Monitoring, evaluating, and assessing the pharmaceutical situation in countries are important for determining if people have access to essential medicines that are safe, efficacious, and of good quality, and that these medicines are being used properly.
The World Health Organization in collaboration with Health Action International - Africa, supported the Ministry of Health in carrying out a baseline survey assessing the pharmaceutical situation based on Levels I and II indicators as described in the Operational Package for Monitoring and Assessing the Pharmaceutical Situation in Countries.
This survey was undertaken in 2002 to describe the current status of the pharmaceutical sector in Ghana in relation to the rational use of medicines, storage and management and people's access to essential medicines.
The method was a cross sectional descriptive drug use indicator study covering both prescribing and dispensing practices on rational use of medicines and drug management, stock management and access to medicines in the community.
Using standard indicators, data were collected for the availability of key essential medicines, duration of stock-outs, rational use of medicines, household health care-seeking behaviour and access to prescribed medicines.
Four regions of the country were selected through a combination of purposive and random sampling based on their geographic and socioeconomic profiles. The study units comprised of public health facilities, pharmacies in the public and private sectors, public drug warehouses and households within 5km of a public health facility. These were surveyed at regional, district and sub-district levels.
The outcome measures were percentage of prescribing indicators, patient care indicators, facility indicators and access to medicines (including availability and affordability).
The median percentage availability of key medicines was 78.6% in public health facilities, and 82.2% in public sector warehouses. The median stock out duration of the basket of key medicines in public health facilities and district warehouses was found to be 78 days (~2.5 months) and 50.7 days (~1.5 months) respectively. The median antibiotic and injection use in public health facilities was found to be 43.3% and 30% respectively.
The majority of the households sought healthcare from public health services, and 98% of the people surveyed could not obtain prescribed drugs due to economic and availability factors.
This baseline survey provides key information that will be used to plan and implement interventions to address under-performing areas identified in the assessment, which affect access, quality and rational use of essential medicines.
Although there have been tremendous improvement in the pharmaceutical sector over the past six years resulting from the activities of GNDP, there is still the need to emphasize the setting up of appropriate systems to monitor the pharmaceutical sector regularly. Greater efforts should be directed at drug management practices in public drug outlets to improve their efficiency
This survey provides a baseline for periodic review of work in the pharmaceuticals area so that adjustments may be made according to needs and performance.
