Supply Of Medicines Research Articles

Impact Assessment of Covid19 pandemic on operational aspect of national tuberculosis elimination program in Bhavnagar district

PurposeIndia account more than one forth tuberculosis cases. Covid 19 affect health condition like tuberculosis. We aim to assess impact of covid 19 on National Tuberculosis Elimination Program. MethodIn depth interviews of district tuberculosis officer, private practitioner and tuberculosis patients (who registered in District Tuberculosis Centre during April 2020–September2020) were conducted in Bhavnagar district. Notification rate during covid 19 was obtained from District Tuberculosis Centre of Bhavnagar district. All interviews were audio-recorded after obtaining written informed consent, transcribed in English, and analyzed in the form of codes and categories. ResultHealth care providers perceived covid 19 lockdowns, fear among patients, difficult transportation, diversion of resources and reduced concerns towards tuberculosis were the reason for low notification during the COVID-19 pandemic. ConclusionCOVID-19 lockdown had detrimental effects on notification rate. During such testing time patients felt proper supervision by front line worker, no issued in direct benefit transfer for nutrition support and adequate supply of medicine. Telemedicine, awareness through social media, collaboration with other agencies, bidirectional screening implementation, coping of covid 19 fear among patients, separate tuberculosis facility were the expectation from higher authority if next wave of covid 19 will come. Future studies can evaluate the feasibility, impact, and cost-effectiveness of such interventions.

Drug Traceability using Blockchain

The medicine supply tracking system that has been built uses blockchain-based technology to address the widespread problem of counterfeit pharmaceuticals. The solution utilizes the decentralized structure of blockchain to guarantee confidentiality and transparency in the prescribed medicine distribution chain. The blockchain tracks an individual drug's path from producer to customer, providing auditable and immutable documentation of its legitimacy and provenance. Smart contracts automate procedures and enforce pre-established guidelines. "Examples include confirming the authenticity of medicines and triggering alarms for questionable activity. The technique reduces the possibility of counterfeit medicines entering the market by eliminating the need for trust in middlemen through decentralized consensus procedures. In the end, the blockchain-based medicine traceability system improves patient safety by enabling the quick identification and removal of fake medicines from the market.

Analisis Pengendalian Intern Persediaan Obat-Obatan pada UPT Puskesmas Desa Binjai

The purpose of this research is to find out how to implement the elements of internal control of medicine supplies at the Binjai Village Community Health Center. The research method used was a qualitative method. The data used are primary data and secondary data, with data collection techniques namely observation, data and conclusions. The results of the conclusions show that First, the implementation of internal control of drug supplies at the Binjai Village Health Center is sufficient starting from planning procedures, requests, receipts, storage, control, recording, reporting and archiving as well as monitoring and evaluating drug management are in accordance with applicable Standard Operating Procedures. Second, the Binjai Village Health Center has implemented most of the internal control activities on medicine supplies well, so it can be said that internal control has been carried out effectively. Third, in terms of elements of drug supply control, it is good.

THERAPEUTIC BIOLOGICAL ACTIVITIES OF Balanites aegyptiaca (L.) Delile: A REVIEW

Medicinal plants continue to be a crucial source of safe, less toxic, economical, available, and reliable natural medicine supplies all over the world. Balanites aegyptiaca Del. (Zygophyllaceae), commonly known as the "desert date", is a thorny shrub or tree found in arid parts of Africa and South Asia. It has traditionally been used to cure a variety of maladies such as wounds, haemorrhoids, jaundice, syphilis, intestinal worm infection, malaria, dysentery, constipation, diarrhoea, stomachaches, asthma, and fever. The fruits of B. aegyptiaca are highly effective as antioxidants, anti-inflammatory, antibacterial, antifungal, antiparasitic, antidiabetic, and anticancer. However, the safety and effectiveness of B. aegyptiaca have not beencompletely studied in humans, so additional well-planned clinical trials are required to corroborate preclinical findings. The WHO has stressed on continued research on medical plants since products derived from plants will continue to be in demand. Searches were conducted on Google Scholar, Science Direct, Google.com, Wiley, PubMed, Hindawi, Springer, and other relevant databases for research publications on B. aegyptiaca. Duplicate publications including thesis papers, and reviews of B. aegyptiaca were excluded This review presents a thorough overview of current information on the therapeutic characteristics of B. aegyptiaca with a focus on its biological activities. It briefly examines its traditional usage, taxonomy, and biological evaluation.

