Availability and Utilization of WHO Lifesaving Medicines for Children under Five in Public Health Facilities of the Jimma Zone, South West Ethiopia: A Cross-Sectional Survey

Abstract

Background. The increased morbidity and mortality rates in children under five in developing countries are mostly attributed to poor availability and failure of prescribing lifesaving medicines. This study was aimed at evaluating the availability and utilization of the WHO-recommended priority lifesaving medicines for children under five in public health facilities. Method. A cross-sectional survey complemented with a qualitative method was conducted in 14 health centers and four hospitals in the Jimma Zone, Ethiopia. In the facilities, we assessed the availability within the last half year and on the day of the visit. Utilization of the medicines was assessed through a review of patient records of the last one year. Twelve in-depth interviews were carried out to collect the qualitative data, and the analysis was executed using thematic analysis. Results. For treatment of pneumonia, amoxicillin dispersible tablets and gentamycin injection were available in 94.4% of the facilities. For treatment of malaria, artemether/lumefantrine was available in 61.1% of the facilities. For pain management, paracetamol tablets were available in 94.4% of the facilities. AZT+3TC+NEV for HIV/AIDS management was available in all facilities. At least one essential medicine was out of stock in the past six months with the average duration of 33.6 days in health centers and 28.25 days in hospitals. Oral rehydration salt and zinc (84.7%) and AZT+3TC+NEV (100%) had better utilization. However, for almost all cases, other nonpriority medicines were highly prescribed. Lack of administrative commitment, supply of near expiry products, complexity of diseases, and lack of customized child formulations were among the challenges of availability and utilization of those medicines. Conclusions. The overall availability of lifesaving medicines on the day of the visit was fairly good but with poor utilization in almost all facilities. Some products were not available for considerable length of time in the past six months.