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在埃塞俄比亚亚的斯亚贝巴,优先救命的产妇保健药品的供应和可负担性。

Availability and affordability of priority lifesaving maternal health medicines in Addis Ababa, Ethiopia.

机构信息

Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

出版信息

BMC Health Serv Res. 2022 Apr 20;22(1):524. doi: 10.1186/s12913-022-07793-x.

Abstract

BACKGROUND

Access to life-saving medicines for maternal health remains a major challenge in numerous developing nations. Periodic and continuous assessment of access to lifesaving commodities is of enormous importance to measure progress and ensure sustainable supply. This study aimed to assess the availability and affordability of priority lifesaving maternal medicines in Addis Ababa in January 2021.

METHODS

An institutional-based cross-sectional study design was employed to assess 33 representative private pharmacies, public health facilities, NGO and private hospitals providing maternal health care and dispensing medicines from January 12 to 27, 2021 in Addis Ababa, the capital city of Ethiopia. WHO and Health Action International procedures were followed to determine sample size, sampling of health facilities, and data collection. WHO and UNFPA priority lifesaving maternal health medicines included in the Ethiopia essential medicine list were included in the study. Data were cleaned and entered into SPSS version 25 for analysis.

RESULT

The overall mean availability of maternal health medicines was fairly high, 59% (range 6%-94%), as per the WHO availability index. Among the four sectors, the private pharmacy had the lowest availability (40%), while the mean availability in private hospitals, public and NGO/mission sector facilities were 70%, 72% and 72% respectively. Medicines used only for the management of maternal health conditions had lower availability (47%) compared to commodities used for the broader indication (65%). Compared based on source, the average availability of maternal health medicines which could be sourced locally was (68%) higher than imported medicines (55%). Affordability was not an issue in the public sector, public facilities offered maternal health medicines at no cost to the client. On the other hand, the private hospitals dispensed only 13% of the medicines at affordable prices followed by the private pharmacies (17%) and NGO/Mission facilities (29%). Furthermore, key challenges to access maternal health medicines were frequent stockouts in the public sector and the high cost of medicines in the private sector.

CONCLUSION

Even though it was below the recommended 80% availability, fairly high availability with variabilities across sectors was observed. Except in the public sector, maternal health medicines were unaffordable in Addis Ababa.

摘要

背景

在许多发展中国家,获得拯救生命的药物仍然是一个主要挑战。定期和持续评估获取救命商品的情况对于衡量进展和确保可持续供应至关重要。本研究旨在评估 2021 年 1 月在亚的斯亚贝巴获得优先救命产妇药物的可及性和可负担性。

方法

采用机构间横断面研究设计,于 2021 年 1 月 12 日至 27 日在埃塞俄比亚首都亚的斯亚贝巴评估了 33 家具有代表性的私营药房、公共卫生设施、提供产妇保健和配药的非政府组织和私营医院。遵循世界卫生组织和健康行动国际程序确定样本量、卫生设施抽样和数据收集。研究包括世界卫生组织和联合国人口基金列入埃塞俄比亚基本药物清单的优先救命产妇保健药物。数据清理后输入 SPSS 版本 25 进行分析。

结果

根据世界卫生组织的供应指数,产妇保健药物的总体平均可及性相当高,为 59%(范围为 6%-94%)。在四个部门中,私营药房的可及性最低(40%),而私营医院、公共和非政府组织/使命部门设施的平均可及性分别为 70%、72%和 72%。仅用于管理产妇健康状况的药物的可及性较低(47%),而用于更广泛适应症的药物的可及性较高(65%)。根据来源,可在当地获得的产妇保健药物的平均可及性(68%)高于进口药物(55%)。在公共部门,可负担性不是问题,公共设施向客户免费提供产妇保健药物。另一方面,只有 13%的产妇保健药物在私营医院以负担得起的价格发放,其次是私营药房(17%)和非政府组织/使命设施(29%)。此外,获得产妇保健药物的主要挑战是公共部门经常缺货和私营部门药物价格高昂。

结论

尽管可及性低于建议的 80%,但观察到各部门之间存在相当高的可及性和差异。除了公共部门外,在亚的斯亚贝巴,产妇保健药物都无法负担得起。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8a1/9019981/53d1335f07e0/12913_2022_7793_Fig1_HTML.jpg

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