Abbreviated Name:
Availability of selected essential medicines
Indicator Name:
Availability of selected essential medicines in health facilities
Domain:
Health System Response/ Medicines and medical devices
Related Terms:
Access, Affordability
Definition:
The average percentage of medicines outlets, where a selection of essential medicines are found on the day of the survey.
Access to medicines: Having medicines continuously available and affordable at public or private health facilities or medicine outlets that are within one hour’s walk of the population. Affordability: The cost of treatment in relation to lowest paid government employee
Access to medicines: Having medicines continuously available and affordable at public or private health facilities or medicine outlets that are within one hour’s walk of the population. Affordability: The cost of treatment in relation to lowest paid government employee
Measurment Method:
Current proposed methodology used by EMP and under review for the SDG indicator: On the basis of 2 existing and well-established methodologies, the WHO Service Availability and Readiness Assessment (SARA) and the WHO/Health Action International (HAI) Survey (details on these 2 methodologies below in this table), WHO has developed a data collection application, the EMP Price and Availability Monitoring Mobile App, to be used at facility level to collect information on availability and price of the agreed core basket of medicines. The EMP app can be used as one possible means of collecting information for this indicator.
This data collection methodology uses a modular approach to the basket of medicines, with a core list for regular annual monitoring, as proposed in annex 1, and modular/add on lists for specific categories of diseases, conditions, country interests etc. The proposed core list is composed of essential medicines to be present at all time in primary health care facilities. The medicines in the list will be annually monitored and provide the basis for comparisons among countries. The countries will anyway have the possibility to add more modules to the data collection tool to cover medicines to be present at secondary/tertiary level facilities or special categories of medicines (i.e. cancer drugs, medicines for pain, controlled medicines, HIV/AIDS, antibiotics, etc.). Each country will choose the facilities to survey using a randomized sampling from the national master facility list. The collected information refers to the availability of the product TODAY and to the price-to-patient for the CHEAPEST available product.
This data collection methodology uses a modular approach to the basket of medicines, with a core list for regular annual monitoring, as proposed in annex 1, and modular/add on lists for specific categories of diseases, conditions, country interests etc. The proposed core list is composed of essential medicines to be present at all time in primary health care facilities. The medicines in the list will be annually monitored and provide the basis for comparisons among countries. The countries will anyway have the possibility to add more modules to the data collection tool to cover medicines to be present at secondary/tertiary level facilities or special categories of medicines (i.e. cancer drugs, medicines for pain, controlled medicines, HIV/AIDS, antibiotics, etc.). Each country will choose the facilities to survey using a randomized sampling from the national master facility list. The collected information refers to the availability of the product TODAY and to the price-to-patient for the CHEAPEST available product.
Numerator:
Number of facilities with essential medicines in stock
Denominator
Total number of health facilities.
Estimation method:
Availability of a basket of core essential medicines is used to measure availability of essential medicines in public and private facilities.
Disaggregation:
Facility type, facility managing authority (public/private), specific type of medicine/commodity (e.g. priority medicines for women and children, vaccines, ART, family planning, essential NCD medicines)
WHO-recommended essential core list of medicines: bronchodilator inhaler, steroid inhaler, glibenclamide, metformin, insulin, angiotensin-converting-enzyme (ACE) inhibitor, calcium channel blocker, statin, aspirin, thiazide diuretic, beta-blocker, omeprazole tablet, diazepam injection, fluoxetine tablet, haloperidol tablet, carbamazepine tablet, amoxicillin tablet/capsule, amoxicillin suspension, ampicillin injection, ceftriaxone injection, gentamicin injection, oral rehydration salts, zinc sulfate.
Essential NCD medicines: at least aspirin, a statin, an ACE inhibitor, thiazide diuretic, a long-acting calcium channel blocker, metformin, insulin, a bronchodilator and a steroid inhalant. Priority medicines for women and children: amoxicillin tablet/capsule, amoxicillin suspension, ampicillin injection, ceftriaxone injection, gentamicin injection, oral rehydration salts, zinc sulphate, oxytocin injection, magnesium sulphate injection.
Suggested core list of medicines for pricing/affordability surveys: Salbutamol inhaler 100 mcg per dose (200 doses); beclometasone inhaler 100 mcg/dose (200 doses); glibenclamide 5 mg tablet; metformin 500 mg tablet; insulin regular 100 IU/ml, 10 ml vial; enalapril 5 mg tablet; amlodipine 5 mg tablet; simvastatin 20 mg tablet; aspirin 100 mg tablet; hydrochlorothiazide 25 mg tablet; carvedilol 12.5 mg tablet; omeprazole 20 mg tablet; diazepam 10 mg/2 ml injection; fluoxetine 20 mg tablet; haloperidol 5 mg tablet; carbamazepine 200 mg tablet; amoxicillin 500 mg capsule/tablet; amoxicillin 250 mg/5 ml suspension; ampicillin 500 mg injection; ceftriaxone 1 G vial; gentamicin 80 mg/2 ml injection; oral rehydration salts (sachet for 1 litre); zinc sulfate 2 0mg tablet; oxytocin injection (5 or 10 iu); magnesium sulfate 50% injection 10 ml vial.
WHO-recommended essential core list of medicines: bronchodilator inhaler, steroid inhaler, glibenclamide, metformin, insulin, angiotensin-converting-enzyme (ACE) inhibitor, calcium channel blocker, statin, aspirin, thiazide diuretic, beta-blocker, omeprazole tablet, diazepam injection, fluoxetine tablet, haloperidol tablet, carbamazepine tablet, amoxicillin tablet/capsule, amoxicillin suspension, ampicillin injection, ceftriaxone injection, gentamicin injection, oral rehydration salts, zinc sulfate.
Essential NCD medicines: at least aspirin, a statin, an ACE inhibitor, thiazide diuretic, a long-acting calcium channel blocker, metformin, insulin, a bronchodilator and a steroid inhalant. Priority medicines for women and children: amoxicillin tablet/capsule, amoxicillin suspension, ampicillin injection, ceftriaxone injection, gentamicin injection, oral rehydration salts, zinc sulphate, oxytocin injection, magnesium sulphate injection.
Suggested core list of medicines for pricing/affordability surveys: Salbutamol inhaler 100 mcg per dose (200 doses); beclometasone inhaler 100 mcg/dose (200 doses); glibenclamide 5 mg tablet; metformin 500 mg tablet; insulin regular 100 IU/ml, 10 ml vial; enalapril 5 mg tablet; amlodipine 5 mg tablet; simvastatin 20 mg tablet; aspirin 100 mg tablet; hydrochlorothiazide 25 mg tablet; carvedilol 12.5 mg tablet; omeprazole 20 mg tablet; diazepam 10 mg/2 ml injection; fluoxetine 20 mg tablet; haloperidol 5 mg tablet; carbamazepine 200 mg tablet; amoxicillin 500 mg capsule/tablet; amoxicillin 250 mg/5 ml suspension; ampicillin 500 mg injection; ceftriaxone 1 G vial; gentamicin 80 mg/2 ml injection; oral rehydration salts (sachet for 1 litre); zinc sulfate 2 0mg tablet; oxytocin injection (5 or 10 iu); magnesium sulfate 50% injection 10 ml vial.
Primary data sources:
Special Health facility assessment surveys
Alternate data sources:
Routine facility information systems
Measurment frequency:
Routine facility information systems provide data instantly and for facility assessment survey annually/biannually
