Writes Key Correspondent Akot Janet Nyeko
When a pharmacy has no medicine on the shelf, it is known as a drug stock out. It may happen for one medicine or, in the worst case scenario, for all medicines. Therefore essential medicines will not be available for those who need them. In Uganda essential medicines are not available in 32-50% of Government health facilities across the country according WHO and HAI (2008).
When measuring medicine availability in terms of prices, affordability and other price components, the availability of medicines is higher in the private sector than in the public sector.
The consequences of drug stock outs for PLHIV are many and grave as they have to travel to other health facilities and/or use the private sector which is often too expensive. So they may opt to go without drugs or they may get a non-medicine alternative.
What action is therefore needed to eliminate drug stock outs?
1. District health management teams should be participatory by training people on their health rights and responsibilities where the local population are able to act as the eyes and mouth pieces of government by reporting any drug stock outs, following up issues that cause drug stock outs and reporting any medicines obtained fraudulently from the different health facilities.
2. According to a group of volunteers from Bukungu Health Centre IV from Kamwenge District, Western Uganda, training doctors and nurses on the health rights of patients would help them know the rights of their patients and be forced to act accordingly.
3. Monitoring of availability of medicines at the health facility by appointed government officials is another way to reduce stock outs.
4. Advocate for 100% availability of essential medicines. According to the same volunteers, health facilities in Uganda go for three months per year without medicines. However when these medicines do come, there is a poor system of carrying out examinations on patients and determining which drugs are best. For example, if one says ‘I have a headache’ and have symptoms that are malarial, health facilities may rush to provide them with anti-malarias. The patients then store these, waiting for the period when they have the sickness again so they can self-medicate.
5. Advocate for increased funding for essential medicines by groups of community members, PLHIV, people with diabetes etc. If such groups came together, they could advocate for increased budget allocation and availability of essential medicines in government health facilities for the common man. At the moment 15% of the budget is committed towards health but only 9.8% is actually provided and the Government spends only $0.86 per person on medicines – the equivalent to just a bar of soap. Therefore there is a need to advocate for increased funding for the supply of essential medicines in Uganda.
Of the 9.8% of the budget given to health, 70% goes towards out of pocket expenses such as workshops and training which leaves the hospitals to continue to experience drug stock outs.