scholarly journals Variation in the availability and cost of essential medicines for non-communicable diseases in Uganda: A descriptive time series analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0241555
Author(s):  
Mari Armstrong-Hough ◽  
Srish Sharma ◽  
Sandeep P. Kishore ◽  
Ann R. Akiteng ◽  
Jeremy I. Schwartz
Keyword(s):  
Descriptive Analysis ◽  
Communicable Diseases ◽  
Essential Medicines ◽  
Cross Sectional ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
For Profit ◽  
Middle Income Countries ◽  
The Cost ◽  
Over Time

Background Availability of essential medicines for non-communicable diseases (NCDs) is poor in low- and middle-income countries. Availability and cost are conventionally assessed using cross-sectional data. However, these characteristics may vary over time. Methods We carried out a prospective, descriptive analysis of the availability and cost of essential medicines in 23 Ugandan health facilities over a five-week period. We surveyed facility pharmacies in-person up to five times, recording availability and cost of 19 essential medicines for NCDs and four essential medicines for communicable diseases. Results Availability of medicines varied substantially over time, especially among public facilities. Among private-for-profit facilities, the cost of the same medicine varied from week to week. Private-not-for-profit facilities experienced less dramatic fluctuations in price. Conclusions We conclude that there is a need for standardized, continuous monitoring to better characterize the availability and cost of essential medicines, understand demand for these medicines, and reduce uncertainty for patients.

scholarly journals Variation in the Availability and Cost of Essential Medicines for Non-Communicable Diseases in Uganda: a descriptive time series analysis

2020 ◽  
Author(s):  
Mari Armstrong-Hough ◽  
Srish Sharma ◽  
Sandeep P. Kishore ◽  
Ann R Akiteng ◽  
Jeremy I. Schwartz
Keyword(s):  
Descriptive Analysis ◽  
Communicable Diseases ◽  
Essential Medicines ◽  
Cross Sectional ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
For Profit ◽  
Middle Income Countries ◽  
The Cost ◽  
Over Time

AbstractBackgroundAvailability of essential medicines for non-communicable diseases (NCDs) is poor in low- and middle-income countries. Availability and cost are conventionally assessed using cross-sectional data. However, these characteristics may vary over time.MethodsWe carried out a prospective, descriptive analysis of the availability and cost of essential medicines in 23 Ugandan health facilities over a five-week period. We surveyed facility pharmacies in-person up to five times, recording availability and cost of 19 essential medicines for NCDs and four essential medicines for communicable diseases.ResultsAvailability of medicines varied substantially over time, especially among public facilities. Among private-for-profit facilities, the cost of the same medicine varied from week to week. Private-not-for-profit facilities experienced less dramatic fluctuations in price.ConclusionsWe conclude that there is a need for standardized, continuous monitoring to better characterize the availability and cost of essential medicines, understand demand for these medicines, and reduce uncertainty for patients.

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 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.

scholarly journals Multimorbidity of chronic non-communicable diseases: burden, care provision and outcomes over time among patients attending chronic outpatient medical care in Bahir Dar, Ethiopia—a mixed methods study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051107 ◽  
Author(s):  
Fantu Abebe Eyowas ◽  
Marguerite Schneider ◽  
Shitaye Alemu ◽  
Fentie Ambaw Getahun
Keyword(s):  
Quantitative Study ◽  
Qualitative Data ◽  
Premature Mortality ◽  
Evidence Base ◽  
Communicable Diseases ◽  
Bahir Dar ◽  
Multiple Sources ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Over Time

IntroductionMultimorbidity refers to the presence of two or more chronic non-communicable diseases (NCDs) in a given individual. It is associated with premature mortality, lower quality of life (QoL) and greater use of healthcare resources. The burden of multimorbidity could be huge in the low and middle-income countries (LMICs), including Ethiopia. However, there is limited evidence on the magnitude of multimorbidity, associated risk factors and its effect on QoL and functionality. In addition, the evidence base on the way health systems are organised to manage patients with multimorbidity is sparse. The knowledge gleaned from this study could have a timely and significant impact on the prevention, management and survival of patients with NCD multimorbidity in Ethiopia and in LMICs at large.Methods and analysisThis study has three phases: (1) a cross-sectional quantitative study to determine the magnitude of NCD multimorbidity and its effect on QoL and functionality, (2) a qualitative study to explore organisation of care for patients with multimorbidity, and (3) a longitudinal quantitative study to investigate disease progression and patient outcomes over time. A total of 1440 patients (≥40 years) on chronic care follow-up will be enrolled from different facilities for the quantitative studies. The quantitative data will be collected from multiple sources using the KoBo Toolbox software and analysed by STATA V.16. Multiple case study designs will be employed to collect the qualitative data. The qualitative data will be coded and analysed by Open Code software thematically.Ethics and disseminationEthical clearance has been obtained from the College of Medicine and Health Sciences, Bahir Dar University (protocol number 003/2021). Subjects who provide written consent will be recruited in the study. Confidentiality of data will be strictly maintained. Findings will be disseminated through publications in peer-reviewed journals and conference presentations.

scholarly journals A comprehensive capacity assessment tool for non-communicable diseases in low- to middle-income countries: development and results of pilot testing

2016 ◽  
Vol 25 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Isabel Garcia de Quevedo ◽  
Felipe Lobelo ◽  
Loren Cadena ◽  
Madalena Soares ◽  
Michael Pratt
Keyword(s):  
Assessment Tool ◽  
Public Health Problem ◽  
Premature Mortality ◽  
Communicable Diseases ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
Care Services ◽  
Primary Care Services ◽  
Challenges And Opportunities

Non-communicable diseases (NCDs) are the leading causes of death worldwide, with higher rates of premature mortality in low- and middle-income countries (LMICs). This places a high economic burden on these countries, which usually have limited capacity to address this public health problem. We developed a guided self-assessment tool for describing national capacity for NCD prevention and control. The purpose of this tool was to assist countries in identifying key opportunities and gaps in NCD capacity. It was piloted in three countries between 2012 and 2013: Mozambique, Colombia, and the Dominican Republic. The tool includes details about NCD burden; health system infrastructure and primary care services; workforce capacity; surveillance; planning, policy, and program management; and partnerships. In the three pilot countries, the tool helped to identify differences in capacity needs pertaining to staff, training, and surveillance, but similarities were also found related to NCD challenges and opportunities. The NCD tool increased our understanding of needs and critical capacity elements for addressing NCDs in the three pilot countries. This tool can be used by other LMICs to map their efforts toward addressing NCD goals and defining priorities.

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