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埃塞俄比亚南部地区各民族国家卫生机构中儿童基本药物的可及性和可负担性:获得的关键决定因素。

Availability and affordability of children essential medicines in health facilities of southern nations, nationalities, and people region, Ethiopia: key determinants for access.

机构信息

Pharmacy Unit, Pharmaceutical Supply Management, Doctor Bogalech Gebre Memorial General Hospital, Durame, Ethiopia.

Department of Pharmacy, College of Medicine and Health Sciences, Wachemo University, P.O. BOX: 667, Hossaena, Ethiopia.

出版信息

BMC Public Health. 2021 Apr 13;21(1):714. doi: 10.1186/s12889-021-10745-5.

Abstract

BACKGROUND

Children in resource-limited countries are more likely to die from treatable conditions than those in higher resource settings due to a lack of the right essential medicine at the right time. Globally millions of children die every year from conditions that could be treatable with existing medicines before they reach their fifth birthday. This study aimed in assessing the availability and affordability of essential medicine for children in selected health facilities of southern nations, nationalities, and peoples' regions (SNNPR), Ethiopia.

METHOD

A medicine outlets-based cross-sectional study was conducted to assess the availability, affordability, and prices of the 30 selected essential medicines (EMs) for children in 30 public and 30 private medicine outlets in SNNPR from March 29 to May 5, 2019, applying WHO and Health Action International (HAI) tools. Availability was expressed as the percentage of sampled medicine outlets per sector that the surveyed medicine was found on the day of data collection. The amount of daily wages required for the lowest-paid government unskilled worker (LPGW) to buy one standard treatment of an acute condition or treatment for a chronic condition for a month was used to measure affordability and median price ratio for the price of EMs.

THE RESULTS

Availability varied by sector, type of medication, and level of health facilities. The average availability of EM was 57.67% for the public sector and 53.67% for the private sector. Ceftriaxone, SOR, zinc sulfate, and cotrimoxazole were the most widely available types of medications in the two sectors. The median price ratios (MPR) for the cheapest drugs LP were 1.26 and 2.24 times higher than their International Reference Price (IRP) in the public and private sectors respectively. Eighty-two percent of LP medicines in the public and 91 % of LP medicines in the private sectors used in the treatments of prevalent common conditions in the region were unaffordable as they cost a day's or more wages for the LPGW.

CONCLUSION

Availability, affordability, and price are determinant pre-requisite for EMs access. According to the current work, although fair availability was achieved, the observed high price affected affordability and hence access to EMs.

摘要

背景

由于在适当的时间缺乏正确的基本药物,资源有限国家的儿童因可治疗的疾病而死亡的可能性高于资源较丰富国家的儿童。全球每年有数百万儿童在年满五岁之前死于可以用现有药物治疗的疾病。本研究旨在评估埃塞俄比亚南部地区、民族和人民地区(SNNPR)选定卫生机构中儿童基本药物的供应情况和可负担性。

方法

2019 年 3 月 29 日至 5 月 5 日,采用世界卫生组织和健康行动国际工具,在 SNNPR 的 30 家公立和 30 家私立药店进行了一项基于药店的横断面研究,以评估 30 种儿童基本药物(EMs)的供应、可负担性和价格。供应情况按抽样药店当天发现调查药物的药店比例表示。用最低工资的政府非熟练工人(LPGW)购买一个月的急性病标准治疗或慢性病治疗所需的日工资数来衡量可负担性,并计算 EMs 的中位数价格比。

结果

供应情况因部门、药物类型和卫生设施级别而异。公立部门和私立部门的平均 EM 供应率分别为 57.67%和 53.67%。头孢曲松、SOR、硫酸锌和复方磺胺甲噁唑是这两个部门最广泛供应的药物类型。公立部门和私立部门中最便宜的 LP 药物的中位数价格比(MPR)分别比其国际参考价格(IRP)高 1.26 倍和 2.24 倍。该地区常见疾病治疗中使用的公立部门 82%的 LP 药物和私营部门 91%的 LP 药物均不可负担,因为它们的价格相当于 LPGW 一天或更多的工资。

结论

供应、可负担性和价格是获得 EMs 的先决条件。根据目前的工作,尽管实现了公平供应,但观察到的高价格影响了可负担性,从而影响了 EMs 的获得。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8187/8045262/c390c16b3075/12889_2021_10745_Fig1_HTML.jpg

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