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评估世卫组织推荐的用于 5 岁以下儿童的基本救命药物在阿姆哈拉地区基层公立卫生机构的可及性和面临的挑战。

Assessment of availability and challenges of WHO recommended priority life-saving medicines for under five-year children in primary public health facilities of Amhara region.

机构信息

Ethiopia Pharmaceutical Supply Agency, Bahir Dar, Ethiopia.

College of Medicine and Health Sciences, Department of Pharmacy, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

BMC Pediatr. 2023 Aug 9;23(1):395. doi: 10.1186/s12887-023-04216-6.

Abstract

BACKGROUND

The world health organization (WHO) priority lifesaving medicines are medicines recommended for the prevention and treatment of leading causes of under-five morbidity and mortality. They should be available in all health systems and at all times. However, the availability of these medicines and its determinants is not well studied in Ethiopia in general and in primary public health facilities Amhara region in particular.

OBJECTIVE

The study aimed to assess the availability and challenges of the WHO-recommended priority lifesaving medicines for under-five children in primary public health facilities of the Amhara region.

METHODS

A cross-sectional study design was conducted from February to December 2020 in 98 health centers and 22 primary hospitals in the Amhara region, Ethiopia. Facilities were selected with a simple random sampling technique. The data were collected through a pretested and structured questionnaire. Binary logistic regression was used to identify predictors associated with availability of WHO-recommended priority lifesaving medicines for under-five children.

RESULTS

The availability of oral rehydration salt was high (82.5%) and the availability of vitamin A (47.5%), morphine tablet (13.3%), and artesunate rectal suppository (7.5%) were within low and very low WHO range respectively. Budget adequacy (AOR = 12.9 CI= (2.1-78.2)), periodic review of stock level ((AOR = 13.4,CI=(1.9-92.0)), training on integrated pharmaceutical logistic system ((AOR = 4.5,CI=(1.0-20.5)), inclusion of WHO priority under five children facility specific medicine list (AOR = 12.4,CI=(2.3-66.4)), lead time for EPSA(Ethiopia Pharmaceutical Supply Agency) procurement (AOR = 7.9,CI=(1.3-44.8)) were significantly associated with availability of all WHO priority lifesaving medicines for under- five children.

CONCLUSION

The average availability of WHO-recommended priority lifesaving medicines for under-five children was low. The habit of updating bincard and adoption of the life-saving medicine list were the independent predictors of medication availability.

摘要

背景

世界卫生组织(WHO)优先救命药物是推荐用于预防和治疗五岁以下儿童发病率和死亡率主要原因的药物。这些药物应该在所有卫生系统中随时提供。然而,在埃塞俄比亚,特别是在阿姆哈拉地区的初级公立卫生设施中,这些药物的供应情况及其决定因素并没有得到很好的研究。

目的

本研究旨在评估阿姆哈拉地区初级公立卫生设施中为五岁以下儿童提供的 WHO 推荐优先救命药物的供应情况和面临的挑战。

方法

2020 年 2 月至 12 月期间,在埃塞俄比亚阿姆哈拉地区的 98 个卫生中心和 22 个初级医院进行了一项横断面研究。采用简单随机抽样技术选择设施。通过预测试和结构化问卷收集数据。采用二项逻辑回归分析确定与为五岁以下儿童提供 WHO 推荐优先救命药物的供应情况相关的预测因素。

结果

口服补液盐的供应情况较高(82.5%),而维生素 A(47.5%)、吗啡片剂(13.3%)和青蒿琥酯直肠栓剂(7.5%)的供应情况分别处于低和极低的 WHO 范围内。预算充足(AOR=12.9,CI=(2.1-78.2))、定期审查库存水平(AOR=13.4,CI=(1.9-92.0))、综合药品物流系统培训(AOR=4.5,CI=(1.0-20.5))、将 WHO 优先五岁以下儿童专用药物列入设施清单(AOR=12.4,CI=(2.3-66.4))、EPSA(埃塞俄比亚药品供应机构)采购的前置时间(AOR=7.9,CI=(1.3-44.8))与为五岁以下儿童提供所有 WHO 优先救命药物的供应情况显著相关。

结论

为五岁以下儿童提供的 WHO 推荐优先救命药物的平均供应情况较低。更新药卡的习惯和采用救命药物清单是药物供应的独立预测因素。

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