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 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 Impact of National Drug Pricing Policy 2018 on access to medicines in Lahore division, Pakistan: a pre-post survey study using WHO/HAI methodology

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e034720
Author(s):  
Amna Saeed ◽  
Hamid Saeed ◽  
Zikria Saleem ◽  
Caijun Yang ◽  
Minghuan Jiang ◽  
...  
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Standard Treatment ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Drug Pricing ◽  
Pricing Policy ◽  
The Public ◽  
National Drug ◽  
The Mean

ObjectiveTo evaluate the impact of new National Drug Pricing Policy (NDPP) 2018 on access to medicines in terms of prices, availability and affordability.DesignTwo cross-sectional surveys were undertaken before and after the launch of NDPP 2018, using a modified WHO/Health Action International (WHO/HAI) methodology.SettingFour districts of Lahore division, Pakistan.Participants16 public sector hospitals and 16 private sector retail pharmacies.MeasuresThe pre and post survey data on prices and availability of lowest price generics (LPGs) and originator brands (OBs) of 50 medicines were obtained by visiting the same public and private sector health facilities (n=32). Out of 50, 46 surveyed medicines were from the National Essential Medicines List. Inflation-adjusted median unit prices (MUPs) and median price ratios (MPRs) from 2019 were used for price comparison. Affordability was calculated in terms of number of days’ wages required to get a standard treatment by the lowest paid unskilled government worker.ResultsThe overall mean percent availabilities remained poor in both years, that is, far less than 80%. In the public sector, the mean percent availability of OBs improved from 6.8% to 33.1%, whereas, in the case of LPGs, it was reduced from 35.1% to 9%. In the private sector, the mean percent availability of both OBs and LPGs demonstrated slight improvements in 2019, that is, 55.0%–58.3% and 20.3%–32.3%. The adjusted MUPs and MPRs of OBs significantly increased by a median of 4.29% (Wilcoxon test p=0.001, p=0.0001), whereas the adjusted MUPs and MPRs of LPGs increased by a median of 15.7% (p=0.002, p=0.0002). Overall, the affordability of many medicines for common ailments was reduced significantly in 2019.ConclusionsThe availability of medicines slightly improved, except in the case of LPGs, which was reduced in the public sector. The implementation of NDPP 2018 led to increase in drug prices, making the standard treatment for some of the most prevalent ailments unaffordable. So verily, the drug pricing policy must be reviewed to ensure access to essential medicines.

scholarly journals Availability, prices and affordability of essential medicines: A cross-sectional survey in Hanam province, Vietnam

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260142
Author(s):  
Huong Thi Thanh Nguyen ◽  
Dai Xuan Dinh ◽  
Trung Duc Nguyen ◽  
Van Minh Nguyen
Keyword(s):  
Public Sector ◽  
Urban Areas ◽  
Health Facilities ◽  
Essential Medicines ◽  
World Health ◽  
Price Ratio ◽  
The Public ◽  
Private Medicine ◽  
The Mean ◽  
Medicine Outlets

Objective To measure medicines’ prices, availability, and affordability in Hanam, Vietnam. Methods The standardized methodology developed by the World Health Organization (WHO) and Health Action International was used to survey 30 essential medicines (EMs) in 30 public health facilities and 35 private medicine outlets in 2020. The availability of medicine was computed as the percentage of health facilities in which this medicine was found on the data-collection day. International reference prices (IRPs) from Management Sciences for Health (2015) were used to compute Median Price Ratio (MPR). The affordability of treatments for common diseases was computed as the number of days’ wages of the lowest-paid unskilled government worker needed to purchase medicines prescribed at a standard dose. Statistic analysis was done using R software version 4.1.1. Results The mean availability of originator brands (OBs) and lowest-priced generics (LPGs) was 0.7%, 63.2% in the public sector, and 13.7%, 47.9% in the private sector, respectively. In private medicine outlets, the mean availability of both OBs and LPGs in urban areas was significantly higher than that in rural areas (p = 0.0013 and 0.0306, respectively). In the public sector, LPGs’ prices were nearly equal to their IRPs (median MPRs = 0.95). In the private medicine outlets, OBs were generally sold at 6.24 times their IRPs while this figure for LPGs was 1.65. The affordability of LPGs in both sectors was good for all conditions, with standard treatments costing a day’s wage or less. Conclusion In both sectors, generic medicines were the predominant product type available. The availability of EMs was fairly high but still lower than WHO’s benchmark. A national-scale study should be conducted to provide a comprehensive picture of the availability, prices, and affordability of EMs, thereby helping the government to identify the urgent priorities and improving access to EMs in Vietnam.

