Assessment of Availability, Affordability and Prices of Essential Medicines for Under-Five Children in Northwest Ethiopia
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Date
2023
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Addis Ababa University
Abstract
Background: Maintaining the health of under-five children is a major indicator of a countries well-
functioning health care system and socioeconomic development. To ensure this, essential medicines need
to be available and affordable at all times. Thus, the objective of this study was to determine the availability,
prices and affordability of essential medicines for under-five children in selected health facilities of North
West Ethiopia.
Methods: The availability and prices data of fifty essential medicines (EMs) for under-five children in 30
public and 30 private health facilities was collected by employing the WHO/HAI methodology using a
cross sectional study design. Availability was calculated by dividing the number of health sectors which
stocked the medicines at the time of data collection by the total number of facilities surveyed and expressed
as percentage. Affordability was measured as the number of daily wages required for the lowest-paid
government worker to purchase a full treatment course for an acute condition or a 30-day treatment for a
chronic condition.
Results: The mean availabilities of lowest priced generic (LPG) medicines were 52.1% in the public sector
and 40.2% in the private sectors, whereas for highest priced medicines (HPMs) it was found to be 0% and
11.5% respectively. The median price ratios (MPRs) of LPG medicines were 0.98 and 2.3 times the
international reference price (IRP) for public and private sectors respectively. In the private sector the
patient prices of HPMs were 4 times the IRP. The percentages of unaffordable medicines for the assessed
common conditions were 75% and 91% in the public and private sectors respectively.
Conclusion: The overall availability of EMs for under-5 children was suboptimal. Prices of EMs in the
private sector exceed the IRP and most EMs for under-5 children were found to be unaffordable in both
public and private sectors. Thus, further analysis of reasons for low availability and regulations on price
markups in the private sector are needed to promote health and prevent catastrophic expenses.
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Keywords
Availability, prices, affordability, children under five, northwest Ethiopia