Guerra Augusto Afonso, Acúrcio Francisco de Assis, Gomes Carlos Alberto Pereira, Miralles Maria, Girardi Sábado Nicolau, Werneck Gustavo Azeredo Furquim, Carvalho Cristiana Leite
Centro Universitário Newton Paiva, Faculdade de Ciências Biológicas e da Saúde, Curso de Farmácia, Belo Horizonte (MG), Brazil.
Rev Panam Salud Publica. 2004 Mar;15(3):168-75. doi: 10.1590/s1020-49892004000300005.
To investigate the availability of essential drugs in municipalities with a human development index < 0.699.
We surveyed 69 institutions, including municipal pharmacies, public clinics, private and philanthropic health units, and commercial pharmacies, in 19 municipalities of the state of Minas Gerais, Brazil. The municipalities were chosen according to the following selection criteria: (1) a human development index (HDI) < 0.699 (the HDI for the entire state of Minas Gerais in 1991) in the microregion where the municipality was located; (2) the municipality had to be the seat of government for the microregion where it was located; (3) there had to be at least two eligible institutions (belonging to the public, private, or philanthropic sectors) in full functioning in the municipality during the survey period. Health professionals who were directly responsible for stock control and drug dispensation at the institutions surveyed were interviewed. Institutional documents and records were also reviewed. A list of 21 tracer essential drugs, which were selected among the drugs most widely employed in the State of Minas Gerais' Basic Pharmacy Program, was used to measure availability. The availability of each tracer drug was calculated at the time of the site visit and for the 12-month period immediately before the survey. In addition, the availability of tracer drugs was calculated for each type of institution surveyed.
The availability of essential drugs in municipal pharmacies was 52.0%; in public health clinics, 46.9%; and in philanthropic and private health units, 41.0% and 38.1%, respectively. In commercial pharmacies, the availability of essential drugs reached 81.2%.
The availability of essential drugs in public facilities is low and varies widely, with the result that persons who need such drugs the most are often those who lack access to them. Private pharmacies are the main source of essential drugs. The results of this study point to the need to seek increased awareness and implementation of the concept of essential drugs throughout the country.
调查人类发展指数＜0.699的市基本药物的可及性。
我们对巴西米纳斯吉拉斯州19个市的69家机构进行了调查，这些机构包括市药房、公立诊所、私立和慈善卫生单位以及商业药房。这些市是根据以下选择标准选定的：（1）所在微区域的人类发展指数（HDI）＜0.699（1991年米纳斯吉拉斯州全州的HDI）；（2）该市必须是所在微区域的政府所在地；（3）在调查期间，该市必须至少有两家符合条件的机构（属于公共、私立或慈善部门）在全面运作。对接受调查机构中直接负责库存管理和药品配发的卫生专业人员进行了访谈。还查阅了机构文件和记录。从米纳斯吉拉斯州基本药房计划中使用最广泛的药物中挑选了21种追踪基本药物清单，用于衡量可及性。在实地考察时以及调查前紧接的12个月期间计算每种追踪药物的可及性。此外，还计算了接受调查的每种机构类型的追踪药物可及性。
市药房基本药物的可及性为52.0%；公立卫生诊所为46.9%；慈善和私立卫生单位分别为41.0%和38.1%。在商业药房，基本药物的可及性达到81.2%。
公共机构中基本药物的可及性较低且差异很大，结果是最需要此类药物的人往往是无法获得这些药物的人。私立药房是基本药物的主要来源。本研究结果表明需要在全国提高对基本药物概念的认识并加以实施。