The Impact of Covid-19 Pandemic on Reproductive Health in Kenya: Challenges, Lessons and Opportunities

Health systems and healthcare delivery around the world have been greatly affected by the COVID-19 pandemic. In Kenya, the attainment of universal health coverage (UHC) has been hampered by the pandemic, particularly in the areas of reproductive, maternal, newborn, and child health (RMNCH). This paper examines the effect of COVID-19 on RMNCH in Kisumu, Isiolo, Machakos, and Nyeri counties in Kenya. The objective of the study was to determine if there was a significant change in service delivery under reproductive, maternal, newborn, and child health in hospitals under the Universal Health Coverage Program. The target population was the patients seeking RMNCH services in these hospitals. The study arrived at a sample of 78 respondents achieving a response rate of 84%. The study used a mixed-methods approach, comprising both quantitative and qualitative data collection methods. The quantitative data were collected through a retrospective analysis of RMNCH indicators from January 2019 to June 2021, while the qualitative data were collected through in-depth interviews with healthcare workers and community members. The key finding of the study was that there was a significant decrease in the quality of RMNCH services during the COVID-19 period compared to before the pandemic. This conclusion is based on the results of a Wilcoxon Signed Ranks Test, which produced a test statistic Z of -4.321 and an Asymp. Sig. (2-tailed) value of 0. The challenges identified as hindering access to and provision of RMNCH services during the pandemic include inadequate personal protective equipment, inadequate supply of essential medicine, and reduced funding for RMNCH services. The study concluded that COVID-19 pandemic had a significant negative impact on RMNCH in the four counties. The pandemic led to disruptions in health service delivery, resulting in reduced access to essential RMNCH services. Consequently, there was an increase in maternal and child deaths. Recommendations include strengthening health systems, improving access to essential RMNCH services, and providing necessary resources and support to healthcare workers for delivering high-quality care.

A scoping review on the use of traditional medicine and oral health in Africa.

This review aimed to chart the landscape of literature concerning the precise applications of traditional medicine in managing specific oral diseases and, in doing so, to pinpoint knowledge gaps surrounding the use of traditional medicine for oral disease management in the African context. A systematic search of the literature was conducted on PubMed, Web of Science, Scopus, and CINAHL. The search was conducted from the inception of the database till September 2023. A search of related citations and references was also carried out. Only English language publications were included. A summary of studies that met the inclusion criteria was conducted. Of the 584 records identified, 11 were duplicates and 12 studies, published between 2006 and 2021, met the inclusion criteria. The studies were published from eight countries located in the five sub-regions on the continent. All the studies were either experimental designs or ethnobotanical surveys and they all utilized plant-based remedies. The five experimental studies aimed to assess the impact of whole plants or plant extracts on the three microorganisms responsible for dental caries and seven responsible for periodontal diseases. The number of plant species identified by the seven ethnobotanical surveys ranged from 29 to 62 while the number of plan families ranged from 15 to 29. The remedies were either topical applied, use as mouth rinses, gargled, or chewed. The systemic routes of administration identified were inhalation and drinking. The remedies were used for the treatment of hard such as dental caries and tooth sensitivity, to soft tissue lesions such as mouth ulcers, gingival bleeding, and mouth thrush. Other oral disorders managed include halitosis, jaw fracture, and oral cancer. Given the increasing prevalence of oral diseases within the region, the shortage of oral healthcare professionals and limited access to financial resources, it becomes imperative to support the generation of empirical evidence to enhance the provision of traditional medicine for oral healthcare in Africa.

