Accessibility crisis of essential medicines at Sudanese primary healthcare facilities: a cross-sectional drugs’ dispensaries assessment and patients’ perspectives

International Journal for Equity in Health

Research

Abubaker E. A. Koko¹  Radia F. Mohamed¹  Eithar M. Ali¹  Yousra Ibrahim Abdallah Mohammed¹  Amna Abdel Rafea Al Hashemi Hamida¹  Abeer Osman Mukhtar Elabid¹  Reem M. Al Fanob¹  Lina Hemmeda¹  Aya M. Haiba¹  Istabraq I. Abdelgadir¹  Alaa T. Omer¹  Saja S. Mohamed Almahadi¹  Sara Ali¹  Suzan A. A Mahgoub¹ 

[1] Faculty of Medicine, University of Khartoum, Khartoum, Sudan;

关键词: Essential medicines;    Primary healthcare services;    Affordability;    Universal health coverage;    Sudan’s healthcare;   

DOI  :  10.1186/s12939-023-02009-y

 received in 2023-07-22, accepted in 2023-09-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAccess to essential medicines is a critical component of universal health coverage. However, the availability of essential medicines in Sudan isn’t well studied. As well, most Sudanese people lack health insurance, making out-of-pocket spending the primary source of drug financing. Therefore, the affordability of medicines in Sudan is questionable, with only 30% of the total population being covered by a public health service or public health insurance. We undertook this study to assess the availability and prices of essential medicines in public-sector health facilities in Khartoum state. Moreover, this study aims at assessing patients’ perceived affordability of essential medicines, and accommodation and acceptability of the public facility.MethodsA cross-sectional study was carried out at 30 primary healthcare facilities’ drug dispensaries across three districts in Khartoum state. Within each Centre’s dispensary unit, a standardized checklist evaluated the availability and affordability of 21 essential medicines selected from Sudan’s national essential medicines list and assessed their storage conditions. Furthermore, 630 patients were selected from all dispensary units for an exit interview that assessed their perceived accessibility, acceptability, accommodation, and affordability of essential medicines. Data were collected through the Kobo toolbox and analyzed using SPSS version 26.ResultsParticipants’ ratings of accessibility, affordability, accommodation, and acceptability were 3.7/5, 1.5/4, 5/6, and 5.4/6, respectively, with a 26.7% full access and weak correlation between some of the indices. The overall availability of adults and pediatric medicines was 36.8% 6.7%, respectively. Cost of a single course of treatment for 10 and 16 drugs out of the 19 drugs consumed exceeds the daily wage of insured and uninsured patients, with a median price ratio of 16.4 and 62.8, respectively. Moreover, the dispensary area conditions were found to be of good quality, yet the storerooms were not functioning in 40% of the outlets.ConclusionPatients had limited access to their needed drugs due to high prices and physical unavailability, and primary healthcare capacities are not meeting the demands of citizens. The outcomes for the patients’ access variables (accessibility, accommodation, acceptance, and affordability) are comparable to those in countries with low incomes. Ensuring access to free medicines is likely to improve patients’ satisfaction with healthcare services and reduce private expenditure on medicines, which is a long-term, sustainable way towards universal health coverage in Sudan.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 1

12951_2015_155_Article_IEq32.gif