scholarly journals Availability and affordability of children essential medicines in health facilities of southern nations, nationalities, and people region, Ethiopia: key determinants for access

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tefera Tadesse ◽  
Habtamu Abuye ◽  
Gizachew Tilahun
Keyword(s):  
Essential Medicine ◽  
Health Facilities ◽  
Essential Medicines ◽  
High Price ◽  
Unskilled Worker ◽  
Price Ratio ◽  
Cross Sectional ◽  
The Public ◽  
The Right ◽  
Medicine Outlets

Abstract Background Children in resource-limited countries are more likely to die from treatable conditions than those in higher resource settings due to a lack of the right essential medicine at the right time. Globally millions of children die every year from conditions that could be treatable with existing medicines before they reach their fifth birthday. This study aimed in assessing the availability and affordability of essential medicine for children in selected health facilities of southern nations, nationalities, and peoples’ regions (SNNPR), Ethiopia. Method A medicine outlets-based cross-sectional study was conducted to assess the availability, affordability, and prices of the 30 selected essential medicines (EMs) for children in 30 public and 30 private medicine outlets in SNNPR from March 29 to May 5, 2019, applying WHO and Health Action International (HAI) tools. Availability was expressed as the percentage of sampled medicine outlets per sector that the surveyed medicine was found on the day of data collection. The amount of daily wages required for the lowest-paid government unskilled worker (LPGW) to buy one standard treatment of an acute condition or treatment for a chronic condition for a month was used to measure affordability and median price ratio for the price of EMs. The results Availability varied by sector, type of medication, and level of health facilities. The average availability of EM was 57.67% for the public sector and 53.67% for the private sector. Ceftriaxone, SOR, zinc sulfate, and cotrimoxazole were the most widely available types of medications in the two sectors. The median price ratios (MPR) for the cheapest drugs LP were 1.26 and 2.24 times higher than their International Reference Price (IRP) in the public and private sectors respectively. Eighty-two percent of LP medicines in the public and 91 % of LP medicines in the private sectors used in the treatments of prevalent common conditions in the region were unaffordable as they cost a day’s or more wages for the LPGW. Conclusion Availability, affordability, and price are determinant pre-requisite for EMs access. According to the current work, although fair availability was achieved, the observed high price affected affordability and hence access to EMs.

scholarly journals Availability and Affordability of Children Essential Medicines in Health Facilities of Southern Nations, Nationalities, And People Region, Ethiopia: Key Determinants for Access.

2020 ◽  
Author(s):  
Tefera Tadesse ◽  
Habtamu Abuye L ◽  
Gizachew Tilahun
Keyword(s):  
Essential Medicine ◽  
Health Facilities ◽  
Essential Medicines ◽  
High Price ◽  
Unskilled Worker ◽  
Price Ratio ◽  
Cross Sectional ◽  
The Public ◽  
The Right ◽  
Medicine Outlets

Abstract Background: Children in resource-limited countries are more likely to die from treatable conditions than those in higher resource settings due to a lack of the right essential medicine at the right time. Globally millions of children die every year from conditions that could be treatable with existing medicines before they reach their fifth birthday. This study aimed in assessing the availability and affordability of essential medicine for children in selected health facilities of southern nations, nationalities, and peoples’ regions (SNNPR), Ethiopia. Method: A medicine outlets-based cross-sectional study was conducted to assess the availability, affordability, and prices of the 30 selected EMs for children in 30 public and 30 private medicine outlets in SNNPR from March 29 to May 5, 2019, applying WHO and Health Action International (HAI) tools. Availability was expressed as the percentage of sampled medicine outlets per sector that the surveyed medicine was found on the day of data collection. The number of daily wages required for the lowest-paid government unskilled worker (LPGW) to buy one standard treatment of an acute condition or treatment for a chronic condition for a month was used to measure affordability and median price ratio for the price of EDs. Results: Availability was varied by sectors, type of medicines, and level of health facilities. The average availability of EMs was 57.67% in the public sector and 53.67% in private sectors. Ceftriaxone, ORS, zink sulfate, and cotrimoxazole were the most widely available medicine types in both sectors. The median price ratios (MPR) for lowest-priced (LP) medicines were 1.26 and 2.24 times higher than their international reference price (IRP) in the public and private sectors respectively. Eighty-two percent of LP medicines in the public and ninety-one percent of LP medicines in the private sectors used in the treatments of prevalent common conditions in the region were unaffordable as they cost a day’s or more wages for the LPGW.Conclusion: Availability, affordability, and price are determinant pre-requisite for EMs access. According to the current work, although fair availability was achieved, the observed high price affected affordability and hence access to EMs.