Intelligent privacy‐preserving data management framework for medicine supply chain system

AbstractIn today's era, the pharmaceutical industry has integrated blockchain to secure the sensitive information of medicines, wherein public and private blockchains are used to preserve the security and privacy of the medicine supply chain data. However, conventional blockchains often limit scalability due to limited storage. Moreover, blockchain has loopholes; for example, it is not able to prove the validity of the data prior to being stored in the blockchain, which leads to fake data being added to the blockchain. As a result, it causes an issue of data provenance. Motivated by this, the proposed framework incorporated artificial intelligence (AI) algorithms to enhance the efficiency of the medicine supply chain data. The proposed framework integrated machine learning (ML) and blockchain, where ML classifies the valid and invalid data of the medicine supply chain, whereas blockchain stores only valid data and maintains its security and privacy. This identification helps the blockchain to verify medicine supply chain data before adding it to the blockchain. Additionally, we employed an InterPlanetary file system (IPFS) that saves medicine supply chain data and computes its hash to offer decentralized storage. Further, this hash data is stored on a private Hyperledger Fabric blockchain, which requires minimal storage instead of storing an entire large file. This minimal storage optimizes the process of data storage and retrieval in the Hyperledger Fabric blockchain, which enhances the scalability of the proposed framework. Finally, the result of the proposed framework is assessed in two phases: ML and blockchain, wherein the ML model's performance is measured by statistical measures and the blockchain‐based result is assessed using several performance parameters such as throughput is around (618 transactions per second), latency (0.12 s), response time (11 s) and data rate (282 Mbps).

Status and future developments for downstream processing of biological products: Perspectives from the Recovery XIX yield roundtable discussions.

Governments and biopharmaceutical organizations aggressively leveraged expeditious communication capabilities, decision models, and global strategies to make a COVID-19 vaccine happen within a period of 12 months. This was an unusual effort and cannot be transferred to normal times. However, this focus on a single vaccine has also led to other treatments and drug developments being sidelined. Society expects the pharmaceutical industry to provide an uninterrupted supply of medicines. However, it is often overlooked how complex the manufacture of these compounds is and what logistics are required, not to mention the time needed to develop new drugs. The overarching theme, therefore, is patient access and how we can help ensure access and extend it to low- and middle-income countries. Despite unceasing efforts to make medications available to all patient populations, this must never be done at the expense of patient safety. A major fraction of the costs in biopharmaceutical manufacturing are for drug discovery, process development, and clinical studies. Infrastructure costs are very difficult to quantify because they often depend on whether a greenfield facility or an existing, depreciated facility is used or adapted for a new product. To accelerate process development concepts of platform process and prior knowledge are increasingly leveraged. While more traditional protein therapeutics continue to dominate the field, we are also experiencing the exciting emergence and evolution of other therapeutic formats (bispecifics, tetravalent mAbs, antibody-drug conjugates, enzymes, peptides, etc.) that offer unique treatment options for patients. Protein modalities are still dominant, but new modalities are being developed that can be learned from including advanced therapeutics-like cell and gene therapies. The industry must develop a model-based strategy for process development and technologies such as continuous integrated biomanufacturing must be adopted. The overall conclusion is that the pandemic pace was unsustainable, focused on vaccine delivery at the expense of other modalities/disease targets, and had implications for professional and personal life (work-life balance). Routinely reducing development time from 10 years to 1 year is nearly impossible to achieve. Environmental aspects of sustainable downstream processing are also described.

Centre–State Relations in India: An Appraisal During Covid-19 Period

The framers of the Indian Constitution have tried to establish a federal system in which there is less of contradictions and more of coordination between the Union and the states. Accordingly, there is a clear division of powers between the States and the Centre in the Constitution. This arrangement has been in operation for more than seventy years. The changing sociopolitical and economic conditions have affected these relations at different phases including the Covid-19 pandemic crisis. The Indian federal structure was put to test during this period. However, during this pandemic period, both conflict and coordination in the Indian federal system have been noticed. In the initial phase of the pandemic, there was a clear conflict between the Centre and the states as the states were almost ignored in policy decisions and their implementation. Unilateral and all-of-a-sudden nationwide lockdown was imposed by the Centre during the first wave of the pandemic, but later on, a more reciprocal relationship evolved regarding the supply of essential medical inputs, advisories, medicines and medical equipments, issues related to migrant workers, etc. The Supreme Court of India had to intervene with stringent observations to regulate these relations for an effective and efficient disposal of various services to counter the pandemic outbreak. Therefore, during the pandemic, in spite of conflicts and challenges, cooperation by and large, prevailed in the Indian federation. The present research article evaluates the nature of the Indian federation, Centre–State relationships, particularly to deal with problems like that of the Covid-19 pandemic along with appropriate remedial measures.

