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Poor availability of essential medicines for women and children threatens progress towards Sustainable Development Goal 3 in Africa
  1. Benson Droti1,
  2. Kathryn Patricia O’Neill2,
  3. Matthews Mathai3,
  4. Delanyo Yao Tsidi Dovlo4,
  5. Jane Robertson5,6
  1. 1Health Systems and Services, World Health Organization, the Regional Office for Africa, Brazzaville, Congo
  2. 2Information, Evidence and Research, World Health Organization, Geneva, Switzerland
  3. 3Department of maternal, newborn and adolescent health, Organisation mondiale de la Sante, Geneve, GE, Switzerland
  4. 4Health Systems and Services Cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo
  5. 5Health Technology and Pharmaceuticals, World Health Organization, Regional Office for Europe, Copenhagen, Denmark
  6. 6Clinical Pharmacology, University of Newcastle, Waratah, New South Wales, Australia
  1. Correspondence to Dr Benson Droti; drotib{at}who.int

Abstract

Background Most maternal and child deaths are preventable or treatable with proven, cost-effective interventions for infectious diseases and maternal and neonatal complications. In 2015 sub-Saharan Africa accounted for up to 66% of global maternal deaths and half of the under-five deaths. Access to essential medicines and commodities and trained healthcare workers to provide life-saving maternal, newborn and post-natal care are central to further reductions in maternal and child mortality.

Methods Available data for 24 priority medicines for women and children were extracted from WHO service availability and readiness assessments conducted between 2012 and 2015 for eight countries in sub-Saharan Africa. The mean availability of medicines in facilities stating they provide services for women or children and differences by facility type, ownership and location are reported.

Results The mean availability of 12 priority essential medicines for women ranged from 22% to 40% (median 33%; IQR 12%) and 12 priority medicines for children ranged from 28% to 57% (median 50%; IQR 14%). Few facilities (<1%) had all nominated medicines available. There was higher availability of priority medicines for women in hospitals than in primary care facilities: range 32%–80% (median 61%) versus 20%–39% (median 23%) and for children’s medicines 31%–71% (median 58%) versus 27%–57% (median 48%). Availability was higher in public than private facilities: for women’s medicines, range 21%–41% (median 34%) versus 4%–36% (median 27%) and for children’s medicines 28%–58% (median 51%) versus 5%–58% (median 46%). Patterns were mixed for rural and urban location for the priority medicines for women, but similar for children’s medicines.

Conclusions The survey results show unacceptably low availability of priority medicines for women and children in the eight countries. Governments should ensure the availability of medicines for mothers and children if they are to achieve the health sustainable development goals.

  • essential medicines
  • priority medicines
  • availability
  • women
  • children
  • sub-saharan africa

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Handling editor Valery Ridde

  • Contributors BD and JR conceived the idea. BD assembled the data, did analysis of the data and wrote the study methods and results that were reviewed by JR, KPO’N, DYTD and MM. JR wrote the background document that was reviewed by BD, KPO’N, DYTD and MM. BD and JR wrote the discussion and conclusion sections that were reviewed by KPO’N, DYTD and MM.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The data that support the findings of this study areavailable on request from the corresponding author BD.