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 Availability and prices of medicines for non-communicable diseases at health facilities and retail drug outlets in Kenya: a cross-sectional survey in eight counties

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035132 ◽  
Author(s):  
Paul G Ashigbie ◽  
Peter C Rockers ◽  
Richard O Laing ◽  
Howard J Cabral ◽  
Monica A Onyango ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Essential Medicines ◽  
Price Ratio ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Non Profit ◽  
For Profit ◽  
The Mean

ObjectivesThe objective of this study was to determine the availability and prices of medicines for non-communicable diseases (NCDs) in health facilities and private for-profit drug outlets in Kenya.DesignCross-sectional study.MethodsAll public and non-profit health facilities in eight counties (Embu, Kakamega, Kwale, Makueni, Narok, Nyeri, Samburu and West Pokot) that purchased medicines from the Mission for Essential Drugs and Supplies, a major wholesaler, were surveyed in September 2016. For each health facility, one nearby private for-profit drug outlet was also surveyed. Data on availability and price were analysed for 24 NCD and 8 acute medicine formulations. Availability was analysed separately for medicines in the national Essential Medicines List (EML) and those in the Standard Treatment Guidelines (STGs). Median price ratios were estimated using the International Medical Products Price Guide as a reference.Results59 public and 78 non-profit facilities and 135 drug outlets were surveyed. Availability of NCD medicines was highest in private for-profit drug outlets (61.7% and 29.3% for medicines on the EML and STGs, respectively). Availability of STG medicines increased with increasing level of care of facilities: 16.1% at dispensaries to 31.7% at secondary referral facilities. The mean proportion of availability for NCD medicines listed in the STGs (0.25) was significantly lower than for acute medicines (0.61), p<0.0001. The proportion of public facilities giving medicines for free (0.47) was significantly higher than the proportion of private non-profit facilities giving medicines for free (0.09) (p<0.0001). The mean price ratio of NCD medicines was significantly higher than for acute medicines in non-profit facilities (4.1 vs 2.0, respectively; p=0.0076), and in private for-profit drug outlets (3.5 vs 1.7; p=0.0013).ConclusionPatients with NCDs in Kenya appear to have limited access to medicines. Increasing access should be a focus of efforts to achieve universal health coverage.

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 A Study on Service Availability and Readiness Assessment of Non-Communicable Diseases Using the WHO Tool for Gazipur District in Bangladesh

2016 ◽  
Vol 7 (2) ◽  
pp. 1-13 ◽  
Author(s):  
Mohammad Rashemdul Islam ◽  
Shamima Parvin Laskar ◽  
Darryl Macer
Keyword(s):  
Respiratory Disease ◽  
Chronic Respiratory Disease ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Essential Medicines ◽  
Service Availability ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Service Readiness

Non-communicable diseases (NCDs) disproportionately affect low and middle-income countries where nearly three quarters of NCD deaths occur. Bangladesh is also in NCD burden. This cross-sectional study was done on 50 health facilities centres at Gazipur district in Bangladesh from July 2015 to December 2015 to introduce SARA for better monitoring and evaluation of non-communicable diseases health service delivery. The General Service readiness index score was 61.52% refers to the fact that about 62% of all the facilities were ready to provide general services like basic amenities, basic equipment, standard precautions for infection prevention, and diagnostic capacity and essential medicines to the patients. But in case of non-communicable diseases, among all the health facilities 40% had chronic respiratory disease and cardiovascular diseases diagnosis/ management and only 32% had availability of diabetes diagnosis/management. Overall readiness score was 52% in chronic respiratory disease, 73% in cardiovascular disease and 70% in diabetes. Therefore, service availability and readiness of the health facilities to provide NCD related health services were not up to the mark for facing future targets.  A full-scale census survey of all the facilities of the study area would give a better understanding of the availability and service readiness.

