Metzler Mutsumi, Stationwala Murtuza, Mukumbayi Philippe, Kibonge Samuel, Doi Naoko, Coffey Patricia
PATH, Seattle, Washington, USA.
PATH, Mumbai, India.
BMJ Open. 2025 Sep 17;15(9):e095521. doi: 10.1136/bmjopen-2024-095521.
The aim was to assess point-in-time stock availability and pricing of drugs used for postpartum haemorrhage management (oxytocin, misoprostol, heat-stable carbetocin and tranexamic acid (TXA)).
Cross-sectional point-in-time survey using an adapted version of the WHO/Health Action International methodology.
In public, for-profit and not-for-profit private health facilities and in pharmacies in the Democratic Republic of the Congo (DRC), India and Kenya.
211 health facilities in the DRC (n=63), India (n=76) and Kenya (n=72).
Availability was calculated as a mean percentage of facility types where each medicine was observed on the day of data collection. Average procurement prices were calculated by obtaining the current purchase price per drug at each facility and then averaging prices across all facility types.
Availability of the four medicines was limited, and only oxytocin in the DRC met the WHO's benchmark of 80%. Across all countries, availability of oxytocin, misoprostol and TXA was lower in public health facilities than in other facility types, indicating an important gap. Where the four medicines were available, non-quality-assured products were predominant across the three countries. The average facility procurement prices in India and Kenya were reported to be lower than those in the DRC.
Availability of oxytocin, misoprostol, heat-stable carbetocin and TXA was suboptimal and varied by facility type and geography, and similar trends were found across the four drugs. This indicates that access strategies should be tailored to each drug, geographical area and facility type. Strategies to improve commodity access in public-sector facilities will be especially important, as well as improving the availability of quality-assured products, possibly through value-based procurement practices.
旨在评估用于产后出血管理的药物（催产素、米索前列醇、热稳定卡贝缩宫素和氨甲环酸（TXA））的即时库存可用性和定价。
采用世界卫生组织/国际卫生行动组织方法的改编版进行横断面即时调查。
在刚果民主共和国（DRC）、印度和肯尼亚的公立、营利性和非营利性私立医疗机构以及药店。
刚果民主共和国的211家医疗机构（n = 63）、印度的（n = 76）和肯尼亚的（n = 72）。
可用性通过在数据收集当天观察到每种药物的医疗机构类型的平均百分比来计算。平均采购价格通过获取每个机构每种药物的当前采购价格，然后对所有机构类型的价格进行平均来计算。
这四种药物的可用性有限，只有刚果民主共和国的催产素达到了世界卫生组织80%的基准。在所有国家，公立医疗机构中催产素、米索前列醇和氨甲环酸的可用性低于其他机构类型，这表明存在重大差距。在这四种药物有供应的地方，在这三个国家中无质量保证的产品占主导地位。据报告，印度和肯尼亚的机构平均采购价格低于刚果民主共和国。
催产素、米索前列醇、热稳定卡贝缩宫素和氨甲环酸的可用性未达最佳水平，且因机构类型和地理位置而异，这四种药物呈现出类似趋势。这表明获取策略应针对每种药物、地理区域和机构类型进行调整。改善公共部门机构商品获取的策略将尤为重要，同时可能通过基于价值的采购做法提高有质量保证产品的可用性。
