) was higher than that in the public sector (24.9%, SD=39.4%) (p<0.05). The mean availability of HPMs was extremely low in both sectors (11.3% and 5.8%, respectively). The mean availability of cEMs in urban areas was significantly higher than that in rural areas (36.5% and 31.6%, respectively, p<0.05). In the public sector, the prices of LPMs were nearly equal to the international reference prices (IRPs). In the private sector, LPMs were generally sold at 4.06 times their IRPs. However, in both sectors, the affordability of LPMs was reasonable for most conditions as standard treatments only cost a day’s wage or less.ConclusionThe low availability was the main reason hindering access to cEMs in Hanam, especially in the countryside. A national study on cEMs should be conducted, and some practical policies should be promulgated to enhance access to cEMs.

scholarly journals Building people up: Leadership and employee resilience

2021 ◽  
Author(s):  
◽  
Esmé Franken
Keyword(s):  
Public Sector ◽  
Convergent Validity ◽  
Mixed Method Research ◽  
Cross Sectional Survey ◽  
Public Servants ◽  
Cross Sectional ◽  
The Public ◽  
The Face ◽  
Definition Of ◽  
Five Phases

<p>This mixed method research, in the area of HR and leadership, explores leadership behaviours that foster employee resilience. Resilience is a key capacity in contexts where job demands and challenges are often dynamic and complex, such as in the public sector. This research uses a contemporary definition of resilience, one that views employee resilience as a set of behaviours that help people grow and develop in their jobs, even in the face of challenges. Two questions guide this research: 1. What leadership behaviours enable employee resilience in the public sector?, and 2. How do these behaviours enable employee resilience? This study is situated in the public sector context.  The research consists of five phases. The first phase was a cross-sectional survey of public servants’ views on whether paradoxical leadership behaviours, mediated by perceptions of organisational support, might foster resilience. These connections reflect the correspondence between paradoxical leadership and the dilemmas and paradoxes that arise in public sector work. Phases two and three concerned a series of qualitative studies which identified further leadership behaviours, as well as possible mechanisms and outcomes, and generated an explanatory framework to illustrate how managers can enable employee resilience. This led to the development of the construct resilience-enabling leadership. Phase four gathered feedback on the construct’s validity so that it could be tested quantitatively in a scale. The fifth and final phase tested the resilience-enabling leadership scale (RELS) as a predictor of resilience. It also tested psychometric properties of the scale, including factor structure, and discriminant and convergent validity.  Findings show that a unique combination of leadership behaviours that foster growth, trust and collaboration in employees, is likely to play a pivotal role in developing employee resilience. The RELS is an innovative contribution to organisational scholarship. It represents a leadership model that recognises the changing nature of leadership and responds to the development needs of employees.</p>

scholarly journals Financial Control Practices and Accountability in the Public Sector in Nigeria

2021 ◽  
Vol 04 (07) ◽  
Author(s):  
Olaoye, Samuel Adebayo ◽  
Keyword(s):  
Public Sector ◽  
Significant Influence ◽  
Management Strategies ◽  
Target Population ◽  
Financial Control ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Public ◽  
Physical Control ◽  
Questionnaire Research

The Nigerian government has for a long time recognized problems relating to mismanagement of public funds evidenced by lack of transparency, poor accountability, corruption, financial leakages and budgeting processes, financial excesses, poor cash management and resource allocation. This is coupled with the fact that there is a near total absence of the notion and ethics of accountability in the conduct of public activities in the country. This study investigates the effects of financial control practices on accountability in Nigeria public sector. This is due to dearth of literature in this area of study. The cross-sectional survey research design was employed, the data were primarily sourced by means of a questionnaire (research instrument) and empirically analyzed. The target population of this study was the staff (2,125) of public/civil servants working in the Accounts and Finance departments of Lagos and Ogun States government Secretariats, Taro Yaman was adopted to arrive at 337 sample size. Data were analyzed using the SPSS 20.0 version software, inferences were made at 5% significant level. The study showed that financial control has a significant influence on accountability of public sector (Adj. R2= 0.468, F(4, 349) = 77.692, P< 0.05). Based on this finding, the concluded that there is significant effect of financial control practices on accountability in the public sector. The study also established that financial control has a significant influence on responsibility of public sector (Adj. R2= 0.141, F(4, 349) = 15.296, P< 0.05). Therefore the study concluded that there is significant effect of financial control practices on responsibility of public sector accountability. The study therefore, concludes that there is a positive significant effect between financial control practices and accountability in public sector. Based on the findings of this study the study recommends that: The existing physical control assets should be strengthened in order to ensure effective financial control and improve on accountability thereafter due to the insignificant effect of physical control of assets has on accountability in public sector. Effective and efficient application of financial control methods and management strategies to accountability in the public sectors will compel each employee to be more serious, focused and loyal in the discharge of their responsibilities.

