International Journal of Health Policy Planning(IJHPP)
ISSN: 2833-9320 | DOI: 10.33140/IJHPP
Impact Factor: 1.08
Assessment of Essential Medicines Affordability in Primary Health Care Facilities in Southern Nigeria: “Effect of Drug Revolving Fund Performance
Abstract
Frederick Ifijeh O*, Bravo Otohabru and Ejiyere Harrison O
Background: Essential medicines save lives and improve health when available, affordable, of assured quality, and used rationally. However, high medical costs remain a barrier to access and better health outcomes. This study assessed the effect of Drug Revolving Fund (DRF) performance on the affordability of essential medicines in primary health care facilities in Esan Southeast Local Government Area, Edo State, Nigeria.
Methods: A descriptive cross-sectional study was conducted using quantitative and qualitative approaches, following the World Health Organization/Health Action International (WHO/HAI) methodology. Prices of 27 essential medicines for common diseases and 12 key reproductive health medicines were assessed in 22 primary health care facilities. DRF operations were evaluated using a researcher-administered questionnaire. Affordability was measured against the daily wage of the lowest-paid unskilled government worker.
Results: The lowest-paid worker required 0.34 of a day’s wage for adult malaria treatment with Artemisinin-Based Combination Therapy (ACT), compared with 0.50 for quinine. Childhood malaria treatment required 0.07 of a day’s wage with ACT versus 0.43 with quinine. Only one comprehensive health center (33.3%) and two primary health centers (11.8%) had good Drug Revolving Fund (DRF) performance, while none of the health posts had a functional DRF. Facilities with better DRF performance showed greater affordability. However, currency devaluation reduced purchasing power, further constraining medicine affordability.
Conclusion: Essential medicines were generally affordable when measured against local wage benchmarks; however, affordability was undermined by currency devaluation and weak Drug Revolving Fund (DRF) performance. Sustaining equitable access will require strengthening DRF schemes, expanding local pharmaceutical production, and adopting financing and procurement policies that protect medicine supply from exchange rate volatility.