Evidence map›Paper›PMID 37848939›Full record

ArticleInternational journal for equity in health2023

Accessibility crisis of essential medicines at Sudanese primary healthcare facilities: a cross-sectional drugs' dispensaries assessment and patients' perspectives.

Lina Hemmeda, Abubaker E A Koko, Radia F Mohamed, Yousra Ibrahim Abdallah Mohammed, Abeer Osman Mukhtar Elabid, Alaa T Omer, Amna Abdel Rafea Al Hashemi Hamida, Aya M Haiba, Eithar M Ali, Istabraq I Abdelgadir and 4 more

Open access · goldAbstract read
In one paragraph

Article in International journal for equity in health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
4.6field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Lina HemmedaFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Abubaker E A KokoFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Radia F MohamedFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Yousra Ibrahim Abdallah MohammedFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Abeer Osman Mukhtar ElabidFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Alaa T OmerFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Amna Abdel Rafea Al Hashemi HamidaFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Aya M HaibaFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Eithar M AliFaculty of Medicine, University of Khartoum, Khartoum, Sudan. eitharmohamed995@outlook.com.
Istabraq I AbdelgadirFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Reem M Al FanobFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Saja S Mohamed AlmahadiFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Sara AliFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Suzan A A MahgoubFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
University of Khartoum · SD

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccess 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.

methodsA 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.

resultsParticipants' 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.

conclusionPatients 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.

Indexed as

Drugs, EssentialHealth Services AccessibilityChildCross-Sectional StudiesHumansPrimary Health CarePrivate SectorPublic SectorDrugs, EssentialAffordabilityEssential medicinesPrimary healthcare servicesSudan’s healthcareUniversal health coverage

Identifiers

PMID37848939
PMCPMC10583350
OpenAlexW4387705837

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.