scholarly journals Building people up: Leadership and employee resilience

2021 ◽  
Author(s):  
◽  
Esmé Franken
Keyword(s):  
Public Sector ◽  
Convergent Validity ◽  
Mixed Method Research ◽  
Cross Sectional Survey ◽  
Public Servants ◽  
Cross Sectional ◽  
The Public ◽  
The Face ◽  
Definition Of ◽  
Five Phases

<p>This mixed method research, in the area of HR and leadership, explores leadership behaviours that foster employee resilience. Resilience is a key capacity in contexts where job demands and challenges are often dynamic and complex, such as in the public sector. This research uses a contemporary definition of resilience, one that views employee resilience as a set of behaviours that help people grow and develop in their jobs, even in the face of challenges. Two questions guide this research: 1. What leadership behaviours enable employee resilience in the public sector?, and 2. How do these behaviours enable employee resilience? This study is situated in the public sector context.  The research consists of five phases. The first phase was a cross-sectional survey of public servants’ views on whether paradoxical leadership behaviours, mediated by perceptions of organisational support, might foster resilience. These connections reflect the correspondence between paradoxical leadership and the dilemmas and paradoxes that arise in public sector work. Phases two and three concerned a series of qualitative studies which identified further leadership behaviours, as well as possible mechanisms and outcomes, and generated an explanatory framework to illustrate how managers can enable employee resilience. This led to the development of the construct resilience-enabling leadership. Phase four gathered feedback on the construct’s validity so that it could be tested quantitatively in a scale. The fifth and final phase tested the resilience-enabling leadership scale (RELS) as a predictor of resilience. It also tested psychometric properties of the scale, including factor structure, and discriminant and convergent validity.  Findings show that a unique combination of leadership behaviours that foster growth, trust and collaboration in employees, is likely to play a pivotal role in developing employee resilience. The RELS is an innovative contribution to organisational scholarship. It represents a leadership model that recognises the changing nature of leadership and responds to the development needs of employees.</p>

scholarly journals Infection prevention and control situation in public hospitals of Islamabad

2020 ◽  
Vol 14 (09) ◽  
pp. 1040-1046
Author(s):  
Saba Savul ◽  
Farida Khurram Lalani ◽  
Aamer Ikram ◽  
Muhammad Amjad Khan ◽  
Mumtaz Ali Khan ◽  
...  
Keyword(s):  
Public Sector ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Public Hospitals ◽  
World Health ◽  
Infection Prevention And Control ◽  
Global Public Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
And Control

Introduction: Healthcare-associated infections represent a global public health challenge and are associated with significant mortality and morbidity. Infection Prevention and Control (IPC) is a neglected area in healthcare facilities across Pakistan. The objective of our study was to elucidate the current state of infection prevention and control practices in public sector hospitals of Islamabad to underscore potential areas for improvement. Methodology: A cross-sectional survey was conducted between November and December 2019 at five public sector hospitals of Islamabad. The World Health Organization’s Infection Prevention and Control Assessment Framework (IPCAF) was used to assess the strengths and weaknesses of hospitals regarding infection prevention and control. Adapted tools derived from Centers for Disease Control and Prevention and Infection Prevention Society were used for detailed assessment of various departments. Data was analyzed using Microsoft Excel 2016. Results: In all five hospitals, the total IPCAF score was less than 200 denoting that infection prevention and control implementation is deficient and significant improvement is needed. The median IPCAF score was 117.5 with an interquartile range of 53.75. With the exception of central sterile services unit at one hospital, departments at all hospitals failed to meet even 50% of required IPC standards. Conclusions: Significant change is needed to improve the existent situation of infection prevention and control in public sector hospitals of Islamabad. This would involve establishment of functional programs, development and implementation of infection prevention and control guidelines and provision of adequate supplies.

scholarly journals Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Caijun Yang ◽  
Shuchen Hu ◽  
Dan Ye ◽  
Minghuan Jiang ◽  
Zaheer-Ud-Din Babar ◽  
...  
Keyword(s):  
Private Sector ◽  
Access To Medicines ◽  
Public Hospitals ◽  
Essential Medicines ◽  
Shaanxi Province ◽  
Price Ratio ◽  
Medicine Price ◽  
Cross Sectional ◽  
The Public ◽  
Health Action

Objectives: To evaluate the price and availability of medicines in China.Methods: A standard methodology developed by WHO and Health Action International was used to collect medicine price and availability data. We obtained cross-sectional data for 48 medicines from 519 facilities (280 public hospitals and 239 private retail pharmacies) in five provinces in China in 2018. We also collected longitudinal data for 31 medicines in Shaanxi Province in 2010, 2012, 2014, and 2018. Medicine price was compared with the international reference price to obtain a median price ratio (MPR). The availability and price in five provinces were compared in matched sets. We used general estimating equations to calculate differences in availability and median prices from 2010 to 2018.Findings: Mean availability of surveyed medicines in five provinces was low in both public (4.29–32.87%) and private sectors (13.50–43.75%). The MPR for lowest priced generics (LPGs) was acceptable (1.80–3.02) and for originator brands (OBs) was much higher (9.14–12.65). The variation was significant for both availability and price of medicines across provinces. In Shaanxi Province, the availability of medicines decreased between 2010 and 2018, but this was not significant in the public or private sector. Compared with 2010, the median adjusted patient price was significantly lower in 2018 for nine OBs (difference −22.4%; p = 0.005) and 20 LPGs (−20.5%; p = 0.046) in the public sector and 10 OBs (−10.2%; p = 0.047) in the private sector.Conclusion: Access to medicines was found to be poor and unequal across China in 2018. Future interventions are needed, and possible strategies include effective and efficient procurement, promoting the development of retail pharmacies and increasing medicine price transparency.

