Availability, Costs and Stock-Outs of Essential NCD Drugs in Three Rural Rwandan Districts

Background: To reduce the non-communicable diseases (NCDs) burden, the World Health Organization has set a target to reach 80% availability of the affordable essential medicines required to treat NCDs by 2025. Objectives: This study described the availability, costs, and stock-outs of essential NCD...

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Autores principales:	Jean Paul Mukundiyukuri, Jean Jacques Irakiza, Naome Nyirahabimana, Loise Ng’ang’a, Paul H. Park, Gedeon Ngoga, Ziad El-Khatib, Louis Nditunze, Etienne Dusengeyezu, Christian Rusangwa, Tharcisse Mpunga, Joel Mubiligi, Bethany Hedt-Gauthier
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2020
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/8a57d4c75a8840feb3e7810edfc44daa
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spelling	oai:doaj.org-article:8a57d4c75a8840feb3e7810edfc44daa2021-12-02T12:18:16ZAvailability, Costs and Stock-Outs of Essential NCD Drugs in Three Rural Rwandan Districts2214-999610.5334/aogh.2729https://doaj.org/article/8a57d4c75a8840feb3e7810edfc44daa2020-09-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2729https://doaj.org/toc/2214-9996Background: To reduce the non-communicable diseases (NCDs) burden, the World Health Organization has set a target to reach 80% availability of the affordable essential medicines required to treat NCDs by 2025. Objectives: This study described the availability, costs, and stock-outs of essential NCD drugs in three rural Rwandan districts. Methods: We retrospectively assessed 54 NCD drugs listed for district hospitals or health centers in the Rwanda national essential medicines list. Data were collected from three district hospitals and 17 health centers that host NCD clinics. We extracted data on drug availability, quantity dispensed, costs, stock-outs, and the replenishing supplier for these drugs between January 1 and December 31, 2017. Results: Overall, 71% of essential medicines for health centers and 78% of essential medicines for district hospitals were available at facilities. Only 15% of health centers experienced a stock-out of beclomethasone, while 77% experienced at least one stock-out of amlodipine and metformin. The median length of stock-out ranged from nine to 72 days, and 78% of the stock-outs across all health centers were replenished by a Non-Governmental Organization (NGO) partner. Except for enoxaparin and metformin, all district hospitals experienced at least one stock-out of each drug. The median length of stock-out ranged from 3.5 to 228 days, and 82% of the stock-outs across all district hospitals were replenished by the Rwandan Ministry of Health (RMOH). The least expensive drug was digoxin ($0.02, Interquartile range (IQR): 0.01, 0.10), while the most expensive was beclomethasone ($9.35, IQR: 3.00, 13.20). Conclusions: This study shows the viability of drug-supported NCD care in rural settings of sub-Saharan Africa. Stock-outs are a challenge; our study emphasizes the importance of the MOH/NGO partnerships in this context. Medicine costs are also challenging, though, in these districts, drugs are more affordable through community-based health insurance, government, and NGO partner subsidies.Jean Paul MukundiyukuriJean Jacques IrakizaNaome NyirahabimanaLoise Ng’ang’aPaul H. ParkGedeon NgogaZiad El-KhatibLouis NditunzeEtienne DusengeyezuChristian RusangwaTharcisse MpungaJoel MubiligiBethany Hedt-GauthierUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 86, Iss 1 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Jean Paul Mukundiyukuri Jean Jacques Irakiza Naome Nyirahabimana Loise Ng’ang’a Paul H. Park Gedeon Ngoga Ziad El-Khatib Louis Nditunze Etienne Dusengeyezu Christian Rusangwa Tharcisse Mpunga Joel Mubiligi Bethany Hedt-Gauthier Availability, Costs and Stock-Outs of Essential NCD Drugs in Three Rural Rwandan Districts
description	Background: To reduce the non-communicable diseases (NCDs) burden, the World Health Organization has set a target to reach 80% availability of the affordable essential medicines required to treat NCDs by 2025. Objectives: This study described the availability, costs, and stock-outs of essential NCD drugs in three rural Rwandan districts. Methods: We retrospectively assessed 54 NCD drugs listed for district hospitals or health centers in the Rwanda national essential medicines list. Data were collected from three district hospitals and 17 health centers that host NCD clinics. We extracted data on drug availability, quantity dispensed, costs, stock-outs, and the replenishing supplier for these drugs between January 1 and December 31, 2017. Results: Overall, 71% of essential medicines for health centers and 78% of essential medicines for district hospitals were available at facilities. Only 15% of health centers experienced a stock-out of beclomethasone, while 77% experienced at least one stock-out of amlodipine and metformin. The median length of stock-out ranged from nine to 72 days, and 78% of the stock-outs across all health centers were replenished by a Non-Governmental Organization (NGO) partner. Except for enoxaparin and metformin, all district hospitals experienced at least one stock-out of each drug. The median length of stock-out ranged from 3.5 to 228 days, and 82% of the stock-outs across all district hospitals were replenished by the Rwandan Ministry of Health (RMOH). The least expensive drug was digoxin ($0.02, Interquartile range (IQR): 0.01, 0.10), while the most expensive was beclomethasone ($9.35, IQR: 3.00, 13.20). Conclusions: This study shows the viability of drug-supported NCD care in rural settings of sub-Saharan Africa. Stock-outs are a challenge; our study emphasizes the importance of the MOH/NGO partnerships in this context. Medicine costs are also challenging, though, in these districts, drugs are more affordable through community-based health insurance, government, and NGO partner subsidies.
format	article
author	Jean Paul Mukundiyukuri Jean Jacques Irakiza Naome Nyirahabimana Loise Ng’ang’a Paul H. Park Gedeon Ngoga Ziad El-Khatib Louis Nditunze Etienne Dusengeyezu Christian Rusangwa Tharcisse Mpunga Joel Mubiligi Bethany Hedt-Gauthier
author_facet	Jean Paul Mukundiyukuri Jean Jacques Irakiza Naome Nyirahabimana Loise Ng’ang’a Paul H. Park Gedeon Ngoga Ziad El-Khatib Louis Nditunze Etienne Dusengeyezu Christian Rusangwa Tharcisse Mpunga Joel Mubiligi Bethany Hedt-Gauthier
author_sort	Jean Paul Mukundiyukuri
title	Availability, Costs and Stock-Outs of Essential NCD Drugs in Three Rural Rwandan Districts
title_short	Availability, Costs and Stock-Outs of Essential NCD Drugs in Three Rural Rwandan Districts
title_full	Availability, Costs and Stock-Outs of Essential NCD Drugs in Three Rural Rwandan Districts
title_fullStr	Availability, Costs and Stock-Outs of Essential NCD Drugs in Three Rural Rwandan Districts
title_full_unstemmed	Availability, Costs and Stock-Outs of Essential NCD Drugs in Three Rural Rwandan Districts
title_sort	availability, costs and stock-outs of essential ncd drugs in three rural rwandan districts
publisher	Ubiquity Press
publishDate	2020
url	https://doaj.org/article/8a57d4c75a8840feb3e7810edfc44daa
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Availability, Costs and Stock-Outs of Essential NCD Drugs in Three Rural Rwandan Districts

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