Improving Access to Essential Medicines for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa

2014 ◽  
Author(s):  
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2018 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Joseph Gallagher ◽  
Kenneth McDonald ◽  
Mark Ledwidge ◽  
Chris J Watson ◽  
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...  

Heart failure is a growing problem in sub-Saharan Africa. This arises as the prevalence of risk factors for cardiovascular disease rises, life expectancy increases and causes of heart failure more common in Africa, such as rheumatic heart disease and endomyocardial fibrosis, continue to be a significant issue. Lack of access to diagnostics is an issue with the expense and technical expertise required for echocardiography limiting access. Biomarker strategies may play a role here. Access to essential medicines is also limited and requires a renewed focus by the international community to ensure that appropriate medications are readily available, similar to that which has been implemented for HIV and malaria.


2021 ◽  
Author(s):  
Noel Namuhani ◽  
Suzanne N Kiwanuka ◽  
Martha Akulume ◽  
Simeon Kalyesubula ◽  
William Bazeyo ◽  
...  

Abstract Background Clinical laboratory services are a critical component of the health system for effective disease diagnosis, treatment, control and prevention. However, many laboratories in Sub Saharan Africa remain dysfunctional. The high costs of tests in the private sector also remain a hindrance to accessing testing services. This study aimed at assessing the functionality of laboratories based on test menus and the associated constraints in Uganda. Methods This cross sectional quantitative study involved an assessment of 100 laboratories randomly selected in 20 districts from four regions of the country. Sixteen percent of the studied laboratories were regional hub laboratories. Laboratory in charges and managers in each of the selected laboratories were interviewed. A checklist for laboratory supplies adapted from the Essential Medicines and Health supplies list for Uganda, (2012) was used to assess availability of testing supplies. Data was analyzed using excel and STATA 14. Results At the point of assessment, generally, all laboratories were able to perform malaria tests and HIV tests. All the hub laboratories conducted malaria tests and TB screening. Less than half had electrolytes tests due to lack of equipment, nonfunctioning equipment and lack of reagents. Full blood count tests were missing in 25% of the hub laboratories mainly due to lack of equipment. The lack of reagents (66.7%) and the lack of equipment (58.3%) caused the majority 10/16 of the hubs to routinely referred specimens for tests that are supposed to be carried out in these laboratories due to lack of reagents (66.7%) and non-functional equipment (58.3%). Although officially recognized as an operational structure, Hub laboratories lacked a list of essential and vital supplies. Conclusions Most laboratories performed well for the common tests. However, many laboratories did not meet testing requirements especially for the advanced tests according to standard testing menus for Uganda due to non-functioning equipment, lack of equipment and reagents. Hubs lack list of essential supplies. Therefore, there is need to provide equipment to laboratories, repair the non-functional ones and develop an essential list of supplies for the hub laboratories.


2021 ◽  
Author(s):  
Augustina Koduah ◽  
Leonard Baatiema ◽  
Anna Cronin de Chavez ◽  
Anthony Danso-Appiah ◽  
Irene A Kretchy ◽  
...  

Abstract Background: High medicine prices contribute to increasing cost of healthcare worldwide. Many patients with limited resources in sub-Saharan Africa (SSA), are confronted with out-of-pocket charges, constraining their access to medicines. Different medicine pricing policies are implemented to improve affordability and availability. However, evidence on the experiences of implementations of these policies in SSA settings appears limited. To bridge this knowledge gap, we reviewed published evidence and answered the question: what are the key determinants of implementation of medicines pricing policies in SSA countries? Methods: We identified policies, examined implementation processes, key actors involved, contextual influences on and impact of these policies. We searched five databases and grey literature; screening was done in two stages following clear inclusion criteria. A structured template guided the data extraction and data analysis followed thematic narrative synthesis. The review followed best practices and reported using PRISMA guidelines.Results: Of the 5595 studies identified, 32 met the inclusion criteria. The results showed fourteen pricing policies were implemented across SSA between 2003 and 2020. These were in four domains: targeted public subsides, regulatory frameworks and direct price control, generic medicine policies and purchasing policies. Main actors involved were government, wholesalers, manufacturers, retailers, professional bodies, community members and private and public health facilities. Key contextual barriers to implementation were: limited awareness about policies, lack of regulatory capacity, and lack of price transparency in external reference pricing process. Key facilitators were: favourable policy environment on essential medicines, strong political will, and international support. Evidence on effectiveness of these policies on reducing prices of, and improving access to, medicines were mixed. Reductions in prices were reported occasionally and implementation of medicine pricing policy sometimes led to improved availability and affordability to essential medicines.Conclusions: Implementation of medicine pricing policies in SSA shows some mixed evidence of improved availability and affordability to essential medicines. It is important to understand country-specific experiences, diversity of policy actors and contextual barriers and facilitators to policy implementation. Our study suggests three policy implications: avoiding ‘one-size-fits-all’ approach, engaging both private and public sector policy actors in policy implementation and continuously monitor implementation and effects of policies. Systematic review protocol registration: PROSPERO registration number CRD42020178166.


2019 ◽  
Vol 4 (Suppl 9) ◽  
pp. e001306 ◽  
Author(s):  
Benson Droti ◽  
Kathryn Patricia O’Neill ◽  
Matthews Mathai ◽  
Delanyo Yao Tsidi Dovlo ◽  
Jane Robertson

BackgroundMost maternal and child deaths are preventable or treatable with proven, cost-effective interventions for infectious diseases and maternal and neonatal complications. In 2015 sub-Saharan Africa accounted for up to 66% of global maternal deaths and half of the under-five deaths. Access to essential medicines and commodities and trained healthcare workers to provide life-saving maternal, newborn and post-natal care are central to further reductions in maternal and child mortality.MethodsAvailable data for 24 priority medicines for women and children were extracted from WHO service availability and readiness assessments conducted between 2012 and 2015 for eight countries in sub-Saharan Africa. The mean availability of medicines in facilities stating they provide services for women or children and differences by facility type, ownership and location are reported.ResultsThe mean availability of 12 priority essential medicines for women ranged from 22% to 40% (median 33%; IQR 12%) and 12 priority medicines for children ranged from 28% to 57% (median 50%; IQR 14%). Few facilities (<1%) had all nominated medicines available. There was higher availability of priority medicines for women in hospitals than in primary care facilities: range 32%–80% (median 61%) versus 20%–39% (median 23%) and for children’s medicines 31%–71% (median 58%) versus 27%–57% (median 48%). Availability was higher in public than private facilities: for women’s medicines, range 21%–41% (median 34%) versus 4%–36% (median 27%) and for children’s medicines 28%–58% (median 51%) versus 5%–58% (median 46%). Patterns were mixed for rural and urban location for the priority medicines for women, but similar for children’s medicines.ConclusionsThe survey results show unacceptably low availability of priority medicines for women and children in the eight countries. Governments should ensure the availability of medicines for mothers and children if they are to achieve the health sustainable development goals.


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