Abstract
Background The increased morbidity and mortality rates in children under five in developing countries are mostly attributed to poor availability and failure of prescribing lifesaving medicines. This study was aimed at evaluating the availability and utilization of the WHO-recommended priority lifesaving medicines for children under five in public health facilities. Method A cross-sectional survey complemented with a qualitative method was conducted in 14 health centers and four hospitals in the Jimma Zone, Ethiopia. In the facilities, we assessed the availability within the last half year and on the day of the visit. Utilization of the medicines was assessed through a review of patient records of the last one year. Twelve in-depth interviews were carried out to collect the qualitative data, and the analysis was executed using thematic analysis. Results For treatment of pneumonia, amoxicillin dispersible tablets and gentamycin injection were available in 94.4% of the facilities. For treatment of malaria, artemether/lumefantrine was available in 61.1% of the facilities. For pain management, paracetamol tablets were available in 94.4% of the facilities. AZT+3TC+NEV for HIV/AIDS management was available in all facilities. At least one essential medicine was out of stock in the past six months with the average duration of 33.6 days in health centers and 28.25 days in hospitals. Oral rehydration salt and zinc (84.7%) and AZT+3TC+NEV (100%) had better utilization. However, for almost all cases, other nonpriority medicines were highly prescribed. Lack of administrative commitment, supply of near expiry products, complexity of diseases, and lack of customized child formulations were among the challenges of availability and utilization of those medicines. Conclusions The overall availability of lifesaving medicines on the day of the visit was fairly good but with poor utilization in almost all facilities. Some products were not available for considerable length of time in the past six months.
Highlights
The increased morbidity and mortality rates in children under five in developing countries are mostly attributed to poor availability and failure of prescribing lifesaving medicines
As per World Health Organization (WHO) classification, availability was fairly high for the health centers and high for the hospitals
Almost all medicines for pneumonia treatment were available in the hospitals and in more than 80% of the health centers
Summary
The increased morbidity and mortality rates in children under five in developing countries are mostly attributed to poor availability and failure of prescribing lifesaving medicines. Despite the global progress in reducing child mortality, an estimated 5.4 million children under the age of five died in 2017. Half of those deaths occurred in sub-Saharan Africa [1]. The World Health Organization (WHO) reported that the majority of the morbidities in children under five are preventable or treatable if lifesaving medicines are available and consistently utilized [2]. To tackle this problem, the WHO, United Nations Population Fund (UNFPA), and UNICEF have jointly developed a list of priority medicines. The list identified malaria, pneumonia, sepsis, pain, diarrhea, HIV, and vitamin A deficiency as the leading causes of morbidity in children under five [3]
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