Perumal-Pillay Velisha Ann, Suleman Fatima
Discipline of Pharmaceutical Sciences, School of Health Sciences, Westville Campus, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000, South Africa.
BMC Health Serv Res. 2017 Jun 19;17(1):417. doi: 10.1186/s12913-017-2385-y.
Inadequate access to affordable essential medicines poses a challenge to achieving Universal Health Coverage. Access to essential medicines for children has been in the spotlight in recent research. However, information from the end users of medicines, i.e. patients is scarce. Obtaining information at a household level is integral to understanding how people access, obtain and use medicines. This study aimed to gather opinions and perceptions from parents/guardians on availability, affordability and quality of medicines and healthcare for children in SA.
Eight Focus group discussions were held with 41 individuals in eThekwini, South Africa (SA), from September-November 2016. Participants were parents/guardians of children up to 12 years from different ethnicities, ages, gender, and socio-economic backgrounds. Key informants identified by the principal researcher recruited participants using snowball sampling. Focus group discussions were recorded, transcribed verbatim, coded by the first author, verified by the second author, reconciled for consensus and imported into NVIVO for data analysis.
Medicines and healthcare facilities are accessible in urban and peri-urban areas in eThekwini. Medicines may not always be available in public sector facilities due to medicine shortages, compelling parents to purchase medicines from private sector pharmacies. Common medicines were perceived as affordable for most socio-economic groups except the 'Poor' group. Quality of medicines was perceived as 'good' especially if obtained from the private sector but sometimes perceived as 'poor' and viewed with suspicion when received from public sector clinics. Quality of healthcare was perceived as 'good' but requires improvement for both sectors.
This is the first study in SA to report on parent/guardian perceptions on availability, affordability and quality of medicines and healthcare for children. It has the potential to be up-scaled to a country-wide investigation to paint a national picture of parents' opinions of healthcare for children. This will allow for patient input into pharmaceutical and healthcare policy governing access to and availability of essential medicines and services within the country. The study recommends that patient input be sought to assess impact of policies on the intended target group in the country to ensure that the policy objectives are achieved.
难以获得价格合理的基本药物对实现全民健康覆盖构成挑战。儿童基本药物的获取问题在近期研究中备受关注。然而，来自药品最终用户即患者的信息却很匮乏。在家庭层面获取信息对于理解人们如何获取、获得和使用药品至关重要。本研究旨在收集南非父母/监护人对儿童药品及医疗保健的可及性、可负担性和质量的意见与看法。
2016年9月至11月，在南非夸祖鲁 - 纳塔尔省的伊代昆尼与41人进行了八次焦点小组讨论。参与者是来自不同种族、年龄、性别和社会经济背景的12岁以下儿童的父母/监护人。首席研究员确定的关键信息提供者采用滚雪球抽样法招募参与者。焦点小组讨论进行了录音，逐字转录，由第一作者编码，第二作者核实，达成共识后进行核对，并导入NVIVO进行数据分析。
在伊代昆尼的城市和城郊地区可获得药品和医疗保健设施。由于药品短缺，公共部门设施中可能并非总能获得药品，这迫使父母从私营部门药店购买药品。除“贫困”群体外，大多数社会经济群体认为常用药品价格可承受。药品质量被认为“良好”，尤其是从私营部门获得的药品，但有时从公共部门诊所获得的药品被认为“质量差”且受到怀疑。医疗保健质量被认为“良好”，但两个部门都需要改进。
这是南非第一项报告父母/监护人对儿童药品及医疗保健的可及性、可负担性和质量看法的研究。它有潜力扩大到全国范围的调查，以描绘出全国父母对儿童医疗保健意见的全貌。这将使患者能够对该国有关基本药物和服务的获取及可及性的制药和医疗保健政策提供意见。该研究建议寻求患者意见，以评估政策对该国目标群体的影响，确保实现政策目标。
