E-DRUG: Revolving Drug Fund - Recent evaluation study
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I have recently completed my PhD thesis entitled: 'Accessibiity of
essential medicines and primary health care: the impact of the RDF
Khartoum State', below its abstract. This evaluation study reveals
that the RDF has improved the accessibility of essenial medicines in
Khartoum State in Sudan and more than three million benfited from the
RDF every year. The study also showed that the user fee policy in
public health facilities without RDF has negatively affected the
utilziation of these facilities and increased patients suffering.
Accessibility of Medicines and Primary Health Care: the Impact of the
RDF in Khartoum State
This thesis presents a comprehensive evaluation of an experience where
a Revolving Drug Fund (RDF) lasts for fifteen years and serves more
than three million patients annually, with more than SDD2.8 billion
(US$11.1 million) annual turnover. Various studies of user fees in
various countries in general have focused particularly on the
revenues, and on community financing and community participation.
Little is known regarding the accessibility of essential medicines and
their impact on the utilization of public health facilities in areas
where the RDF programmes have been or are being implemented, despite
the fact that the supply of medicines and improvement in public health
facilities utilization are among the main objectives of such policy.
While the health literature is seriously lacking in empirical studies
that specifically demonstrate the benefits of the RDF and examine the
factors explaining success in achieving its objectives, it is widely
accepted, based on theoretical grounds and personal experience, that
RDF facilitates access to essential medicines. This thesis has used
qualitative and quantitative research techniques to collect data from
different stakeholders (i.e. health care providers and users) in order
to evaluate the experience of the RDF operating in Khartoum State
(KS). The findings are based on an analysis of forty-one
semi-structured interviews with health care providers and 186
structured interviews with users. In addition, the data from my
personal observations, and from archival and statistical records were
also analysed. This doctoral study suggests that the unique RDF
project implemented by the KS managed to make essential medicines
available at its health facilities and consequently increases their
utilization compared to non-RDF ones. Sustained availability of low
cost medicines near to where people live through the RDF, is clearly
benefiting previously disadvantaged poor population, particularly
vulnerable rural groups. This doctoral study has made a meaningful
contribution to Cost-Sharing Policy in Sudan in finding that the RDF
could be successfully implemented as a self-sustainable medicine
supply system in other states in Sudan. It also makes a significant
contribution in exploring factors that make the RDF achieves its
objectives. This study, therefore, presents empirical evidence
suggesting that a RDF project could be designed and implemented to
maintain a regular, self-financing medicines supply system, if certain
prerequisites were put in place. Finally, the thesis will enrich the
long debate about the effectiveness of RDFs as mechanisms for
financing medicines in developing countries, particularly in
Sub-Saharan Africa, by presenting the findings of a comprehensive
evaluation study of the largest RDF in the world.
Yours sincerely
Dr Gamal Khalafalla Mohamed Ali
Residence Tel. +441159701240
Mobile+4479 40 25 69 42
College of Business,Law and Social Sciences
The Nottingham Trent University
Burton Street
Nottingham NG1 4BU
United Kingdom
gamalkh@hotmail.com