Abstract:
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
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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.