Baseline assessment of therapeutic injection practices in Pakistan in 2020: a cross-sectional study

2021 ◽  
pp. 16-21
Author(s):  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Nikhat Iftikar ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  
Keyword(s):  
Public Sector ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Injection Equipment ◽  
Public And Private ◽  
Healthcare Facilities ◽  
The Public ◽  
Injection Safety

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...

scholarly journals Assesssment of Health Facilities for Implementation of Package of Essential Non-communicable Disease in Nepal: Baseline Study in Kailali and Ilam District

2018 ◽  
Vol 16 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Binod Kumar Aryal ◽  
Mohammad Daud ◽  
Ambika Thapa ◽  
Anita Mahotra ◽  
Sudip Ale Magar ◽  
...  
Keyword(s):  
Health Workers ◽  
Communicable Disease ◽  
Action Plan ◽  
Descriptive Analysis ◽  
Health Facilities ◽  
Essential Medicines ◽  
World Health ◽  
Cross Sectional ◽  
Baseline Study ◽  
Non Communicable Disease

Background: Non-communicable Diseases are an alarming public health emergency in Nepal. Owing to the risk of NCD’s in Nepal, Government of Nepal has developed a Multisectoral Action Plan for Non-communicable Disease 2014-2020 and has adopted the World Health Organization Package of Essential Non-communicable Disease protocol. Prior for its implementation in Nepal, baseline study has been carried out to assess the status of health facilities in Nepal.Methods: A descriptive cross-sectional study was carried out in Kailali and Ilam district encompassing a total of 92 health facilities. A set of structured questionnaire and interview guideline was used to obtain the data. Collected data was transferred to Microsoft Excel, cleaned and analyzed in SPSS 16.0. Descriptive analysis was performed to express the frequencies and relative frequencies Results: Of the total health facilities, 49 and 43 health facilities of Ilam and Kailali were interviewed. The hospital of Ilam consisted all the procedure, equipment and medicine for the management of NCDs whilst, health posts lacked Oxygen services. Only 592 posts were fulfilled out of 704 sanctioned post in both the districts of which only 161 were trained in management of NCDs. Atotal of 231 patients were diagnosed with NCDs before the day of study in all the health facilities of both districts. Conclusions: Study reveals the gaps in capacity of health institution and system in terms of training, supply, equipments, and diagnostics. However, training of health workers, supply of essential medicines and improvising the service delivery would supplement the effective implementation of PEN in Nepal.

scholarly journals Essential Medicine and Equipment for Emergency Obstetric and Newborn Care in Zanzibar: Situation at a Glance

2019 ◽  
pp. 1-7
Author(s):  
Andrea B. Pembe ◽  
Bruno Sunguya ◽  
Stella Mushy ◽  
Sebalda Leshabari ◽  
George Kiwango ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Essential Medicine ◽  
Newborn Care ◽  
Newborn Health ◽  
Structure Interview ◽  
Essential Medicines ◽  
Maternal And Newborn Health ◽  
Cross Sectional ◽  
Live Births ◽  
Delivery Services

Background:Maternal and neonatal mortality are unacceptably high in Zanzibar. Maternal mortality and neonatal mortality ratio stand at 350 per 100,000 live births and 29 per 1,000 live births respectively as of 2018. Addressing challenges facing maternal and newborn health requires among others, the assurance of essential medicine and equipment to deliver evidence based interventions. This paper reports evidence gathered on the availability of essential medicines and equipment in providing Emergency Obstetric and Newborn Care (EmoNC) services in Zanzibar. Methods:A cross-sectional mixed methods study design was used to collect information on the availability of drugs and equipment from all health facilities providing delivery services in Zanzibar. Semi-structure interview guide was used to carry in-depth interviews (IDIs) with health facility in-charges while observation on availability of essential medicine and equipment for EmONC was carried using standard observation guide as adopted from Averting Maternal Death and Disability program.

scholarly journals Kemampuan Klinik Pratama dalam Menangani 195 Diagnosis di Kota Surabaya

2021 ◽  
Vol 24 (1) ◽  
pp. 11-19
Author(s):  
Eka Fitria Sari ◽  
Faihatul Mukhbitin ◽  
Ernawaty Ernawaty
Keyword(s):  
Primary Care ◽  
Cost Containment ◽  
Health Department ◽  
Health Facilities ◽  
Cross Sectional ◽  
Primary Care Clinics ◽  
Primary Health ◽  
Clinical Diagnoses ◽  
The Right ◽  
Primary Health Facilities