scholarly journals Evaluation of rational prescribing and dispensing of medicines in Mali

2017 ◽  
Author(s):  
Yaya Coulibaly ◽  
Fanta Sangho ◽  
Aboubacar Alassane Oumar
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Treatment Guidelines ◽  
Generic Drugs ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
The Public ◽  
Quality Of Prescribing

Objective: The drug policy of Mali is based on the concept of essential generic drugs. The adoption of generic drugs in a program is often accompanied by irrational use of these drugs precisely because of the availability of these drugs. Thus, this study was initiated to assess the quality of prescribing and dispensing drugs in Mali. Methods: This is a descriptive cross-sectional study was conducted from 2004 to 2013, the survey was conducted in 20 primary health centers and 20 private pharmacies in three regions of the country. In each of these structures, 30 prescriptions filled at the time of the survey were collected. Results: The average number of drugs per prescription was 3.0 ± 1.3 and 2.4 ± 1.2, respectively, in the public and private sectors. Prescription of drugs under international name was 91.6% in the public sector and 37.2% in the private sector. The public sector prescribed 33.7% of injectable drug against 16.2% in the private sector (p <0.001). The average cost of a prescription was lower in the public sector (3415.3 FCFA or 5.21euros) than in the private sector (7111 FCFA or 10.85 euros).Conclusion: Generic drugs are commonly used in the public, but much less in the private sector. The treatment guidelines are already available, should be introduced interactively to medical practitioners, through visits and intensive supervision by more experienced managers in the hierarchy, it would be likely to improve the quality of prescribing practitioners.

scholarly journals Tuberculosis control activities in the private and public health sectors of Kenya from 2013 to 2017: how do they compare?

2019 ◽  
Vol 113 (12) ◽  
pp. 740-748
Author(s):  
Eunice W Mailu ◽  
Philip Owiti ◽  
Serge Ade ◽  
Anthony D Harries ◽  
Marcel Manzi ◽  
...  
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Nutritional Assessment ◽  
Treatment Success ◽  
Cross Sectional Study ◽  
Sputum Smear ◽  
Cross Sectional ◽  
The Public ◽  
For Profit ◽  
Private And Public

Abstract Background Large numbers of tuberculosis (TB) patients seek care from private for-profit providers. This study aimed to assess and compare TB control activities in the private for-profit and public sectors in Kenya between 2013 and 2017. Methods We conducted a retrospective cross-sectional study using routinely collected data from the National Tuberculosis, Leprosy and Lung Disease Program. Results Of 421 409 patients registered and treated between 2013 and 2017, 86 894 (21%) were from the private sector. Data collection was less complete in the private sector for nutritional assessment and follow-up sputum smear examinations (p&lt;0.001). The private sector notified less bacteriologically confirmed TB (43.1% vs 52.6%; p&lt;0.001) and had less malnutrition (body mass index &lt;18.5 kg/m2; 36.4% vs 43.3%; p&lt;0.001) than the public sector. Rates of human immunodeficiency virus (HIV) testing and antiretroviral therapy initiation were &gt;95% and &gt;90%, respectively, in both sectors, but more patients were HIV positive in the private sector (39.6% vs 31.6%; p&lt;0.001). For bacteriologically confirmed pulmonary TB, cure rates were lower in the private sector, especially for HIV-negative patients (p&lt;0.001). The private sector had an overall treatment success of 86.3% as compared with the public sector at 85.7% (p&lt;0.001). Conclusions The private sector is performing well in Kenya although there are programmatic challenges that need to be addressed.

Patterns in the Delivery of Psychiatric Care in Saskatchewan 1971–1972: Part III: Patient Socio-Demographic and Medical Characteristics

1977 ◽  
Vol 22 (5) ◽  
pp. 215-223 ◽  
Author(s):  
Carl D'Arcy
Keyword(s):  
Health Care ◽  
Public Sector ◽  
Private Sector ◽  
Delivery System ◽  
Urban Areas ◽  
Psychiatric Care ◽  
Care Delivery ◽  
Psychiatric Inpatient ◽  
The Public ◽  
Private And Public

