ESSENTIAL MEDICINES AVAILABILITY AND AFFORDABILITY: A CASE STUDY OF THE TOP TEN REGISTERED DISEASES IN BUILSA DISTRICT

ABSTRACT

Background Access to essential medicines is a major component for an effective health service delivery system. The purpose of this study was to evaluate the availability and affordability of essential medicines used in the treatment of the top ten registered diseases in Builsa District in the year 2009. Method The survey was a cross sectional descriptive study, that employed both quantitative and qualitative approaches, following the standardized World Health Organization and Health Action International (WHO/ HAI) methodology (WHO and HAI, 2008a). Price and availability data for 20 medicines were collected from 11 public service delivery points and 4 private licensed chemical sellers‟ stores. Medicine prices were compared with international reference prices (IRPs) to obtain a median price ratio. The daily wage of the lowest paid unskilled government worker was used to gauge the affordability of medicines. Results

The percentage availability of 20 essential medicines was 73% (SD±19.3) for all the medicines outlets. The availability of 20 essential medicines for the Clinic and Health Centre levels was 85% (SD±17) higher than the private Licensed Chemical Sellers with 71.3% (SD±35.6). The availability of 10 essential medicines for Community level was 62.5% in the CHPS compounds, which was lower than the private Licensed Chemical Sellers with 77.5%. Artesunate + Amodiaquine used as first line for malaria treatment was found in 80% of medicine outlets. The prices of medicines to patients were high at the public health delivery points with a comparative Median Price Ratio (MPR) of 1.84 times international reference prices (IRP), while that of the private Licensed Chemical Sellers was 2.05 times the IRP. It takes more than a day‟s wage to treat malaria in an adult client. Conclusion The availability of essential medicines for the treatment of the top ten diseases of 2009 in the Builsa district is fairly high. The average cost of treatment for the common diseases was unaffordable to the un-insured clients, with the median price ratio of medicines above the acceptable range of 1.5 for public health delivery points. Key words: Availability, Affordability, Essential Medicine, Builsa district.