Accessibility, Availability and Affordability of Life-Saving Commodities for Maternal and Child Health in Public and Private Sectors of Kashmir Province

Several World Health Organization (WHO) and UN initiatives aim to improve the accessibility, availability and affordability of maternal and child health commodities. A first step in achieving this goal is to obtain a baseline measure of access to such essential medicines. The objective of this study was to measure the accessibility, availability and affordability of maternal and child health commodities in primary and secondary health centers at ten districts of Kashmir division. An adaption of the standardized methodology developed by WHO and Health Action International (HAI) was used to conduct a cross sectional survey to collect data on accessibility, availability and affordability of maternal and child health commodities in public hospitals and  private sector medicine outlets between June, 2012 to July, 2013.

 

In this study, data was collected on the availability, affordability and prices of thirteen essential commodities from the core list that includes 3 maternal, 4 new born, 3 childhood and 3 reproductive health commodities and 27 essential commodities from the supplementary list published by UN Commission on Life-saving Commodities for Women and Children in 2012, in both public and private sectors within ten districts of the Kashmir province. In each district, a sample of health centres and medicine outlets were surveyed systematically that included a total of 10 district hospitals, 10 sub-district hospitals (SDH), 15 Maternal and Child Health (MCH) centres, 14 Primary Health Centres (PHC), 4 Allopathic Dispensaries and all GMC associated hospitals and a total of 20 licensed pharmacies in the private sector.

 

Study revealed that district hospitals, SDH, PHCs, allopathic dispensaries and CHCs had the lowest average availability (40%) compared to the private sector (65%). In DHs availability was (55%), in SDHs it was (45%), in PHCs it was (20%) and in MCHs it was (60%). In the private sector, highest as well as lowest priced medicines were more expensive than their international reference price comparisons. Treatments were generally unaffordable, costing as much as 15 day wages for a course of Ceftriaxone. In our state, this is the first kind of study conducted on accessibility, availability and affordability of maternal and child health commodities. The findings of this study can be used to structure policies to improve the accessibility, availability and affordability of maternal and child health commodities in Kashmir and help the country meet Millenium Development Goals - MDG4 and MDG5 by the year 2015.