背景:获得基本药物是全民健康覆盖的关键组成部分。然而,苏丹基本药物的供应没有得到很好的研究。同样,大多数苏丹人缺乏健康保险,使自付支出成为毒品融资的主要来源。因此,苏丹的药品负担能力值得怀疑,只有30%的人口被公共卫生服务或公共健康保险覆盖。我们进行了这项研究,以评估喀土穆州公共部门医疗机构中基本药物的可用性和价格。此外,这项研究旨在评估患者对基本药物的感知负担能力,以及公共设施的住宿和可接受性。
方法:在喀土穆州三个地区的30个初级卫生保健机构进行了一项横断面研究。在每个中心的药房内,标准化清单评估了从苏丹国家基本药物清单中选择的21种基本药物的可获得性和可负担性,并评估了其储存条件。此外,从所有药房中选择630名患者进行退出访谈,评估他们的感知可及性,可接受性,住宿,和基本药物的可负担性。通过Kobo工具箱收集数据,并使用SPSS版本26进行分析。
结果:参与者对可访问性的评分,负担能力,住宿,可接受性分别为3.7/5、1.5/4、5/6和5.4/6,26.7%的完全访问率和一些指数之间的弱相关性。成人和儿科药物的总体可获得性为36.8%6.7%,分别。在所消耗的19种药物中,10种和16种药物的单疗程治疗费用超过了参保和未参保患者的每日工资,中位数价格比分别为16.4和62.8。此外,药房区的条件被发现质量很好,然而,40%的商店的储藏室没有运作。
结论:由于高昂的价格和身体不可用,患者获得所需药物的机会有限。初级保健能力不能满足公民的需求。患者访问变量的结果(可访问性,住宿,接受,和负担能力)与低收入国家相当。确保获得免费药品可能会提高患者对医疗保健服务的满意度,并减少私人药品支出,这是一个长期的,实现苏丹全民健康覆盖的可持续方式。
Access to essential medicines is a critical component of universal health coverage. However, the availability of essential medicines in Sudan isn\'t well studied. As well, most Sudanese people lack health insurance, making out-of-pocket spending the primary source of drug financing. Therefore, the affordability of medicines in Sudan is questionable, with only 30% of the total population being covered by a public health service or public health insurance. We undertook this study to assess the availability and prices of essential medicines in public-sector health facilities in Khartoum state. Moreover, this study aims at assessing patients\' perceived affordability of essential medicines, and accommodation and acceptability of the public facility.
A cross-sectional study was carried out at 30 primary healthcare facilities\' drug dispensaries across three districts in Khartoum state. Within each Centre\'s dispensary unit, a standardized checklist evaluated the availability and affordability of 21 essential medicines selected from Sudan\'s national essential medicines list and assessed their storage conditions. Furthermore, 630 patients were selected from all dispensary units for an exit interview that assessed their perceived accessibility, acceptability, accommodation, and affordability of essential medicines. Data were collected through the Kobo toolbox and analyzed using SPSS version 26.
Participants\' ratings of accessibility, affordability, accommodation, and acceptability were 3.7/5, 1.5/4, 5/6, and 5.4/6, respectively, with a 26.7% full access and weak correlation between some of the indices. The overall availability of adults and pediatric medicines was 36.8% 6.7%, respectively. Cost of a single course of treatment for 10 and 16 drugs out of the 19 drugs consumed exceeds the daily wage of insured and uninsured patients, with a median price ratio of 16.4 and 62.8, respectively. Moreover, the dispensary area conditions were found to be of good quality, yet the storerooms were not functioning in 40% of the outlets.
Patients had limited access to their needed drugs due to high prices and physical unavailability, and primary healthcare capacities are not meeting the demands of citizens. The outcomes for the patients\' access variables (accessibility, accommodation, acceptance, and affordability) are comparable to those in countries with low incomes. Ensuring access to free medicines is likely to improve patients\' satisfaction with healthcare services and reduce private expenditure on medicines, which is a long-term, sustainable way towards universal health coverage in Sudan.