Head of Surabaya City Health Department Decree No.440/19547/436.3/2016 is based on Indonesian Minister of Health Decree No.HK.02.02/MENKES/514/2015. The regulation explains the need for the management of 195 clinical diagnoses in primary health facilities because it is related to the primary health facilities' capability to handle 195 clinical diagnoses. The RRNS achievement table in January-May 2017 shows that primary care clinics were primary health facilities that occupy the unsafe zone (RRNS>5%) namely 16.68% in Surabaya City. The research objective is to analyze the primary care clinics' capability in Surabaya City to handle the 195 clinical diagnoses. This research used a descriptive cross-sectional design in four primary care clinics with 20 people sampled. The results showed that all clinics had not been able to provide complete services. Clinical doctors had good capabilities in accordance with the Head of Surabaya City Health Department Decree No.440/19547/436.3/2016 but were not supported by the completeness of supply following the Indonesia Minister of Health Decree No.HK.02.02/MENKES/514/2015. In conclusion, only 65 (≤33%) clinical diagnoses can be handled properly with the imbalance between the doctors' capabilities and completeness of supply. This research suggests the regulation makers must also review the primary care clinics' capability to provide supplies and clinics can determine the right cost-containment strategy to handle 195 clinical diagnoses. Abstrak SK Kadinkes Kota Surabaya No.440/19547/436.3/2016 didasari oleh Kepmenkes RI No.HK.02.02/MENKES/514/2015. Peraturan yang menjelaskan tentang kebutuhan penatalaksanaan penanganan 195 diagnosis klinis di FKTP karena berkaitan dengan kemampuan FKTP melakukan penanganan. Tabel pencapaian RRNS bulan Januari-Mei 2017 menunjukkan klinik pratama merupakan jenis FKTP yang paling banyak menempati zona tidak aman (RRNS>5%) yakni 16,68% di Surabaya. Penelitian bertujuan menganalisis kemampuan klinik pratama di Kota Surabaya dalam menangani 195 diagnosis klinis. Penelitian menggunakan desain crosssectional deskriptif di empat klinik pratama dengan sampel 20 orang. Hasil menunjukkan semua klinik yang diteliti belum mampu menyediakan pelayanan secara lengkap. Dokter klinik memiliki kemampuan yang baik sesuai SK Kadinkes Kota Surabaya No.440/19547/436.3/2016 tetapi tidak didukung dengan kelengkapan supply yang dibutuhkan sesuai Kepmenkes RI No.HK.02.02/MENKES/514/2015. Kesimpulannya, diagnosis klinis yang dapat ditangani dengan baik hanya sebanyak 65 (≤33%) dengan hambatan ketidakseimbangan antara kemampuan dokter dan kelengkapan supply. Penelitian ini menyarankan pembuat kebijakan juga meninjau kemampuan klinik dalam menyediakan supply dan klinik dapat menentukan strategi cost containment yang tepat untuk menangani 195 diagnosis klinis.

scholarly journals Health facility preparedness of maternal and neonatal health services: a survey in Jumla, Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pasang Tamang ◽  
Padam Simkhada ◽  
Paul Bissell ◽  
Edwin van Teijlingen ◽  
Rose Khatri ◽  
...  
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Essential Medicine ◽  
Essential Medicines ◽  
Neonatal Health ◽  
Cross Sectional ◽  
The Past ◽  
Ambulance Transport ◽  
Emergency Ambulance ◽  
Maternal And Neonatal Health

Abstract Background Over the past 20 years, Nepal has seen major improvements in childhood and maternal survival. In 2015, the Nepalese government introduced a new federal political structure. It is unclear how this has affected the health system, and particularly, maternal and child health care. Hence, this study aims to describe and analyse health facility preparedness in the light of the federalization process with regards to providing appropriate and timely maternal and neonatal health services. Methods A descriptive cross-sectional study was conducted in Jumla district, Nepal in 2019 covering all 31 state health facilities (HF) to assess the availability of maternal and neonatal health services including appropriate workforce and access to essential medicines. Tests of association between demographic factors and the probability of a facility experiencing a shortage of essential medicine within the last 3 months were also conducted as exploratory procedures. Results Out ot 31 HFs, more than 90% of them had all their staff positions filled. Most facilities (n = 21) had experienced shortages of essential medicines within the past 3 months. The most common out of stock medicine were: Amoxicillin (n = 10); paracetamol (n = 10); Vitamin A (n = 7); and Metronidazole (n = 5). Twenty-two HFs had referred maternal and newborn cases to a higher centre within the past 12 months. However, more worryingly, twenty HFs or their catchment communities did not have emergency ambulance transport for women and newborns. Conclusion HFs reported better staffing levels than levels of available drugs. HFs should be supported to meet required minimal standards such as availability of essential medicines and the provision of emergency ambulance transport for women and newborns.

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