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. 2021 Aug 3;11(8):e051465.
doi: 10.1136/bmjopen-2021-051465.

Access to essential medicines for children: a cross-sectional survey measuring medicine prices, availability and affordability in Hanam province, Vietnam

Dai Xuan Dinh  1 , Huong Thi Thanh Nguyen  2 , Van Minh Nguyen  3
Affiliations

Access to essential medicines for children: a cross-sectional survey measuring medicine prices, availability and affordability in Hanam province, Vietnam

Dai Xuan Dinh et al. BMJ Open. .

Abstract

Objective: To identify the availability, prices and affordability of essential medicines for children (cEMs) in Hanam province, Vietnam.

Design: Cross-sectional study.

Setting: One city and five districts of Hanam province.

Participants: 66 public health facilities and 66 private drugstores.

Primary and secondary outcome measures: The standardised methodology of the WHO and Health Action International was used to investigate 30 paediatric essential medicines. For each medicine, data were collected for two products: the lowest-priced medicine (LPM) and the highest-priced medicine (HPM). The availability of medicine was computed as the percentage of facilities in which this medicine was found on the day of data collection. Median prices of individual medicines were reported in local currency. Affordability was calculated as the number of days' wages required for the lowest-paid unskilled government worker to purchase standard treatments for common diseases. Data were analysed using R software V.4.1.0.

Results: The mean availability of LPMs in the private sector (33.2%, SD=38.0%) was higher than that in the public sector (24.9%, SD=39.4%) (p<0.05). The mean availability of HPMs was extremely low in both sectors (11.3% and 5.8%, respectively). The mean availability of cEMs in urban areas was significantly higher than that in rural areas (36.5% and 31.6%, respectively, p<0.05). In the public sector, the prices of LPMs were nearly equal to the international reference prices (IRPs). In the private sector, LPMs were generally sold at 4.06 times their IRPs. However, in both sectors, the affordability of LPMs was reasonable for most conditions as standard treatments only cost a day's wage or less.

Conclusion: The low availability was the main reason hindering access to cEMs in Hanam, especially in the countryside. A national study on cEMs should be conducted, and some practical policies should be promulgated to enhance access to cEMs.

Keywords: health policy; paediatrics; quality in health care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Regional analysis for the private sector: comparison of the mean availability of LPMs in six areas. LPM, lowest-priced medicine.
Figure 2
Figure 2
Comparison of the mean availability of LPMs between NT drugstores and QT drugstores. LPM, lowest-priced medicine; NT, Nha Thuoc; QT, Quay Thuoc
See this image and copyright information in PMC

References

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    1. United Nations International Children’s Emergency Fund (UNICEF) . Children in Vietnam. Available: https://www.unicef.org/vietnam/children-viet-nam [Accessed 08 Jul 2021].
    1. United Nation Fund Population Agency (UNFPA) Vietnam . Results of the population and housing census, 2019. Available: https://vietnam.unfpa.org/en/news/results-population-and-housing-census-... [Accessed 08 Jul 2021].
    1. World Health Organization . World health statistics 2020: monitoring health for the SDGs, sustainable development goals
    1. World Health Organization . Signpost: WHO essential medicines. Available: https://www.who.int/rhem/signpost/essential_medicines/en/ [Accessed 08 Jul 2021].

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