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.

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.

Leadership of change in South Africa public sector turnarounds

2018 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mampe Kumalo ◽  
Caren Brenda Scheepers
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Current Literature ◽  
Organisational Change ◽  
Director General ◽  
Change Processes ◽  
Structured Interviews ◽  
Content Type ◽  
The Public ◽  
Financial Consequences

PurposeOrganisational decline has far-reaching, negative emotional and financial consequences for staff and customers, generating academic and practitioner interest in turnaround change processes. Despite numerous studies to identify the stages during turnarounds, the findings have been inconclusive. The purpose of this paper is to address the gap by defining these stages, or episodes. The characteristics of leaders affect the outcome of organisational change towards turnarounds. This paper focusses, therefore, on the leadership requirements during specific episodes, from the initial crisis to the full recovery phases.Design/methodology/approachA total of 11 semi-structured interviews were conducted with executives from the public sector in South Africa who went through or were going through turnaround change processes and 3 with experts consulting to these organisations.FindingsContrary to current literature in organisational change, this study found that, in these turnaround situations, leadership in the form of either an individual CEO or director general was preferable to shared leadership or leadership distributed throughout the organisation. This study found four critical episodes that occurred during all the public service turnarounds explored, and established that key leadership requirements differ across these episodes. The study shows how these requirements relate to the current literature on transactional, transformational and authentic leadership.Practical implicationsThe findings on the leadership requirements ultimately inform the selection and development of leaders tasked with high-risk turnaround change processes.Originality/valueFour episodes with corresponding leadership requirements were established in the particular context of public sector turnaround change processes.

scholarly journals South African Renal Registry Annual Report 2018

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
M. Razeen Davids ◽  
Thabiet Jardine ◽  
Nicola Marais ◽  
Julian C. Jacobs ◽  
Sajith Sebastian
Keyword(s):  
Public Sector ◽  
South African ◽  
Annual Report ◽  
Population Group ◽  
Healthcare Sector ◽  
Western Cape ◽  
The South ◽  
The Public ◽  
Number Of Patients ◽  
Kidney Replacement Therapy

The seventh annual report of the South African Renal Registry summarises the 2018 data on kidney replacement therapy (KRT) for patients with kidney failure in South Africa. In December 2018, the number of patients who were being treated with chronic dialysis or transplantation stood at 10 730, a prevalence of 186 per million population (pmp). Most patients are treated with haemodialysis in the private healthcare sector, where the prevalence was 839 pmp. In the public sector, which serves 85% of the South African population, the prevalence of KRT (67 pmp) remained below the level reported for 1994. Limpopo and Mpumalanga remain the most under-served provinces and Blacks the most under-served population group. The Western Cape province had the highest public sector treatment rates by a large margin and was also where most of the country’s public sector kidney transplants were performed.

How well does Malaysia achieve value for money in public sector purchasing of medicines? Evidence from medicines procurement prices from 2010 to 2014

2020 ◽  
Author(s):  
Nurhafiza Md Ham ◽  
Prasadini N Perera ◽  
Ravindra P Rannan-Eliya
Keyword(s):  
Public Sector ◽  
Price Competition ◽  
Public Procurement ◽  
Weighted Average ◽  
Access To Medicines ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Continuous Increase ◽  
The Public ◽  
Pharmaceutical Procurement

Abstract Background Malaysia’s public healthcare sector provides a greater volume of medicines at lower overall cost, indicating its importance in providing access to medicines for Malaysians. However, the Ministry of Health (MOH), as the main healthcare provider, has concerns about the continuous increase in the public sector medicines budget, and achieving efficiencies in medicines procurement is an important goal. The objectives of this study were to assess the overall trend in public sector pharmaceutical procurement efficiency from 2010 to 2014, and determine if the three different ways in which MOH procures medicines influences efficiency.Methods We matched medicines from the public sector procurement report by medicine formulation to medicines with a Management Sciences for Health (MSH) International Reference Price (IRP) for each year. Price ratios were calculated, and utilizing the information on quantity and expenditure for each product, summary measures of procurement efficiency were reported as quantity- and expenditure-weighted average price ratios (WAPRs) for each year. Utilizing MOH procurement data to obtain information on procurement type, a multiple regression analysis, controlling for a number of factors that can influence prices, assessed whether procured efficiency (relative to IRPs) differed by MOH procurement type.Results Malaysia’s public sector purchased medicines at two to three times the IRP throughout the study period. However, procurement prices were relatively stable in terms of WAPRs each year (2.2 and 3.2 in 2010 to 1.9 and 2.9 in 2014 for quantity and expenditure WAPRs, respectively). Procurement efficiency did not vary between the three different methods of MOH procurement. Procurement efficiency of both imported innovators and imported generics were significantly lower ( P <0.001 and P <0.01) than local generic products, and medicine source and category influenced the procurement efficiency of each MOH procurement mechanism.Conclusion The design of different medicines procurement mechanisms, along with the balance of interests that Malaysia has sought to achieve in its public procurement procedures, have not been able to achieve lower public sector medicines procurement prices (relative to IRP). Introducing pooled procurement options along with continuous monitoring of procurement efficiency and exploring ways to improve price competition among local and foreign suppliers is recommended.

Public sector entrepreneurship in South Africa

2019 ◽  
Vol 8 (4) ◽  
pp. 500-512
Author(s):  
Boris Urban ◽  
Mmapoulo Lindah Nkhumishe
Keyword(s):  
South Africa ◽  
Public Sector ◽  
South African ◽  
Middle Level ◽  
Primary Data ◽  
Content Type ◽  
The Public ◽  
Provision Of Services ◽  
Efficiency And Effectiveness ◽  
Organisational Factors

Purpose Many unanswered questions remain regarding the authors’ understanding of how entrepreneurship can be fostered in the public sector. To fill this knowledge gap, the purpose of this paper is to conduct an empirical investigation to determine the relationship between different organisational factors and entrepreneurial orientation (EO) in the South African public sector. Design/methodology/approach Primary data are sourced from middle-level managers at municipalities in the three largest provinces across South Africa. Hypotheses are statistically tested using regression analyses. Findings Results reveal that the organisational antecedents of structure and culture explain a significant amount of variation in the EO dimensions of innovativeness, risk taking and proactiveness. Additionally, the findings on organisational rewards converge with an emerging stream of research which highlights that while rewards works well to motivate individuals in the private sector, they are negatively correlated with entrepreneurship in the public sector. Research limitations/implications The study implications relate to the efficiency and effectiveness of service delivery of municipalities in South Africa. Due to increases in community protest actions, it is necessary not only to maximise efficiency in the provision of services, but also to innovate and be proactive in order to achieve more with less resources. Originality/value By investigating previously unrelated factors in the public sector, the authors create closer conceptual and empirical links between the role of organisational factors and each of the EO dimensions. Furthermore, the study takes place in a relatively under-researched entrepreneurship and public sector context.

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