Perspectives and Update on the Global Shortage of Verteporfin (Visudyne®).

An ongoing global shortage of verteporfin (Visudyne®) limits the treatment possibilities for several chorioretinal diseases, including central serous chorioretinopathy, choroidal hemangioma, and polypoidal choroidal vasculopathy. Verteporfin is required to perform photodynamic therapy in these ocular diseases. Therefore, the current situation has a substantial impact on eye care worldwide. The worldwide supply of verteporfin appears to be manufactured by a single factory, which is situated in the United States. The distribution of verteporfin is done by different companies for different regions of the world. Official communication on the shortage by the responsible companies has been scarce and over the past years several promises with regards to resolution of the shortage have not been fulfilled. The delivery of new batches of verteporfin is at irregular intervals, unpredictable, and may not be fairly balanced between different regions or countries in the world. To ensure a fair distribution of available verteporfin within a country, several measures can be taken. In the Netherlands, a national committee, consisting of ophthalmologists, is in place to arrange this. On the European level, the European Union and European Medicine Agency have plans to monitor medicine shortages more closely and to intervene if necessary. With a more intensified monitoring and regulation of medicine supplies, future impending shortages may be prevented. Remarkably, the amount of medicine shortages is increasing, having a significant and sometimes irreversible impact on patient care. Thus, efforts should be undertaken to minimize the consequences and, whenever possible, to prevent future medicine shortages.

Retraction Note: Sustainable and optimal design of Chinese herbal medicine supply chain network based on risk dynamic regulation mechanism

Retraction Note: Sustainable and optimal design of Chinese herbal medicine supply chain network based on risk dynamic regulation mechanism

Manajemen Supply pada Produk HNI-HPAI Halal Mart di Kabupaten Sambas Perspektif Ekonomi Islam

Islam is a religion that has a universal system that regulates good business and is in accordance with religion. Many companies are switching to an Islamic business system, called sharia economics. Currently, people really like the Islamic business system. Sharia-based companies include PT HPAI (Herbal Penawar al-Wahida Indonesia), which later became HNI-HPAI (Herba Penawar Al-Wahida Indonesia-Halal Network International). This research aims to determine the supporting and inhibiting factors for implementing supply management at the herbal HPAI halal mart in Sambas Regency. In this research, qualitative research was used. The data collection technique is carried out by means of interviews, then analyzed through data reduction, classifying the data, presenting the data and finally drawing conclusions. The data sources in this research consist of 2, namely primary data and secondary data. One of the supporting factors for carrying out herbal medicine supply management in Sambas Regency can involve operational efficiency, product quality and good marketing strategies. Meanwhile, inhibiting factors may include raw material supply instability, regulatory changes, or logistical constraints. The external supporting factor is that many people know the quality of HPAI products, so they are easy to sell because the prices are affordable. The internal inhibiting factor is not having its own way or rules to handle orders for lots of herbal products by consumers and delays in delivery of goods. These delays are due to an overload of goods to be sent by the expedition.

