PO376 Measuring Access to Essential CVD Medicines and Diagnostics in Maputo City, Mozambique

Jessen, Neusa; Mocumbi, Ana Olga; Boladuadua, Sainimere; Jones, Joanne; Auala, Tangeni; Jingi, Ahmadou Musa; Sharma, Abhishek

doi:10.1016/j.gheart.2018.09.291

Cited by 2 publications

(5 citation statements)

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“…The accessibility of care related-enablers for the implementation of both the EDL 96,98,103 and EML 48,50,53,69,79,84,87, 68, 69, 57,128,134, 85, 64, 83, 104,133, are opposite to the barriers listed above.…”

Section: Accessibility Of Carementioning

confidence: 96%

Section: Accessibility Of Carementioning

confidence: 99%

“…This included limited access to care facilities by patients due to financial constraints: out of pocket expenses 103,139 and high test costs 96,99 . Other EDL barriers were poor geographical access contributing to limited access to essential in vitro diagnostics in rural areas 96 , and limited health facility access: availability of essential in vitro diagnostics at referral hospitals but not primary health care facilities 96 and public facilities 98 , and poorly resourced health facilities 97 . The barriers for the implementation of the EML are similar to the EDL barriers reported above, and the main barriers were poor financial access 39,48,78,79,83,[86][87][88][89]104,110,136,[140][141][142][143][144][145][146][147][148][149] , poor geographical access 36,65,74,82,104,143,146,150 and health facility access 73,74,106,[150][151][152] .…”

Section: Accessibility Of Carementioning

confidence: 99%

“…The most reported barrier to implementing WHO essential lists (EDL&EML) was the facility-related constraints (Table 3 and Table 4). Unavailability of EDL tests 6,[96][97][98][99][100][101][102] , and reagent stock-outs 6,100,103 were the most prominent themes within the facilityrelated barriers to EDL implementation. Other EDL barriers referenced lack of proper equipment and supplies described as low availability of key consumables for laboratory diagnosis, limited items of the major laboratory equipment's 6,96 , and inadequate infrastructure and space 96 to facilitate laboratory and diagnostics services.…”

Section: Health Systems-level Facilitiesmentioning

confidence: 99%

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Implementing essential diagnostics-learning from essential medicines: A scoping review

Nyanchoka

Mulaku

Nyagol

et al. 2022

Preprint

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Background The World Health Organization (WHO) model list of Essential In vitro Diagnostic (EDL) introduced in 2018 complements the established Essential Medicines List (EML) and improves its impact on advancing universal health coverage and better health outcomes. We conducted a scoping review of the literature on the implementation of the WHO essential lists in Africa to inform the implementation of the recently introduced EDL. Methods We searched eight electronic databases for studies reporting on the implementation of the WHO EDL and EML in Africa. Two authors independently conducted study selection and data extraction, with disagreements resolved through discussion. We used the Supporting the Use of Research Evidence (SURE) framework to extract themes and synthesized findings using thematic content analysis. We used the Mixed Method Appraisal Tool (MMAT) version 2018 to assess the quality of included studies where applicable. Results We included 172 studies reporting on EDL and EML after screening 3,813 articles titles and abstracts and 1,545 full-text papers. Most (75%, n=129) included studies were purely quantitative in design comprising descriptive cross-sectional designs (60%, n=104), 15% (n=26) were purely qualitative, and 10% (n=17) had mixed-methods approaches. There were no qualitative or randomised experimental studies about the EDL. The main barrier facing the EML and EDL was poorly equipped health facilities - including unavailability or stock-outs of essential in vitro diagnostics and medicines and inadequate infrastructure to enable health service delivery. Financial and non-financial incentives to health facilities and workers were a key enabler to the implementation of the EML however, their impact differed from one context to another. Fifty-six (33%) of the included studies were of high quality. Conclusions The EDL implementation at the national level can learn from health system interventions to improve the availability and supply of essential medicines such as financial and non-financial incentives in different contexts.

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Section: Accessibility Of Carementioning

confidence: 96%

Section: Accessibility Of Carementioning

confidence: 99%

Section: Accessibility Of Carementioning

confidence: 99%

Section: Health Systems-level Facilitiesmentioning

confidence: 99%

See 2 more Smart Citations

Implementing essential diagnostics-learning from essential medicines: A scoping review

Nyanchoka

Mulaku

Nyagol

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The facility-related constraints were the most reported barriers to implementing WHO essential lists (EDL&EML) (Tables 3 and 4). Unavailability of EDL tests [6,[33][34][35][36][37][38][39] and reagent stock-outs [6,37,40] were the most prominent themes within the facility-related barriers to EDL implementation. Other EDL barriers referenced lack of proper equipment and supplies described as low availability of key consumables for laboratory diagnosis, limited items of the major laboratory equipment [6,33], and inadequate infrastructure and space [33] to facilitate laboratory and diagnostics services.…”

Section: Barriers and Enablers For The Implementation Of The Edl And Emlmentioning

confidence: 99%

Implementing essential diagnostics-learning from essential medicines: A scoping review

Nyanchoka

Mulaku²,

Nyagol³

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

The World Health Organization (WHO) model list of Essential In vitro Diagnostic (EDL) introduced in 2018 complements the established Essential Medicines List (EML) and improves its impact on advancing universal health coverage and better health outcomes. We conducted a scoping review of the literature on implementing the WHO essential lists in Africa to inform the implementation of the recently introduced EDL. We searched eight electronic databases for studies reporting on implementing the WHO EDL and EML in Africa. Two authors independently conducted study selection and data extraction, with disagreements resolved through discussion. We used the Supporting the Use of Research Evidence (SURE) framework to extract themes and synthesised findings using thematic content analysis. We used the Mixed Method Appraisal Tool (MMAT) version 2018 to assess the quality of included studies. We included 172 studies reporting on EDL and EML after screening 3,813 articles titles and abstracts and 1,545 full-text papers. Most (75%, n = 129) studies were purely quantitative in design, comprising descriptive cross-sectional designs (60%, n = 104), 15% (n = 26) were purely qualitative, and 10% (n = 17) had mixed-methods approaches. There were no qualitative or randomised experimental studies about EDL. The main barrier facing the EML and EDL was poorly equipped health facilities—including unavailability or stock-outs of essential in vitro diagnostics and medicines. Financial and non-financial incentives to health facilities and workers were key enablers in implementing the EML; however, their impact differed from one context to another. Only fifty-six (33%) of the included studies were of high quality. Poorly equipped and stocked health facilities remain an implementation barrier to essential diagnostics and medicines. Health system interventions such as financial and non-financial incentives to improve their availability can be applied in different contexts. More implementation study designs, such as experimental and qualitative studies, are required to evaluate the effectiveness of essential lists.

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PO376 Measuring Access to Essential CVD Medicines and Diagnostics in Maputo City, Mozambique

Cited by 2 publications

References 0 publications

Implementing essential diagnostics-learning from essential medicines: A scoping review

Implementing essential diagnostics-learning from essential medicines: A scoping review

Implementing essential diagnostics-learning from essential medicines: A scoping review

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