Access to essential medicines used in the management of noncommunicable diseases in Southern Ethiopia: Analysis using WHO/HAI methodology

Author:

Asmamaw Getahun1ORCID,Shimelis Tekalign2,Tewuhibo Dinksew3,Bitew Teshome4,Ayenew Wondim5ORCID

Affiliation:

1. Department of Social and Administrative Pharmacy, Directorate of Pharmacy Education and Clinical Services, Arba Minch University, Arba Minch, Ethiopia

2. Directorate of Pharmacy Education and Clinical Services, Arba Minch University, Arba Minch, Ethiopia

3. Department of Pharmacy, Madda Walabu University, Bale Robe, Oromia, Ethiopia

4. Department of Pharmaceutics and Social Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia

5. Department Social and Administrative Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia

Abstract

Objectives: This study aims to assess access to essential medicines used in the management of noncommunicable diseases through analysis of the availability, prices, and affordability of these essential medicines in Arba Minch town, Gamo Zone, Southern Ethiopia. Methods: A cross-sectional design was carried out using the World Health Organization/health action international methodology between 2 March and 2 May 2023, within public and private healthcare facilities located in Arba Minch town, Southern Ethiopia. The median price ratio served as a metric. Statistical tests like the Shapiro-Wilk and Kolmogorov-Smirnov were utilized to assess the normal distribution of price data. The Wilcoxon-Mann-Whitney U test was also employed to compare median buyer’s prices (patient prices) between public and private healthcare institutions. Treatment affordability was determined by estimating the number of days’ wages required by the lowest-paid government employee in Ethiopia to afford the prescribed medication regimen. Results: Among 23 health facilities surveyed, the pooled availability of essential medicine used in the management of noncommunicable diseases was 18.7% (range: 0%–30.1%), with the public and private facilities contributing 16.3% and 38.3%, respectively. The overall percentage of availability originator brand versions was 1.1% for overall health sectors, 0.6% for public sectors, and 1.2% for private sectors. The overall percent availability of lowest price generics was 36.2% (range: 0%–26.2%; public: 32.0%; private: 37.1%). Only seven lowest price generics satisfied the World Health Organization target of 80% and above. The overall median price of lowest price generic medicines in private was two times higher than in public sectors. The top five median price scorers were amlodipine, furosemide, insulin, beclomethasone, and salbutamol. The Mann-Whitney U test showed that 11.6% of lowest price generics medicines had a statistically significant median price disparity between the public and private sectors ( p < 0.05). The overall percent of unaffordability was found to be 100.0%, (public: 70.4; private: 100.0%). Conclusions: This study revealed the limited availability and potential financial burdens on patients seeking essential noncommunicable disease medications. Limited availability suggests the need for better supply chain management and consistent stock availability. The price disparities and affordability challenges identified underscore the necessity for policy interventions such as price regulation and subsidized programs to ensure equitable access to essential noncommunicable disease medications in Arba Minch town, Southern Ethiopia.

Publisher

SAGE Publications

Reference50 articles.

1. Chigom E. Non-communicable diseases country profiles. World Health Organization, https://www.who.int/publications/i/item/ncd-country-profiles-2018 (2018, accessed 2 July 2023).

2. Institute for Health Metrics (IHME). Global burden of disease collaborative network, Global Burden of Disease Study-2019, https://VizhubHealthdataOrg/Gbd-Results/ (2020, accessed 2 July 2023).

3. Prevalence of chronic non-communicable diseases in Ethiopia: A systematic review and meta-analysis of evidence

4. World Health Organization (WHO). Access to medicines and health products programme, http://apps.who.int/bookorders (2021, accessed 6 August 2023).

5. THE ROLE OF REGULATION: INFLUENCING PRIVATE SECTOR ACTIVITY WITHIN HEALTH SECTOR REFORM

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