Management of Prescription Medicines in Ukraine: Continuation of the Experimental Study on the Organization of Pharmaceutical Provision

Conducted the experimental study on the organization of pharmaceutical provision, complaints of patients from the position of management of prescription medicines in Ukraine. It has been proven that the level of organization of pharmaceutical supply affects patient complaints. 750 complaints from patients about unsatisfactory on the organization of the pharmaceutical provision were processed. Found that 77% of complaints of patients (women accounted for 70%; men – 30%) were related to late or incomplete on the organization of the pharmaceutical provision of prescription medicines. Violation of the rights of patients to receive medicines on discounted and free prescriptions of doctors was recorded in 88% of complaints. The matrix of complaints based on patient reports of unsatisfactory of prescription medicines of different clinical and pharmacological, classification and legal and nomenclature and legal groups was constructed. In accordance to the ATC classification, the clinical and pharmacological groups were distributed of medicines on 9 clinical and pharmacological groups. According to ATC code A, 5 INN medicines were not available to patients, and more complaints were received. According to ATC code B, 7 INN medicines were not available to patients, and more complaints were received. According to ATC code C, 25 INN medicines were not available to patients, and more complaints were received. According to ATC code D, 1 INN medicines were not available to patients, and more complaints were received. According to ATC code L, 2 INN medicines were not available to patients, and more complaints were received. According to ATC code M, 1 INN medicines were not available to patients, and more complaints were received. According to ATC code N, 13 INN medicines were not available to patients, and more complaints were received. According to ATC code R, 5 INN medicines were not available to patients, and more complaints were received. According to ATC code S, 2 INN medicines were not available to patients, and more complaints were received. The organization of pharmaceutical provision of these drugs was at a low level. It is substantiated that the main feature of pharmaceutical provision of patients is social orientation. It is proved that it is necessary to actively develop the social potential of health care facilities in the format of transparency, completeness, reliability, and efficiency of information about the costs that form the cost of drugs. In the course of the study, a matrix of complaints based on patient reports of unsatisfactory pharmaceutical provision of drugs of different clinical and pharmacological, classification and legal, nomenclature and legal groups was constructed. On the basis of the matrix of complaints, three national lists of drugs were developed with the further development of organizational and legal measures to increase the level of pharmaceutical provision of patients. It is noted that the reference mechanism of drug pricing is aimed at establishing the level of reimbursement at the expense of the state and reducing costs to 50% for pharmaceutical provision of patients.

Blockchain for Organ Transplantation: A Survey

As blockchain becomes more widely used, a growing number of application fields are becoming interested in blockchain to benefit from its decentralised nature, invariability, security, transparency, quick transaction capabilities, and cost-effectiveness. Blockchain has a wide range of applications and uses in healthcare. Distributed ledger technology facilitates the secure transfer of patient medical records, manages the medicine supply chain, and creates an efficient, transparent, safe, and effective way of communicating data across global healthcare. The organ transplantation process (OTP) is one of the healthcare areas that benefit from the use of such technology to make its process more secure and transparent. In this article, we put forward a systematic literature review analysis on the application of blockchain to the OTP. Additionally, we address and highlight the barriers and challenges that arise while using blockchain technology for the OTP. We also offer some suggestions for future developments that would enhance blockchain’s implementation in the OTP domain.

On the issue of logistic support of export of medicinal preparations of national production

The current geopolitical situation raised pointed question of developing new supply chains and looking for rolling stock to develop newly formed cargo flows, including medicinal preparations transportation. Considering necessity in timely and safe supply of medicines, it is necessary to develop set of measures permitting to implement export of this production of national industry to ensure ultimate independence from unfriendly states. The article considers main indicators of import and export operations of medicinal preparations and measures taken by the state to support industry in current conditions, requirements for international transportation of this category of goods. The measures increasing exports within the framework of the Pharmaceutical Industry Development Strategy until 2030, such as expansion of fleet of autonomous refrigerated containers, use of consolidation warehouses in Turkey and Kazakhstan to ensure decreasing of cost of multi-modal transportation of medicinal preparations, as well as validation of rolling stock in accordance with GDP requirements.

Deep learning enhanced mixed integer optimization: Learning to reduce model dimensionality

This work introduces a framework to address the computational complexity inherent in Mixed Integer Programming (MIP) models by harnessing the potential of deep learning. By employing deep learning, we construct problem-specific heuristics that identify and exploit common structures across MIP instances. We train deep learning models to estimate complicating binary variables for target MIP problem instances. The resulting reduced MIP models are solved using standard off-the-shelf solvers. We present an algorithm for generating synthetic data enhancing the robustness and generalizability of our models across diverse MIP instances. We compare the effectiveness of (a) feed-forward neural networks (ANN) and (b) convolutional neural networks (CNN). To enhance the framework's performance, we employ Bayesian optimization for hyperparameter tuning, aiming to maximize the occurrence of global optimum solutions. We apply this framework to a flow-based facility location allocation MIP formulation that describes long-term investment planning and medium-term tactical scheduling in a personalized medicine supply chain.

