The availability of essential medicines plays a crucial role in the efficiency of healthcare systems, directly impacting health outcomes and financial stability of healthcare facilities. Despite their recognized importance, essential medicines in India face significant barriers in terms of accessibility and utilization. This review sheds light on these obstacles, aiming to bridge knowledge gaps by synthesizing evidence from various studies.
A thorough analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on articles about the availability and use of essential medicines in India. The search encompassed multiple databases and specific keywords to identify pertinent, peer-reviewed articles that align with National/State Lists of Essential Medicines. Out of 1,129 articles, 11 were selected for in-depth review.
Availability of Essential Medicines
The review reveals that the availability of essential medicines in India significantly varies across states, ranging from 17% to 51%. Stock-outs are a persistent issue, with durations varying from 4 to 14 weeks. These inconsistencies highlight the systemic challenges within different regions, which are exacerbated by governance issues such as varied procurement mechanisms.
Challenges in Utilization
The utilization of essential medicines is hampered by several factors, including inefficiencies in distribution and purchasing systems, governance-related issues, and facility-level challenges. These hurdles lead to disruptions in drug utilization, often due to improper prescription practices and the non-availability of affordable options. Accessibility and affordability remain critical issues that significantly impact drug utilization.
Key Inferences
– Strengthening procurement and distribution management is essential for improving availability.
– Consistent adherence to guidelines on essential drugs is critical for efficient inventory management.
– Enhancing logistics support can reduce delays in drug receipt.
– Developing a sustainable model is necessary to achieve uniformity in medicine availability and utilization across the country.
Issues with supply chain management and conflicting guidelines further compound the challenges in ensuring the availability and utilization of essential medicines in India. Addressing these critical areas is imperative for improving the public health system.
Ensuring that essential medicines are readily available, accessible, and affordable is crucial. Strengthening the logistics and procurement systems is necessary to minimize delays and enhance the efficiency of drug supply. Adherence to guidelines prepared by the National Health System Resource Centre should be strictly enforced and monitored to improve inventory management.
There is an urgent need to develop and implement a sustainable model to achieve uniformity in the availability and utilization of essential medicines throughout India. By addressing these challenges, the public health system can enhance its capacity to provide essential medicines more effectively, thereby improving health outcomes and reducing financial burdens on healthcare facilities.
Original Article: J Pharm Bioallied Sci. 2024 Apr;16(Suppl 2):S1064-S1071. doi: 10.4103/jpbs.jpbs_1198_23. Epub 2024 Apr 16.
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