The availability of priority medicines for children under 5 years in eThekwini, South Africa

Background: Globally, an estimated 8.1 million children under 5 years die annually in developing countries. Ensur‑ ing essential medicines are accessible and afordable to the population is key to saving lives. This study investigated accessibility, availability and afordability of a basket of priority medicines for children under 5 years in public and private healthcare sector pharmacies in the eThekwini Metropolitan area in Durban, South Africa. Methods: The WHO/HAI survey tool for assessing medicine prices, availability and afordability was adapted and employed for a basket of WHO Priority life-saving medicines for children under 5 years. Six district hospitals in the north, south and central eThekwini Metropolitan were selected as major facility reference points and for data collec‑ tion and pharmacies within a 5 km radius from each major facility were also invited to participate in the study, as out‑ lined in the WHO/HAI tool methodology. Of the 58 pharmacies selected, a total of 27 pharmacies from both private and public healthcare sectors agreed to participate and were surveyed, representing a 47% response rate. Data was analysed using Microsoft excel. Results: All participating pharmacies (and hence the selected basket of priority medicines at these facilities) were deemed accessible. Overall the public sector had more medicines available on the shelf (averaging 64%) than the private sector (48%) which had more medicines available on order (84%). At least one medicine for each of the eight (8) conditions was available at both sectors which meant patients could be treated for these conditions. Medicines for priority conditions (except HIV, which was a 28-day course) were deemed afordable as these regimens were obtain‑ able within a day’s wage for the lowest paid unskilled worker. Priority medicines for children under 5 years were more available and more afordable in the public sector. Conclusion: The basket of WHO essential medicines for priority conditions for children under 5 years were accessible, available and afordable in the eThekwini Metropolitan areas. This was the frst study in eThekwini to determine access to the WHO basket of priority medicines for children and can be scaled-up to a national study to provide a holistic comparison of these medicines in the country, and also for global comparison.

Background: Globally, an estimated 8.1 million children under 5 years die annually in developing countries. Ensur‑ ing essential medicines are accessible and afordable to the population is key to saving lives. This study investigated accessibility, availability and afordability of a basket of priority medicines for children under 5 years in public and private healthcare sector pharmacies in the eThekwini Metropolitan area in Durban, South Africa. Methods: The WHO/HAI survey tool for assessing medicine prices, availability and afordability was adapted and employed for a basket of WHO Priority life-saving medicines for children under 5 years. Six district hospitals in the north, south and central eThekwini Metropolitan were selected as major facility reference points and for data collec‑ tion and pharmacies within a 5 km radius from each major facility were also invited to participate in the study, as out‑ lined in the WHO/HAI tool methodology. Of the 58 pharmacies selected, a total of 27 pharmacies from both private and public healthcare sectors agreed to participate and were surveyed, representing a 47% response rate. Data was analysed using Microsoft excel. Results: All participating pharmacies (and hence the selected basket of priority medicines at these facilities) were deemed accessible. Overall the public sector had more medicines available on the shelf (averaging 64%) than the private sector (48%) which had more medicines available on order (84%). At least one medicine for each of the eight (8) conditions was available at both sectors which meant patients could be treated for these conditions. Medicines for priority conditions (except HIV, which was a 28-day course) were deemed afordable as these regimens were obtain‑ able within a day’s wage for the lowest paid unskilled worker. Priority medicines for children under 5 years were more available and more afordable in the public sector. Conclusion: The basket of WHO essential medicines for priority conditions for children under 5 years were accessible, available and afordable in the eThekwini Metropolitan areas. This was the frst study in eThekwini to determine access to the WHO basket of priority medicines for children and can be scaled-up to a national study to provide a holistic comparison of these medicines in the country, and also for global comparison.