Over the last few years, EPN has been undertaking baseline studies on the access to medicines in several countries.

The overall purpose of the Access to essential medicines project is to support church-related health services in providing effective and efficient pharmaceutical services. The first step towards this goal was to assess the current situation, before interventions. Access baselines studies were intended to measure levels of access to essential medicines in church-related health services (CHSs). Furthermore, these studies have helped in identifying the most prevalent problems in CHSs in relation to access to essential medicines, identifying the priorities and the best approaches to address priority issues.

The purpose of the baseline survey was to provide the required starting point information to allow the development of the country-specific design and management processes for maximizing access to essential medicines. Repeating the same study mechanism enables direct comparison and provides feedback information on whether priorities have changed and also on how interventions may have affected the situation. 

Throughout the studies, an important aspect has been to involve church leaders and church health service staff in the process: both in the assessment and in the intervention phase.

The baseline studies and comparative studies make use of 5 tools: 

• a guided desk review to answer a number of provided questions
• a short survey of existing DSOs and FDSOs
• a self-assessment survey, to be completed by all CHS hospitals and clinics
• guided self-assessment, which uses a number of workshop tools, including spider diagrams and problem trees, to help a group of staff to analyse how things have changed in the past and how things might change in the future
• focus group discussions with church leaders carried out among church leaders in the area surrounding the hospital in which the workshop was completed

Finally, a feedback workshop mechanism has been set up so that results can be presented and priorities for action identified at the national level.  

Access baseline studies have been carried out in the following countries: 

• Ethiopia
• Ghana
• Malawi
• Nigeria
• Tanzania
• Togo
• Uganda 
• Zambia 

The cross-country analysis baseline report was finalized in December 2010. It covers results from 363 health facilities in those 8 countries, representing over 20 000 beds and over 4 million outpatients. Click here to download it: Access to medicines in CHS in Africa - cross country analysis report (1.18 MB)

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Members in action

In 2010, members from countries where access studies were done, were invited to apply for funds to carry out an intervention to address one of the gaps identified from the access baseline studies. APROMESTO (Togo, targeting 4 hospitals and 2 clinics) and CHAM (Malawi, targeting 6 hospitals) chose to address the lack of Medicines and Therapeutics Committees (MTC). MEMS (Tanzania, targeting 6 hospitals) also opted to strengthen existing MTCs and encourage establishment of new ones where none exist. In all, at least 14 hospitals are expected to have functional MTCs by the end of the interventions. JMS plans to address the lack of pharmaceutical information for decision making by developing and piloting a Pharmaceutical Management Information System for use in hospitals.

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