Abstract
Access to medicine for the poor is recognized to be difficult task and one of the major challenges in achieving universal health coverage, particularly in low-and- middle income countries. In order to ensure the availability of essential medicines free of cost in public health facilities, Nepal has also commenced Free Health Care Services (FHCS). So, this study aims to evaluate availability, expiry, and stock-out duration of essential medicines at front line service providers in Nepal. Cross-sectional survey was conducted 28 public health facilities, 7 district warehouses, and 14 private pharmacies in 7 districts of Nepal. The survey was conducted during the March and April 2014. Survey tools recommended by the WHO operational package for assessing, monitoring and evaluating country pharmaceutical situations was used with slight modification as per Nepal's situation. The availability of medicine was found to be 92.44% in this study. The percentage of expired medicines in district warehouse was found to be 8.40. The average stock-out duration in district warehouse was 0.324 days. Although the availability of essential medicines at peripheral health facilities was found to be satisfactory with lesser proportion of expired medicines, a strong monitoring and evaluation of expired and stock medicines are desirable to maintain and improve the access to essential medicines.
Highlights
Universal access to essential medicine is fundamental to the attainment of the universal health coverage (UHC). the need to improve the availability of affordable medicines for the world’s poor has been acknowledged by the MDGs and Sustainable DevelopmentGoals (SDGs),more than half of those poor have no regular access to essential medicines.[4,5,6,7]
For the primary data collection, the public health facility survey tools recommended by the WHO Operational package for assessing, monitoring and evaluating country pharmaceutical situations was used with slight modificationas per Nepal’s situation and focused on acquiring the information on availability and quality of medicine.[9]
The study found that the average availability of medicines is well over 90% the high number of expired medicines are present and even the stock out duration of medicines at some of the public health facilities are worrisome
Summary
METHODSIn the context of functioning health systems, essential medicines are intended to be available all the times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford.[1,2,3] The universal health coverage (UHC)is central to the Sustainable DevelopmentGoals (SDGs) put forward by the United Nations (UN).[4]universal access to essential medicine is fundamental to the attainment of the UHC. the need to improve the availability of affordable medicines for the world’s poor has been acknowledged by the MDGs and SDGs,more than half of those poor have no regular access to essential medicines.[4,5,6,7] The Government ofNepal (GoN) commenced the Free Health Care Services (FHCS) in 2008 hoping to improve the access of essential medicines at public health facilities.[8]. For the primary data collection, the public health facility survey tools recommended by the WHO Operational package for assessing, monitoring and evaluating country pharmaceutical situations was used with slight modificationas per Nepal’s situation and focused on acquiring the information on availability and quality of medicine.[9] A total of 15 essential medicine from list of survey instrument recommended by WHO that are basic requirements at all levels of health care and two additional medicines widely used in Nepal considering prevailing disease pattern as suggested by the experts were assessed. In order to ensure the availability of essential medicines free of cost in public health facilities, Nepal has commenced Free Health Care Services (FHCS). This study aims to evaluate availability, expiry, and stock-out duration of essential medicines at front line service providers in Nepal
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