scholarly journals Impact of COVID-19 pandemic on the utilization of routine immunization services in Lebanon

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246951
Author(s):  
Ziad Mansour ◽  
Jinan Arab ◽  
Racha Said ◽  
Alissar Rady ◽  
Randa Hamadeh ◽  
...  
Keyword(s):  
Public Sector ◽  
National Level ◽  
Professional Associations ◽  
Oral Poliovirus Vaccine ◽  
Routine Immunization ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Public ◽  
Increased Risk ◽  
Immunization Services

Introduction The global abrupt progression of the COVID-19 pandemic may disrupt critical life-saving services such as routine immunization (RI), thus increasing the susceptibility of countries to outbreaks of vaccine-preventable diseases (VPDs). Being endemic to several infectious diseases, Lebanon might be at increased risk of outbreaks as the utilization of RI services might have deteriorated due to the pandemic and the country’s political unrest following the October 2019 uprising. The aim of this study was to assess the changes in the utilization of RI services in both the public and private sectors following the COVID-19 pandemic. Methods A self-administered cross-sectional survey was completed electronically, in April 2020, by 345 private pediatricians who are registered in professional associations of physicians in Lebanon and provide immunization services at their clinics. Means of the reported percentages of decrease in the utilization of vaccination services by pediatricians were calculated. As for the public sector, an examination of the monthly differences in the number of administered vaccine doses in addition to their respective percentages of change was performed. Adjustment for the distribution of RI services between the sectors was performed to calculate the national decrease rate. Results The utilization of vaccination services at the national level decreased by 31%. In the private sector, immunization services provision diminished by 46.9% mainly between February and April 2020. The highest decrease rates were observed for oral poliovirus vaccine (OPV) and hepatitis A, followed by measles and pneumococcal conjugate vaccines. The number of vaccine doses administered in the public sector decreased by 20%. The most prominent reductions were detected for the OPV and measles vaccines, and during October 2019 and March 2020. Conclusion The substantial decrease in the utilization of RI as a result of the COVID-19 pandemic requires public health interventions to prevent future outbreaks of VPDs.

scholarly journals The availability of priority medicines for children under 5 years in eThekwini, South Africa

2022 ◽  
Vol 15 (1) ◽  
Author(s):  
Shannice Mahadeo ◽  
Keshmika Narain ◽  
Lungelo Mhlongo ◽  
Desmaine Chetty ◽  
Lindelani Masondo ◽  
...  
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Essential Medicines ◽  
Healthcare Sector ◽  
Unskilled Worker ◽  
The Public ◽  
Global Comparison ◽  
District Hospitals ◽  
Medicines For Children ◽  
Children Under 5

Abstract Background Globally, an estimated 8.1 million children under 5 years die annually in developing countries. Ensuring essential medicines are accessible and affordable to the population is key to saving lives. This study investigated accessibility, availability and affordability of a basket of priority medicines for children under 5 years in public and private healthcare sector pharmacies in the eThekwini Metropolitan area in Durban, South Africa. Methods The WHO/HAI survey tool for assessing medicine prices, availability and affordability was adapted and employed for a basket of WHO Priority life-saving medicines for children under 5 years. Six district hospitals in the north, south and central eThekwini Metropolitan were selected as major facility reference points and for data collection and pharmacies within a 5 km radius from each major facility were also invited to participate in the study, as outlined in the WHO/HAI tool methodology. Of the 58 pharmacies selected, a total of 27 pharmacies from both private and public healthcare sectors agreed to participate and were surveyed, representing a 47% response rate. Data was analysed using Microsoft excel. Results All participating pharmacies (and hence the selected basket of priority medicines at these facilities) were deemed accessible. Overall the public sector had more medicines available on the shelf (averaging 64%) than the private sector (48%) which had more medicines available on order (84%). At least one medicine for each of the eight (8) conditions was available at both sectors which meant patients could be treated for these conditions. Medicines for priority conditions (except HIV, which was a 28-day course) were deemed affordable as these regimens were obtainable within a day’s wage for the lowest paid unskilled worker. Priority medicines for children under 5 years were more available and more affordable in the public sector. Conclusion The basket of WHO essential medicines for priority conditions for children under 5 years were accessible, available and affordable in the eThekwini Metropolitan areas. This was the first study in eThekwini to determine access to the WHO basket of priority medicines for children and can be scaled-up to a national study to provide a holistic comparison of these medicines in the country, and also for global comparison.

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