ArticleBMJ global health2020
Health system determinants of access to essential medicines for children with cancer in Ghana.
Article in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Pooled it
- Availability of essential medicines for non-communicable diseases: a scoping review of challenges and opportunities.BMJ global health · 2025Article
- Spatial and Temporal Distribution of Pediatric Cancers in Southern Ghana: A Retrospective Observational Study.Health science reports · 2025Article
- Cost-effectiveness and budget impact of covering Burkitt lymphoma in children under Ghana's National Health Insurance Scheme.Cost effectiveness and resource allocation : C/E · 2025Article
- Achieving universal coverage of childhood cancers in Ghana via the National Health Insurance Scheme: A stakeholder analysis.PLOS global public health · 2025Article
- A proposed analytical framework for qualitative evaluation of access to medicines from a health systems perspective.BMC research notes · 2024Article
- Access to childhood cancer medicines in South Africa: a health systems analysis of barriers and enablers.Journal of pharmaceutical policy and practice · 2024Article
- Alignment in the registration, selection, procurement and reimbursement of essential medicines for childhood cancers in South Africa.BMJ global health · 2023Article
- Experience of Pharmacists with Anti-Cancer Medicine Shortages in Pakistan: Results of a Qualitative Study.International journal of environmental research and public health · 2022Article
- Defining Essential Childhood Cancer Medicines to Inform Prioritization and Access: Results From an International, Cross-Sectional Survey.JCO global oncology · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence of the context-specific challenges related to childhood cancer drug (CCD) access is vital to improving outcomes for children with cancer in low- and middle-income countries, such as Ghana. We sought to determine the availability and cost of essential CCD in Ghana and identify the underlying determinants of access.
methodsOur study integrated quantitative data on drug prices and availability with qualitative insights into health system and sociopolitical determinants of CCD access in Ghana. We analysed retrospective monthly price and stock data for 41 cancer and supportive care drugs on the WHO Essential Medicines List (EML) from private retail and public institutional pharmacies. Non-parametric analyses evaluated relationships between drug price and availability, and impacts of drug class and formulation on availability and procurement efficiency. We assessed the determinants of drug access through thematic analysis of policy documents and semi-structured interviews (n=21) with key health system stakeholders.
resultsGhana lists only 47% of essential CCD on its National EML, revealing gaps in domestic formulary inclusion. Stock-outs occurred for 88% of essential CCD, with a 70-day median stock-out duration; 32% had median price ratios above internationally-accepted efficiency thresholds. Drugs procured inefficiently were more susceptible to stock-outs (p=0.0003). Principal determinants of drug access included: (1) lack of sociopolitical priority afforded childhood cancer and (2) the impact of policy and regulatory environments on drug affordability, availability and quality. Establishment of a population-based cancer registry, a nationally-coordinated procurement strategy for CCD, public financing for childhood cancer care and policies to control drug costs emerged as priority interventions to improve drug access in Ghana.
conclusionOur study provides context-specific evidence to enable responsive policy development for efficient drug procurement and supply management in Ghana and establishes a rigorous approach to the analysis of childhood cancer drug access in similar health system settings.
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