Availability and affordability of essential medicines for children in the Western part of Ethiopia: implication for access.

BACKGROUND: Essential medicines (EMs) are those medicines which satisfy the priority health care needs of the population. Although it is a fundamental human right, access to essential medicines has been a big challenge in developing countries particularly for children. WHO recommends assessing the current situations on availability and affordability of EMs as the first step towards enhancing access to them. Therefore, the aim of this study was to assess access to EMs for children based on availability, affordability, and price. METHODS: We adapted the WHO and Health Action International tools to measure availability, affordability, and prices of EMs. We collected data on 22 EMs for children from 15 public to 40 private sectors' drug outlets in east Wollega zone. Availability was expressed as percentage of drug outlets per sector that stocked surveyed medicines on the day of data collection, and prices were expressed as median price ratio. Affordability was measured as the number of daily wages required for the lowest-paid government unskilled worker (1.04 US $per day) to purchase one standard treatment of an acute condition or treatment for a chronic condition for a month. RESULTS: The average availability of essential medicines was 43 % at public and 42.8 % at private sectors. Lowest priced medicines were sold at median of 1.18 and 1.54 times their international reference prices (IRP) in the public and private sectors, respectively. Half of these medicines were priced at 0.90 to 1.3 in the public sector and 1.23 to 2.07 in the private sector times their respective IRP. Patient prices were 36 % times higher in the private sector than in the public sector. Medicines were unaffordable for treatment of common conditions prevalent in the zone at both public and private sectors as they cost a day or more days' wages for the lowest paid government unskilled worker. CONCLUSIONS: Access to EMs to children is hampered by low availability and high price which is unaffordable. Thus, further study on larger scale is critical to identify acute areas for policy interventions such as price and or supply, and to enhance access to EMs to children.

Determinants of fertility intention among women living with hiv in western Ethiopia: implications for service delivery.

Despite increased emphasis on antiretroviral therapy for HIV infected individuals, issues of fertility and childbearing have received relatively little attention in Ethiopia. This study was conducted to assess socio-demographic, reproductive and HIV related characteristics of fertility intention among women living with HIV in Western Ethiopia. Cross sectional study was conducted from May I to May 26, 2012 using structured questionnaire on a sample of 456 women living with HIV who are on follow up care in anti-retroviral therapy clinics. Bivariate and multivariable logistic regression models were fitted to identify significant predictors of fertility desire at 95 CL. Out of 456 respondents 42.1% expressed intention to have children in the future. Educational attainment [AOR (95% CI) = 0.041(0.008-0.220)], partner fertility desire [AOR (95% CI) = 0.012 (0.004-0.034)], number of live children [AOR (95% CI) = 0.344 (0.125-0.950)] and partner sero-status [AOR (95% CI) = 6.578 (4.072-10.881)] were significantly associated with fertility intention. A large proportion of HIV-positive women in the study desired more children in future. Interventions to address this problem include integrated access to contraception methods, and counselling on reproductive health decision-making.