Availability and prices of medicines for non-communicable diseases at health facilities and retail drug outlets in Kenya: a cross-sectional survey in eight counties
The burden of non-communicable diseasesrnNCDs has been on the rise especially inrnlow/middle-income countries LMICs.1 2rnGlobally an estimated 40.5 million deaths inrn2016 were due to NCDs.2rn Eighty per cent ofrnthese deaths were caused by diseases includingrncancers cardiovascular diseases CVDrnchronic respiratory diseases and diabetes.rnNearly 80 of NCD deaths occur in LMICsrnand people living in sub-Saharan Africa facernthe highest risk of death.
The objective of this study was to determine the availability and prices of medicines for non-communicable diseases NCDs in health facilities and private for-profit drug outlets in Kenya.
Cross-sectional study.rnrnMethods All public and non-profit health facilities in eight counties Embu Kakamega Kwale Makueni Narok Nyeri Samburu and West Pokot that purchased medicines from the Mission for Essential Drugs and Supplies a major wholesaler were surveyed in September 2016. For each health facility one nearby private for-profit drug outlet was also surveyed. Data on availability and price were analysed for 24 NCD and 8 acute medicine formulations. Availability was analysed separately for medicines in the national Essential Medicines List EML and those in the Standard Treatment Guidelines STGs. Median price ratios were estimated using the International Medical Products Price Guide as a reference.
59 public and 78 non-profit facilities and 135 drug outlets were surveyed. Availability of NCD medicines was highest in private for-profit drug outlets 61.7 and 29.3 for medicines on the EML and STGs respectively. Availability of STG medicines increased with increasing level of care of facilities: 16.1 at dispensaries to 31.7 at secondary referral facilities. The mean proportion of availability for NCD medicines listed in the STGs 0.25 was significantly lower than for acute medicines 0.61 p0.0001. The proportion of public facilities giving medicines for free 0.47 was significantly higher than the proportion of private non-profit facilities giving medicines for free 0.09 p0.0001. The mean price ratio of NCD medicines was significantly higher than for acute medicines in non-profit facilities 4.1 vs 2.0 respectively p0.0076 and in private for-profit drug outlets 3.5 vs 1.7 p0.0013.
Patients with NCDs in Kenya appear to have limited access to medicines. Increasing access should be a focus of efforts to achieve universal health coverage.
Publication Information
Focus County(s):
Programme Area(s):
Non-Communicable Diseases
Research Priority Area(s):
Disease Domain(s):
Document History:
Publication Date: 14.Apr.2020
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