Availability, prices and affordability of UN Commission’s lifesaving medicines for reproductive and maternal health in Uganda

Abstract

BackgroundUganda was one of seven countries in which the United Nations Commission on Life Saving Commodities (UNCoLSC) initiative was implemented starting from 2013. A nationwide survey was conducted in 2015 to determine availability, prices and affordability of essential UNCoLSC maternal and reproductive health (MRH) commodities.MethodsThe survey at health facilities in Uganda was conducted using an adapted version of the standardized methodology co-developed by World Health Organisation (WHO) and Health Action International (HAI). In this study, six maternal and reproductive health commodities, that were part of the UNCoLSC initiative, were studied in the public, private and mission health sectors. Median price ratios were calculated with Management Sciences for Health International Drug Price Indicator prices as reference. Maternal and reproductive health commodity stocks were reviewed from stock cards for their availability for a period of 6 months preceding the survey. Affordability was measured using wages of the lowest paid government worker.ResultsOverall none of the six maternal and reproductive commodities was found in the surveyed health facilities. Public sector had the highest availability (52%), followed by mission sector (36%) and then private sector had the least (30%). Stock outs ranged from 7 to 21 days in public sector; 2 to 23 days in private sector and 3 to 27 days in mission sector. During the survey, maternal health commodities were more available and had less number of stock out days than reproductive health commodities. Median price ratios (MPR) indicated that medicines and commodities were more expensive in Uganda compared to international reference prices. Furthermore, MRH medicines and commodities were more expensive and less affordable in private sector compared to mission sector.ConclusionAccess to MRH commodities is inadequate in Uganda. Maternal health commodities were more available, cheaper and thus more affordable than reproductive health commodities in the current study. Efforts should be undertaken by the Ministry of Health and stakeholders to improve availability, prices and affordability of MRH commodities in Uganda to ensure that sustainable Development Goals are met.

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

“…In this study, the overall public health facility average mean number of stock-out days was 128.9 over 6 months. A high number of stock-out days as compared to the study conducted by Fentie (2015) in Gondar (30.5 days) [33] and lower than Kibira (2017) study 13 reproductive, maternal, newborn, and child health commodities and stock-outs ranged from 14 days [34]. This difference might be attributed to poor stock management, quantification, and procurement practices.…”

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

“…Availability in each province is reported as the percentage of outlets in which each medicine was found on the day of data collection. Most WHO/HAI surveys use the criteria of availability of medicines as follows: very low: < 30%, low: 30–49%, fairly high: 50–80%, high: > 80% ( Sharma et al, 2016 ; Kibira et al, 2017 ; Liu et al, 2017 ; Gong et al, 2018 ; Sun et al, 2018 ; Wu et al, 2018 ; Kasonde et al, 2019 ). Median unit prices (MUPs) for each medicine is calculated in RMB (yuan, ¥).…”

Access to sexual and reproductive health commodities in East and Southern Africa: a cross-country comparison of availability, affordability and stock-outs in Kenya, Tanzania, Uganda and Zambia

“…Previous research in these countries has focused on identifying the barriers to access on both the supply and demand side [21][22][23][24][25][26], but detailed research on availability and affordability of these medicines at the health system level is lacking. In Uganda research on availability of medicines for SRH has been conducted previously, showing that access remains suboptimal [27,28]. However, this research did not cover an extensive list of SRHC, nor included medical devices essential in offering quality SRH services.…”