Revisiting Traditional Chinese Medicine in Hong Kong during the Influenza Epidemics in the 1950s and 1960s.

This paper examines the supply and utilization of traditional Chinese medicine (TCM) in Hong Kong during the influenza epidemics of the 1950s and 1960s. Existing narratives of TCM in Hong Kong have predominantly framed with within the dichotomy of Western medicine "Xiyi" and Chinese medicine "Zhongyi," portraying TCM as marginalized and nearly wiped out by colonial power. Departing from this binary opposition, this study views TCM as an autonomous space that had never been subjugated by the colonial power which opted for minimal interventionist approach toward TCM. By adopting diachronic and synchronic perspectives on Hong Kong's unique environment shaped by its colonial history and the geopolitics of the Cold War in East Asia, particularly its relationships with "China," this research seeks to reassess the role and status of TCM in post-World War II Hong Kong. In Hong Kong, along with other countries in East Asia, traditional medicine has ceded its position as mainstream medicine to Western medicine. Faced with the crisis of "extinction," Chinese medical professionals, including medical practitioners and merchant groups, persistently sought solidarity and "self-renewal." In the 1950s and 1960s, the colonial authorities heavily relied on private entities, including charity hospitals and clinics; furthermore, there was a lack of provision of public healthcare and official prevention measures against the epidemic influenza. As such, it is not surprising that the Chinese utilized TCM, along with Western medicine, to contain the epidemics which brought about an explosive surge in the number of patients from novel influenza viruses. TCM was significantly consumed during these explosive outbreaks of influenza in 1957 and 1968. In making this argument, this paper firstly provides an overview of the associations of Chinese medical practitioners and merchants who were crucial to the development of TCM in Hong Kong. Secondly, it analyzes one level of active provision and consumption of Chinese medicine during the two flu epidemics, focusing on the medical practices of TCM practitioners in the 1957 epidemic. While recognizing the etiologic agent or agents of the disease as influenza viruses, the group of Chinese medical practitioners of the Chinese Medical Society in Hong Kong adopted the basic principles of traditional medicine regarding influenza, such as Shanghanlun and Wenbingxue, to distinguish the disease status among patients and prescribe medicine according to correct diagnoses, which were effective. Thirdly, this paper examines the level of folk culture among the people, who utilized famous prescriptions of Chinese herbal medicine and alimentotherapy, in addition to Chinese patent medicines imported from mainland China. In the context of regional commercial network, this section also demonstrates how Hong Kong served as a sole exporting port of medicinal materials (e.g., Chinese herbs) and Chinese patent medicines from the People's Republic of China to capitalist markets, including Hong Kong, under the socialist planned or controlled economy in the 1950s and 1960s. It was not only the efficacy of TCM in restoring immunity and alleviating symptoms of the human body, but also the voluntary efforts of these Chinese medical practitioners who sought to defend national medicine "Guoyi," positioning it as complementary and alternative medicine to scientific medicine. Additionally, merchants who imported and distributed Chinese medicinal materials and national "Guochan" Chinese patent medicine played a crucial role, as did the people who utilized Chinese medicine, all of which contributed to making TCM thrive in colonial Hong Kong.

