E-drug: Access to the WHO List of Essential Drugs
---------------------------------------------
In response to Francisco Flores who wanted to know which factors
facilitate access to the list of essential drugs, I would like to
provide a quick, partial, and hopefully helpful response to her
inquiry.
My response is based on the analysis of data collected in two African
countries for my Ph.D. thesis which is titled "Commitment to the
Primary Health Care Strategy and Adoption of Esential Drugs in
Sub-Sahara Africa" (University of Minnesota, 1994).
The results of this study were presented at the 126th annual meeting
of the American Public Health Association (Washington, DC, 1998) and
are part of a study under revision for publication in a French
Journal. A copy of the English version of the abstract is attached for
her information. For those interested in the whole study, I will
advise some patience until the article is published.
Although useful, this limited study (abstract) may not completely
answer your question. However, I would like to mention that given the
amount of data and variables covered by my whole survey, I am in a
good position (except that I do not have very much time to do
everything I would like to accomplish) to analyze and answer a number
of your and other pertinent questions of interest in this area.
Sincerely,
Ngoyi. K. Zacharie Bukonda, M.P.H., Ph.D.
===== ABSTRACT================
THE DIFFUSION OF THE WORLD HEALTH ORGANIZATION'S
MODEL LIST OF ESSENTIAL DRUGS IN TWO AFRICAN COUNTRIES
Background: Since the introduction of the concept of essential drugs
by the World Health Organization (WHO) in 1976, eleven revisions of
the original model list of essential drugs have been completed (World
Health Organization, 1999). The initial list and its subsequent
revisions are considered as useful models or references which, if
adopted, can assist governments and health care professionals in
improving the procurement, selection, prescription, and use of
pharmaceutical products deemed essential for the most common and
prevalent health conditions facing the populations. However, little
is known on the extent to which health care professionals have been
exposed to this concept and how much they appreciate and use the WHO's
model list of essential drugs.
Objective: The study is an assessment of the extent to which the
WHO's model list has been spread within two African countries and of
whether or not there could be a difference between the rural and urban
settings and between the two countries (Zambia and the Ivory Coast) in
terms of how their respective health care professionals have been
exposed to this concept and how much they appreciate and use the WHO's list
of essential drugs.
Methods: The study used T-tests, Chi-squares, and Anova to analyze
data from a multistage survey that was conducted in 46 (24 rural and
22 urban) hospitals in Zambia and in the Ivory Coast in 1993.
Findings: The WHO model list of essential drugs is largely unknown.
More specifically, while about 74.6% of respondents have heard about
this list, only 44 % of respondents have seen one. Only 29.9% have at
their disposal a list of essential drugs that was established by the
WHO. Ignorance and unavailability of this model list are more
prevalent among rural health care professionals. Chi-Square test of
heterogeneity was positive (Pearson coefficient = 5.59, df = 1, p =
0.018) in terms of awareness. However, the two groups (urban and
rural) were not significantly different in terms of visual exposure to
the WHO list (Pearson coefficient = 0.95, df = 1, p = 0.33). In
comparison to their urban counterparts, rural practitioners indicate
on a 1-5 Likert scale a lightly yet insignificantly lower level of
appreciation of the WHO's list of essential drugs (M = 3.72 and SD =
1.32 against M= 3.90 and SD = 1.12 , p = 0.22).
Conclusions: Findings support the proposition that the concept of
essential drugs is not homogeneously spread among urban and rural
health care professionals and between Zambia and the Ivory Coast.
Adequate social marketing strategies are needed to promote the concept of
essential drugs with priority given to those serving in the
undeserved rural communities and in countries with limited exposure
and access to this concept.
====== END OF ABSTRACT ==============
Ngoyi. K. Zacharie Bukonda, M.P.H., Ph.D.,
Assistant Professor,
Public and Community Health Programs
College of Health and Human Sciences
School of Allied Health Professions
Northern Illinois University, DeKalb, IL 60115, USA
Telephone: 815-753-4801
Fax: 815-753-0720
E-mail: nbukonda@niu.edu
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