Trends and Challenges in Access to Essential Medicines in Ethiopia and the Contributions of Local Pharmaceutical Production

Decades ago, the United Nations declared that access to essential medicines was a key element of universal human rights. Accordingly, member states have been striving to address this issue through strategic policies and programs. Strengthening local pharmaceutical production has been a pivotal strategy adopted by many developing countries including Ethiopia. The government of Ethiopia identified local pharmaceutical production as a key industrial sector and has been implementing a ten-years strategic plan to improve capabilities and attract investment. Such support is needed because local production could satisfy only 15 to 20% of the national demand, typically from a limited portfolio of medicines in conventional dosage forms. The increasing prevalence of chronic diseases has accentuated the need for a more sustainable supply to reduce reliance on imports and increase access to essential medicines. A full understanding of the structure, constraints and complexities of the Ethiopian pharmaceutical market structure is vital to direct effective policies, target most impactful investments and exploit opportunities for leapfrogging. Hence, the purpose of this review was to assess the trends and challenges in access to essential medicines and local pharmaceutical production in Ethiopia. Literature search through major databases and review of policy documents and performance reports from relevant sector institutions were made to extract information for the review

Patients' response to waiting time in an out-patient pharmacy in Nigeria

PURPOSE : To identify the dispensing procedure at a pharmacy; investigate the possible operational problems that may lead to excessive patient waiting times as prescriptions are filled and to examine patient disposition to perceived delays at the pharmacy. METHODS : The study was carried out in a 574-bed university teaching hospital in Ile - Ife; Nigeria. The subjects were out-patients who gave their consent to participate in the study. Data were collected using the techniques of workflow analysis and time study in observing the dispensing process. A validated questionnaire was administered on the out-patients to measure their responses to waiting in the pharmacy as well as their level of satisfaction with pharmaceutical services rendered. RESULTS: The workflow analysis revealed considerable delay in the dispensing procedure as a result of extended process components. The total waiting time for a dispensing process averaged 17.09 min; and 89.5 percent of this was due to delay components. Specifically; the major delay components included patient queues for billing prescription sheets and subsequent payment to the cashier. Operational problems identified included patients' indirect access to dispensing pharmacist and the tortuous procedure for prescription billing and payments. Generally; patients were not satisfied with undue delay caused by the dispensing procedure at the pharmacy. CONCLUSION: Most of the patient waiting time in the hospital studied can be accounted for by delay components of the dispensing procedure. Attempts should therefore be made to reduce the time on these components of the dispensing process so that more time could be devoted to counseling while reducing the total time spent by the patient in having their prescriptions sheets filled