The actual delivery of health service in the country is carried out by four levels of health care units which are structured into four-tier health care delivery system.
The four-tier system has a pyramidal structure with a Primary Health Care Unit (PHCU) which consists of a health center and five satellite Community Health Posts (CHPs) at the base, followed by District Hospitals, Zonal Hospital and Specialized hospital up the hierarchy in that order. In this organizational structure, each higher health care unit is supposed to support and serve as a referral unit for the one below it.
The provision of complete health service by each level of health care necessitates the availability of safe, effective and affordable drugs of the required quality, in adequate quantity at all times.
Moreover, the available drugs must be prescribed, dispensed and used by the patient rationally. One of the tools for ensuring the availability, accessibility and rational use of drugs is the preparation of standard list of drugs for each level of health care.
Accordingly, the third edition of the national drug list (1996) was revised in the light of the latest development in the fields of medicine and pharmacy. The resulting fourth edition of the list was further classified by five levels of health care following the four-tier system described above and part of the old six-tier system (i.e. "health stations" which are being phased-out).
The task of revising and categorizing the list was accomplished first by two adhoc committees and then followed by a three-day workshop. The participants of the workshop were specialists in the various disciplines of medicine, representatives of teaching schools, professional associations, health bureaus of all regions, relevant departments of the Ministry of Health, Research Institutions, consumer associations, and other related organizations.
One of these five sub-lists of drugs prepared in this manner is the list of drugs for Zonal Hospitals which are staffed with physicians having specialty in four major disciplines of medicine (i.e. Internal medicine, Surgery, Pediatrics, Gynecology & obstetrics) and other three minor specialties (i.e. psychiatry, ophthalmology and dentistry). In preparing this list various factors such as the functions/services of Zonal Hospitals, level of training of the health personnel, diagnostic facilities, and other drug related factors were considered.
It is hoped that the list contains a range of drugs, which is commensurate with the services rendered by Zonal Hospitals; thus, it serves as an important guide for procurement and distribution of drugs to Zonal Hospitals.
The list is to be updated from time to time following changes in drug therapy. Therefore, comments and suggestions are welcome and can be sent to the "Drug Administration and Control Authority", P.O. Box 5681, Addis Ababa, Ethiopia.
