Comparison of medicine availability measurements at health facilities

Evidence from Service Provision Assessment surveys in five sub-Saharan African countries

Yoonjoung Choi, Paul Ametepi

Research output: Contribution to journalArticle

Abstract

Background: With growing emphasis on health systems strengthening in global health, various health facility assessment methods have been used increasingly to measure medicine and commodity availability. However, few studies have systematically compared estimates of availability based on different definitions. The objective of this study was to compare estimates of medicine availability based on different definitions. Methods. A secondary data analysis was conducted using data from the Service Provision Assessment (SPA) - a nationally representative sample survey of health facilities - conducted in five countries: Kenya SPA 2010, Namibia SPA 2009, Rwanda SPA 2007, Tanzania SPA 2006, and Uganda SPA 2007. For 32 medicines, percent of facilities having the medicine were estimated using five definitions: four for current availability and one for six-month period availability. 'Observed availability of at least one valid unit' was used as a reference definition, and ratios between the reference and each of the other four estimates were calculated. Summary statistics of the ratios among the 32 medicines were calculated by country. The ratios were compared further between public and non-public facilities within each country. Results: Across five countries, compared to current observed availability of at least one valid unit, 'reported availability without observation' was on average 6% higher (ranging from 3% in Rwanda to 8% in Namibia), 'observed availability where all units were valid' was 11% lower (ranging from 2% in Tanzania to 19% in Uganda), and 'six-month period availability' was 14% lower (ranging from 5% in Namibia to 25% in Uganda). Conclusions: Medicine availability estimates vary substantially across definitions, and need to be interpreted with careful consideration of the methods used.

Original languageEnglish (US)
Article number266
JournalBMC Health Services Research
Volume13
Issue number1
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Health Facilities
Namibia
Uganda
Medicine
Rwanda
Tanzania
Kenya
Observation
Surveys and Questionnaires
Health

Keywords

  • Health facility assessment
  • Health systems
  • Medicine availability
  • Survey methodology

ASJC Scopus subject areas

  • Health Policy

Cite this

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title = "Comparison of medicine availability measurements at health facilities: Evidence from Service Provision Assessment surveys in five sub-Saharan African countries",
abstract = "Background: With growing emphasis on health systems strengthening in global health, various health facility assessment methods have been used increasingly to measure medicine and commodity availability. However, few studies have systematically compared estimates of availability based on different definitions. The objective of this study was to compare estimates of medicine availability based on different definitions. Methods. A secondary data analysis was conducted using data from the Service Provision Assessment (SPA) - a nationally representative sample survey of health facilities - conducted in five countries: Kenya SPA 2010, Namibia SPA 2009, Rwanda SPA 2007, Tanzania SPA 2006, and Uganda SPA 2007. For 32 medicines, percent of facilities having the medicine were estimated using five definitions: four for current availability and one for six-month period availability. 'Observed availability of at least one valid unit' was used as a reference definition, and ratios between the reference and each of the other four estimates were calculated. Summary statistics of the ratios among the 32 medicines were calculated by country. The ratios were compared further between public and non-public facilities within each country. Results: Across five countries, compared to current observed availability of at least one valid unit, 'reported availability without observation' was on average 6{\%} higher (ranging from 3{\%} in Rwanda to 8{\%} in Namibia), 'observed availability where all units were valid' was 11{\%} lower (ranging from 2{\%} in Tanzania to 19{\%} in Uganda), and 'six-month period availability' was 14{\%} lower (ranging from 5{\%} in Namibia to 25{\%} in Uganda). Conclusions: Medicine availability estimates vary substantially across definitions, and need to be interpreted with careful consideration of the methods used.",
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N2 - Background: With growing emphasis on health systems strengthening in global health, various health facility assessment methods have been used increasingly to measure medicine and commodity availability. However, few studies have systematically compared estimates of availability based on different definitions. The objective of this study was to compare estimates of medicine availability based on different definitions. Methods. A secondary data analysis was conducted using data from the Service Provision Assessment (SPA) - a nationally representative sample survey of health facilities - conducted in five countries: Kenya SPA 2010, Namibia SPA 2009, Rwanda SPA 2007, Tanzania SPA 2006, and Uganda SPA 2007. For 32 medicines, percent of facilities having the medicine were estimated using five definitions: four for current availability and one for six-month period availability. 'Observed availability of at least one valid unit' was used as a reference definition, and ratios between the reference and each of the other four estimates were calculated. Summary statistics of the ratios among the 32 medicines were calculated by country. The ratios were compared further between public and non-public facilities within each country. Results: Across five countries, compared to current observed availability of at least one valid unit, 'reported availability without observation' was on average 6% higher (ranging from 3% in Rwanda to 8% in Namibia), 'observed availability where all units were valid' was 11% lower (ranging from 2% in Tanzania to 19% in Uganda), and 'six-month period availability' was 14% lower (ranging from 5% in Namibia to 25% in Uganda). Conclusions: Medicine availability estimates vary substantially across definitions, and need to be interpreted with careful consideration of the methods used.

AB - Background: With growing emphasis on health systems strengthening in global health, various health facility assessment methods have been used increasingly to measure medicine and commodity availability. However, few studies have systematically compared estimates of availability based on different definitions. The objective of this study was to compare estimates of medicine availability based on different definitions. Methods. A secondary data analysis was conducted using data from the Service Provision Assessment (SPA) - a nationally representative sample survey of health facilities - conducted in five countries: Kenya SPA 2010, Namibia SPA 2009, Rwanda SPA 2007, Tanzania SPA 2006, and Uganda SPA 2007. For 32 medicines, percent of facilities having the medicine were estimated using five definitions: four for current availability and one for six-month period availability. 'Observed availability of at least one valid unit' was used as a reference definition, and ratios between the reference and each of the other four estimates were calculated. Summary statistics of the ratios among the 32 medicines were calculated by country. The ratios were compared further between public and non-public facilities within each country. Results: Across five countries, compared to current observed availability of at least one valid unit, 'reported availability without observation' was on average 6% higher (ranging from 3% in Rwanda to 8% in Namibia), 'observed availability where all units were valid' was 11% lower (ranging from 2% in Tanzania to 19% in Uganda), and 'six-month period availability' was 14% lower (ranging from 5% in Namibia to 25% in Uganda). Conclusions: Medicine availability estimates vary substantially across definitions, and need to be interpreted with careful consideration of the methods used.

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