Availability of Essential Medicines in Ethiopia: A Systematic Review

Abstract

Objective: Essential Medicines (EMs) are those that satisfy the priority health care needs of the population. Access to health care including EMs is a fundamental human right. In Ethiopia, studies designate the frequent drug shortages in public health facilities. Hence, this review aimed to assess and evaluate the national availability of essential medicines in Ethiopia. Method: A systematic searching for all study designs which are published and/or reported from inception to August 27/2019 strategy was conducted in two literature databases (Google Scholar and PubMed. Additionally, references of related articles were searched using different search engines. Data qualities were assessed by abstracting the quality procedures taken in each individual’s studies and cross checked with Joanna Briggs Institute (JBI) quality appraisal criteria. Results: A total of 256 studies, including duplicates, were primarily searched. Nine studies were met current study inclusion criteria. All included studies were published from 2003 to 2019 G.C. Consequently, reviewed studies conducted a total of 356 public and private drug outlets. All studies used cross-sectional study design. The most frequent concepts emerged in these documents were regarding availability and affordability of EMs (5 Articles), availability and pharmaceutical inventory management (3 Articles), one document on availability and price. The average national availability of EMs was precisely in public and private facilities scored about 70.16% and 70.1%, respectively. Results from the sub-national study indicate that, the national average stock out duration in primary health care facilities was 99.2 days, highest in Benishangul Gumuz (139 days). The most frequently reported stocked out drugs within the past 6-12 months at the time of study were; ORS, Amoxicillin syrup 125mg/5ml, Tetracycline eye ointment and tablet, Ergometrine injection in Adama and chloroquine syrup in Gondar. Whereas, carbamazepine 100mg/5ml syrup, diazepam 5mg/ml ampoule, gentamicin 20mg/2ml ampoule and ibuprofen 100mg/5ml suspension were not found in any drug outlets in both public and private sectors at the day of visit in West Wollega. Conclusion: The finding of this review indicates the average national availability of essential medicines in Ethiopia is presently under the requirements of WHO recommendations. Moreover, the longer stockout period was also perceived in healthcare facilities. Thus, might need further attention of the respective stakeholders.