The knock-on effects of COVID-19 pandemic on the supply and availability of generic medicines in Ethiopia: mixed methods study

Abstract

Background COVID-19 pandemic posed a major impact on the availability and affordability of essential medicines. This study aimed to assess the knock-on effects of the COVID-19 pandemic on the supply availability of non-communicable chronic disease (NCD) medicines and paracetamol products in Ethiopia. Methods A mixed methods study was conducted to assess the supply and availability of twenty-four NCD drugs and four paracetamol products listed on the national essential medicines list for hospitals. Data were collected from twenty-six hospitals located in seven zones of Oromia region in the southwestern part of Ethiopia. We extracted data on drug availability, cost and stock out for these drugs between May 2019 and December 2020. The quantitative data were entered into Microsoft Excel and exported to statistical package software for social science (SPSS) version 22 (IBM Corporation, Armonk, NY, USA) software for analysis. Results The overall mean availability of selected basket medicines was 63.4% (range 16.7% to 80.3%) during the pre-COVID-19 time. It was 46.3% (range 2.8% to 88.7) during the pandemic. There was a relative increase in the availability of two paracetamol products [paracetamol 500 mg tablet (67.5% versus 88.7%) and suppository (74.5% versus 88%)] during the pandemic. The average monthly orders fill rates for the selected products range from 43 to 85%. Pre-COVID-19, the average order fill rate was greater or equal to 70%. However, immediately after the COVID-19 case notification, the percentage of order(s) filled correctly in items and quantities began decreasing. Political instability, shortage of trained human resources, currency inflation, and limited drug financing were considered as the major challenges to medicine supply. Conclusion The overall stock out situation in the study area has worsened during COVID-19 compared to pre-COVID-19 time. None of the surveyed chronic disease basket medicines met the ideal availability benchmark of 80% in health facilities. However, availability of paracetamol 500 mg tablet surprisingly improved during the pandemic. A range of policy frameworks and options targeting inevitable outbreaks should exist to enable governments to ensure that medicines for chronic diseases are consistently available and affordable.

Knowledge of non-communicable diseases and access to healthcare services among adults before and during COVID-19 pandemic in rural Tanzania

“…People with NCDs require medications all the time and require HCP intervention regularly, therefore, the reported shortages could be among the reasons why they severely suffered during the COVID-19 pandemic. The findings are supported by previous studies that reported interruption of medicines and medical devices supply chain in most countries during the COVID-19 pandemic ( 44 , 45 ). The reallocation of healthcare providers to attend to COVID-19 patients has been associated with the reported shortage of providers in routine clinics during the outbreak.…”

Availability of essential, generic medicines before and during COVID-19 at selected public pharmaceutical supply agencies in Ethiopia: a comparative cross-sectional study

“…Recent research, which assessed the availability of the same basket of NCD medicines at the health facility level, showed that COVID-19 significantly increased shortages of these products and worsened the stockout situation at the health facilities. 20 Expanding on its antecedent, the present manuscript delineates and scrutinises the impact of the COVID-19 pandemic on the supply chain dynamics of NCD medications at the level of pharmaceutical supply agencies, immediately preceding their distribution to healthcare facilities.…”

Lesson Learned During a Pandemic: A Phenomenological Study of Pregnant Women’s Experience in Resource-Limited Setting

“…In these settings, access to routine antenatal care and essential resources such as personal protective equipment (PPE), medications, and skilled birth attendants may be limited, exacerbating the risks associated with pregnancy amid the pandemic. [5][6][7] Studies revealed the decreasing number of patients seen at the outpatient department is directly linked to the weakened healthcare system, which has been further worsened by the pandemic. This situation has resulted in increased mortality rates among mothers and children, thus undoing the progress that had been made on this front.…”