Assessment of availability, affordability and prescribing patterns of essential medicines in public health facilities in Tanga region, Tanzania

ABSTRACT. Objective: To determine and assess the availability, affordability and prescribing pattern of essential medicines in public health of Tanzania. Setting: Availability, affordability, and rational use of medicines were assessed in primary health care centers in six different geographical areas of Tanga region. Methods: This was a cross-sectional survey in accordance with the WHO guidelines for monitoring and assessing the pharmaceutical situation in developing countries, which was conducted between May and June 2011 in Tanga. For this survey, a total of 30 public health facilities were selected from the six different geographic areas identified in Tanga and 600 clients were interviewed during the study. Results: The mean average number of medicines prescribed by physician was 2.9 per prescription. The number of prescriptions containing an antibiotic was 66.61% on average. The number of prescriptions containing injectable medicines was 25.72%, with a considerable variation among facilities. Adherence of prescribers to standard treatment guidelines showed only 70.08% of prescriptions were in accordance with the national guidelines for treating various disease conditions. About 61.75 % of the 14 items monitored was available in Public health facilities. Average mean of 66.55% of the medicines prescribed by the physician were dispensed by the health facility medicine dispensing unit. The study revealed a mean stock – out duration of 80.85 days. The correct medicine labeling criteria for prescriptions were met in 62.29% of the analyzed prescriptions. Adequate patient knowledge about the dispensed medicines was met only for 83.85% of patients. Of the 30 facilities, only 19 (63.3%) reported to have the tools in hand and this was proved by physical observation. Medicine availability of 71.43 % and average stock- out duration of 54.37 days per year and good quality of storage condition were observed at the zonal medical store in the region. Conclusion: The prescribing patterns of essential medicines in the region were varying across district with the quite low number of medicines per prescription. The use of antibiotics and injectable medicines were considerable low in most health facilities. The overall availability of medicines in the region is still very low. The stock-out duration of essential medicines is still very high in the region. Affordability of essential medicines in the region was good with an overall ratio that indicated the medicines are affordable Page | xiv in public health facilities. The quality indicators show that storage condition of medicines in the region was satisfactory with very low number of expired medicines on the shelves. Furthermore most health facilities have updated STG and NEML that are used by health care providers.MUHAS - MOHSW and GI