Good practice in sport science and medicine: perceptions of leaders on support and management of practitioners and teams

ABSTRACT The evaluation and delivery of good practice in the provision of Sport Science and Medicine (SSM) is clearly of interest and importance – with applied research, both anecdotal and empirical, that is burgeoning. However, no literature to date explores the role of the organisation and leader in supporting those striving to deliver good practice. The primary aim of this investigation is to explore the perceptions of experienced high-level leaders in the leadership, direction and operation of SSM practitioners and teams. A mixed methods modified Delphi technique, with three stages of investigation – a quantitative survey, individual interviews, and focus group discussions, was undertaken with 13 leaders of high-performance sport organisations in Europe and Australasia. This approach allowed expert consensus to be arrived at on a set of theoretically underpinned principles applicable to the pan regional support of good practice. A plethora of principles are offered relating to three core areas of support: organisational requirements; leadership; and practitioners´ skills and development. Importantly, a number of operational considerations for application are captured, including the impact of situational context in determining the focus and core elements of support required. Findings are particularly relevant for those leading SSM delivery – with a well led, organised and supported approach seemingly enabling good practice. In addition, results offer further empirical support to the importance of interdisciplinary teamwork, non-technical skill sets and relevant development opportunities for the practitioner. Overall, we hope the principles derived offer a practical starting point for those engaged in SSM provision.

Challenges to implementation of IMNCI strategy in First Level Care Facilities.

Objective: To assess IMNCI implementation strategy and identify challenges towards effective implementation in first level care facilities of district Jamshoro. Methodology: This mixed method research was carried out from Jan 2020 to March 2020 at Rural Health Centers (RHC) in District Jamshoro using semi-structured, pre-tested, written questionnaires after taking due approval and written informed consent from respondents. The respondents (representing different cadres of healthcare providers i.e., medical officers (male & female), lady health workers (LHWs), vaccinators, pharmacists and 13 administrative staff. The data obtained (pertaining to perception and views regarding IMNCI implementation and availability of relevant logistics for service provision) was analyzed using SPSS version 22.0 for windows. Results: The mean age of the sample stood at 42 (SD ± 4) years with a majority comprising of male, dispensing/nursing staff with a mean work experience of 13.2 years (SD ± 1.1) Pneumonia was deemed the commonest childhood problem by most respondents, followed by malaria and others uniformly across all catchments. The understanding regarding IMNCI was common (despite the absence of formal training) yet often, the strategies were not implemented while caring for children. Conclusion: Effective implementation is a seldom sight with many challenges, including but not limited to shortage of human resource and a rather limited supply of medicines. Thus, efforts must be dedicated at ensuring an ample human resource and a consistent supply of necessary medication. Keywords: IMNCI, Childhood Illness, Neonatal Illness, Integrated Management, Primary care facility.

Availability, pricing, and affordability of essential medicines for pediatric population in Malawi.

Lack of access to essential medicines negatively impacts on the quality of healthcare delivery and increases morbidity and mortality, especially to the vulnerable pediatric population. We assessed the availability, pricing, and affordability of pediatric formulations in Malawi. The study was conducted in 76 health facilities (public, faith-based and private pharmacies, and clinics) from the northern and southern regions of Malawi from March to May 2023. We adapted the WHO/HAI method for the assessment of both availability and pricing of medicines. Data on availability were collected from stock card records using a WHO/HAI template and medicine prices were provided by the pharmacy personnel who were managing the facilities. Availability of medicines was calculated as the percentage of facilities which had a stock of the respective medicine at the time of data collection while medicine prices was assessed by calculating the median prices of each medicine. To assess the affordability of the medicines, we calculated the number of days it takes for a person who is receiving the government-set minimum wage to work to pay for a treatment course of common indications. The study was approved by the KUHES ethics committee under the numbers U.12/22/3900 and U.12/22/3903. The overall availability of pediatric medicines was 38.1% for public health facilities, 53.7% for private retail pharmacies and drug stores, 49.5% for private clinics and 48.3% for Christian Health Association of Malawi (CHAM) facilities. We found the illegal availability of prescription-only medicines of up to 54% in medicine stores. Medicine median prices were higher in the private clinics followed by retail pharmacies and drugs stores. CHAM had the lowest median prices for medicines of all the sectors. More than 50% of medicines were found to be affordable as less than a day's wage was required to purchase the treatment. We found poor availability of pediatric formulation among public, CHAM, and private sectors in Malawi. This may affect the quality of care among pediatric patients and therefore contribute to morbidity and mortality in Malawi. The supply of medicines and health commodities needs to consider needs of special populations such as children to achieve universal health coverage.