Malawi risks registering high maternal and neonatal deaths due to lack of essential drugs for delivery, a study into availability and access to medicines in health centres has found.
The Universal Health Coverage Coalition (UHCC), a grouping of 25 non-governmental organisations (NGOs) advocating for domestication of universal health coverage, conducted the study in 12 districts, including Mzimba, Phalombe, Nsanje, Dowa, Karonga and Salima.
The Ministry of Health has since adopted the findings of the study and promised to use it to improve its operations.
The study report, released on Friday during a stakeholders meeting in Lilongwe and presented by Development Communications Trust, a member of UHCC, highlights that de-worming tablets albendazole, and oxytocin, used to begin or improve contractions during labour, are among the drugs that are frequently unavailable.
It reads in part: “De-worming tablets [albendazole] in the antenatal care package has been out of stock for over a year in public health facilities.
“Oxytocin and essential drugs in the delivery package have been frequently stocked out, resulting into some public health facilities issuing out expired commodities to [pregnant] women.”
The study attributed the shortages to poor funding towards the health sector and inefficiencies at the Central Medical Stores Trust (CMST).
For example, the report, presented by Development Communications Trust project officer Thandie Mchiswe, shows that allocation for the drugs in the 2021/22 National Budget dropped by 25 percent compared to 2020/21 financial plan.
Funding for health at district level, the study also found, fell by 24 percent in the current financial year compared to last year.
Mchiswe further said there was inadequate specialised human resource in pharmacies at health centre level.
She said: “We discovered that health surveillance assistants and hospital assistants who do not have expertise in pharmacy logistics were conducting the role of pharmacy assistants.
“This leads into non-adherence to guidelines for oversight on health commodities as stipulated in the Malawi Health Commodities and Logistics Manual of 2003.”
The report recommends that government should “increase drugs budget allocations and enhance drug budget transparency [and] recapitalisation of the CMST and efficiency of the Trust to serve communities better”.
In his remarks, Ministry of Health director of health and support services Godfrey Kadewere said the study outcomes will help government achieve universal health coverage, which demands that all people have access to the health services they need without suffering financial hardship.
He said: “In order to deliver the universal health coverage, it is only not about medicine, the other ingredient we need is human resource component. We plan to recruit pharmacy assistants so that each health centre has at least one. If we are to ensure drugs are accounted for this is the way to go.
“The drug shortages have been a constant problem. This is due to financial challenges. However, with engagements with the stakeholders like civil society we believe that we can find lasting solutions. This is why this study was important.”
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