Availability, price, and affordability of WHO priority maternal and child health medicine in public health facilities of Dessie, north-East Ethiopia

Abstract

Background Access to health care is a fundamental human right, and the provision of affordable, high-quality, and appropriate medicines for maternal and child health is a vital component of a well-functioning health system. The study assessed the availability, price, and affordability of WHO priority maternal and child medicines in public health facilities, Dessie, North-East Ethiopia. Methods A retrospective cross-sectional study design was conducted in Dessie town from November 2018 to February 2019. A standard checklist adapted from the Logistics Indicator Assessment Tool and WHO/HAI was used to collecting data on the availability, affordability, and price of 45 priority life-saving medicines from eight public health centers and two public hospitals. Descriptive statistics (percent and median) were computed for availability and prices. Affordability was reported in terms of the daily wage of the lowest-paid unskilled government worker. Results Twenty-two medicines were not found at all in public health facilities. The overall availability of WHO priority maternal and child medicines was 34.02%. The mean number of stock-outs was 3.9, and the mean number was 128.9 days. The mean average point availability was 33.5%, and 7 medicines stock out on the days of assessment. From WHO priority maternal and child medicines, 4 (40%) of the products were unaffordable and 5 (55.5%) had higher prices than international prices. Ceftriaxone 1 g, ceftriaxone 500 mg, and hydralazine 20 mg injection required wages of 6.58, 8.01, and 5.02 to cover specific maternal health problems respectively. The median price ratio of priority lifesaving maternal and child medicines in public health facilities ranged from 0.65 to 3.19. Conclusions The average mean period and point mean availability was very low. The available products were encountered with a high number of stock-outs and unaffordable. The strict control of inventory is recommended to have a steady supply of these essential medicines and improve the quality of health services.

Accessibility of Medicines for Children: A Systematic Review

“…Eventually, a total of 18 studies were enrolled in this systematic review (Figure 1). The 18 included studies were all multicenter cross-sectional surveys and were conducted from 2009 to 2019 (Balasubramaniam et al, 2011;Anson et al, 2012;Ravindran et al, 2012;Balasubramaniam et al, 2014;Nsabagasani et al, 2015;Swain et al, 2015;Sado and Sufa, 2016;Xiao et al, 2017;Abrha et al, 2018;Gereltuya et al, 2018;Saisai et al, 2018; Sun et al, 2018;Guoxu et al, 2019;Neha et al, 2019;Orubu et al, 2019;Demerew and Ahmed, 2020;Xiao et al, 2020;Yi et al, 2020). All studies were conducted in low-income and middleincome countries, including China (6/18), India…”

“…The IRP of medicines comes from the Guidelines for International Medicine Price Indicator Guide issued by the Management Sciences for Health (MSH) and is updated regularly. If the retail price of medicines in the public sectors does not exceed 1.5 times the IRP, MPR <1.5, or the retail price of medicines in the private sectors does not exceed 2 times IRP, MPR <2, the prices are considered reasonable (Abrha et al, 2018;Sun et al, 2018;Demerew and Ahmed, 2020;Xiao et al, 2020;Yi et al, 2020).…”

“…In addition, 15 studies (15/18, 83.3%) selected medicines based on the WHO Model List of Essential Medicines for Children (WHO EMLc). The remaining three studies focused on the WHO recommended priority life-saving medicines for children under five(Nsabagasani et al, 2015;Abrha et al, 2018;Demerew and Ahmed, 2020) (Table1).…”

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

“…Seven other supplementary medicines were chosen to treat important national health problems and the burden of local diseases for children (such as pneumonia, diarrhoea, colds and pain). When developing the supplementary list, we referenced medicine lists from previous studies, [9][10][11][12][13][14][15][16][17][18][19][20] guidelines and documents (such as the NEML (2018), 23 the seventh WHO EMLc (2019), 24 the WHO's list of priority life-saving medicines for women and children (2012) 25 . The suitability of selected medicines was also checked through the results from a pilot test in a public health facility and a private drugstore in October 2020.…”

“…There are only few studies on EMs for children (cEMs). [9][10][11][12][13][14][15][16][17][18][19][20][21] Their results showed that low availability, high prices and poor affordability have kept cEMs out of reach.…”