This paper is one of several examining he variety of patterns in the delivery of psychiatric health care in the Province of Saskatchewan during 1971 and 1972. Previous papers dealt with an overview of service sectors, patient volumes, types of contacts and some patients career characteristics. This paper deals with sociodemographic and medical characteristics of patients treated in the various sectors of the psychiatric care delivery system in Saskatchewan. The private and public psychiatric care delivery systems deal with essentially separate psychiatric populations. These differ in volume, in type of psychiatric disorder, in socio-demographic characteristics and in patient career characteristics. The “private” sector saw proportionately more females in the 20-39 year age group, whereas the public sector saw proportionately more males and females in the 0-19 year age category. The “private” sector also treated more people in rural, village and town areas whereas the public sector appeared to be more city-based. General practitioners were more active in rural and small towns, while psychiatrists tended to be more active in the larger urban areas. This reflects the general practitioner's role as a primary health care source. The vast majority of private sector patients were seen for neurotic and psychosomatic disorders. The public sector patients included those treated for the more intractable schizophrenic, organic, affective, and neurotic depression diagnoses. Comparative data on both the private and public sectors show considerable increases in the volume of services being delivered. Previous data demonstrate a relatively strong relationship between availability of psychiatric services and utilization rates within a region. It would appear that the presence of a psychiatric inpatient facility serves an educative function and increases the volume of general practitioner treatment for psychiatric problems. The present data indicate that the majority of persons seen for psychiatric reasons by medical practitioners in Saskatchewan suffer from relatively minor psychiatric ailments. Therefore, we must question the suitability of the present service delivery system. Is there a need to screen out “medical problems” from “problems of living” which may be better treated by non-medically-oriented counselling services, thus freeing some of the medically-skilled manpower to focus on better and more comprehensive care for the more intractable mental disorders?

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.

Gender wage differential in private and public sector employment

2016 ◽  
Vol 31 (3) ◽  
pp. 222-248 ◽  
Author(s):  
Verena Tandrayen-Ragoobur ◽  
Rajeev Pydayya
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Wage Differential ◽  
Wage Gap ◽  
Wage Distribution ◽  
Economic Sectors ◽  
Cross Sectional ◽  
Public And Private ◽  
Content Type ◽  
The Public

Purpose This paper aims to analyse the magnitude of the gender wage disparity in the public and private sectors in Mauritius across both mean differentials and overall wage distribution. The paper then decomposed the gender wage differential using the Oaxaca and Blinder (1973) decomposition technique. Design/methodology/approach The study uses cross-sectional data from the Continuous Multi-Purpose Household Budget Survey (CMPHS), from 2006 to 2013. The sample size on average is around 12,000 households surveyed per year. Findings The results reveal that that gender wage differentials are prevalent in both economic sectors; however, the disparity is more pronounced in the private sector. In addition, the differences in wages are larger at the bottom compared to the top end of the wage distribution, suggesting the presence of sticky floors. Lastly, it was observed that the unexplained wage gap (discrimination) is higher in the private sector than in public sector across the years. Originality/value The literature on the gender wage gap in Africa is limited. This paper adds to the existing literature on gender wage differential with an analysis of the gender wage disparity across the public and private sectors in Mauritius.

scholarly journals ASSOCIATION OF PROLONG SITTING WITH COMMON MUSCULOSKELETAL DISORDERS AMONG PRIVATE AND PUBLIC SECTOR BANKERS

2013 ◽  
Vol 2 (2) ◽  
pp. 32-37
Author(s):  
Mahmooda Naqvi ◽  
Maryum Zehra ◽  
Ghazala Noor Nizami
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Musculoskeletal Disorders ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Public ◽  
Public Sector Banks ◽  
Private And Public ◽  
One Year ◽  
Study Participants

To compare the frequency of common musculoskeletal disorders due to prolong sitting among private and public sector bankers. This study was a cross-sectional study. Participants between 25-50 years of age, working in banks for more than one year were inducted in the study. All bankers were divided into private and public sector groups. Employees were selected from private sector and public sector banks of Karachi. Self-administered questionnaire was used to collect data from bankers of both sectors. The study shows that 44.6% government employees were suffering from shoulder pain, while 36.9% private sector bankers having this problem. Among them 18.2% of public sector bankers suffered from neck pain. However, only 9% of public sector bankers perform gym activity regularly. The result of the study shows that, participants who work for prolong period of time adapted poor posture while sitting have high frequency of musculoskeletal disorders. The study also shows that private sector bankers are more vigilant about their health and posture as compared to the public sector bankers.

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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