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Changes in the availability and affordability of subsidised artemisinin combination therapy in the private drug retail sector in rural Ghana: before and after the introduction of the AMFm subsidy.
Int Health. 2016 11; 8(6):427-432.IH

Abstract

BACKGROUND

Most people with febrile illness are treated in the private drug retail sector. Ghana was among nine countries piloting the Global Fund Affordable Medicines Facility - malaria (AMFm). AMFm aimed to: increase artemisinin combination therapy (ACT) affordability; increase ACT availability; increase ACT use; and 'crowd out' artemisinin monotherapies.

METHODS

Three censuses were carried out 2 months before (2010), 2 months after and 2.5 years after (2013) the first co-paid ACTs to assess changes in antimalarial (AM) availability and price in private retail shops in a Ghanaian rural district to assess the sustainability of the initial gains. Supply, stock-out and cost were explored.

RESULTS

Of 62 shops in the district, 56 participated with 398, 388 and 442 brands of AMs in the shops during the 3 censuses. The proportion of ACTs increased over the period while monotherapies reduced. Herbal-based AM preparations comprised 40-45% of AMs in stock with minimal variation over the period. ACTs were the most sold AM type for all ages but overall buying and selling prices of Quality Assured-ACTs increased by 40-100%.

CONCLUSIONS

Initial gains in ACT availability were sustained, but not improved on 2.5 years after AMFm. Widespread availability of unproven herbal medicines is a concern; AMFm had little impact on this.

Authors+Show Affiliations

Dangme West District Health Directorate, Ghana Health Service, P.O. Box DD1, Dodowa, Ghana Ansahekdr@yahoo.co.uk.London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.National Malaria Control Programme, Ghana Health Service, P.O. Box KB493, Korle-Bu, Accra, Ghana.Dodowa Health Research Center, Ghana Health Service, P.O. Box DD1, Dodowa, Ghana.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27744327

Citation

Ansah, Evelyn K., et al. "Changes in the Availability and Affordability of Subsidised Artemisinin Combination Therapy in the Private Drug Retail Sector in Rural Ghana: Before and After the Introduction of the AMFm Subsidy." International Health, vol. 8, no. 6, 2016, pp. 427-432.
Ansah EK, Whitty CJ, Bart-Plange C, et al. Changes in the availability and affordability of subsidised artemisinin combination therapy in the private drug retail sector in rural Ghana: before and after the introduction of the AMFm subsidy. Int Health. 2016;8(6):427-432.
Ansah, E. K., Whitty, C. J., Bart-Plange, C., & Gyapong, M. (2016). Changes in the availability and affordability of subsidised artemisinin combination therapy in the private drug retail sector in rural Ghana: before and after the introduction of the AMFm subsidy. International Health, 8(6), 427-432.
Ansah EK, et al. Changes in the Availability and Affordability of Subsidised Artemisinin Combination Therapy in the Private Drug Retail Sector in Rural Ghana: Before and After the Introduction of the AMFm Subsidy. Int Health. 2016;8(6):427-432. PubMed PMID: 27744327.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in the availability and affordability of subsidised artemisinin combination therapy in the private drug retail sector in rural Ghana: before and after the introduction of the AMFm subsidy. AU - Ansah,Evelyn K, AU - Whitty,Christopher Jm, AU - Bart-Plange,Constance, AU - Gyapong,Margaret, Y1 - 2016/10/15/ PY - 2016/04/24/received PY - 2016/07/24/revised PY - 2016/08/09/accepted PY - 2016/10/17/pubmed PY - 2017/9/30/medline PY - 2016/10/17/entrez KW - AMFm KW - Affordability KW - Chemical Seller KW - Drug Retail Shop KW - Ghana KW - Malaria SP - 427 EP - 432 JF - International health JO - Int Health VL - 8 IS - 6 N2 - BACKGROUND: Most people with febrile illness are treated in the private drug retail sector. Ghana was among nine countries piloting the Global Fund Affordable Medicines Facility - malaria (AMFm). AMFm aimed to: increase artemisinin combination therapy (ACT) affordability; increase ACT availability; increase ACT use; and 'crowd out' artemisinin monotherapies. METHODS: Three censuses were carried out 2 months before (2010), 2 months after and 2.5 years after (2013) the first co-paid ACTs to assess changes in antimalarial (AM) availability and price in private retail shops in a Ghanaian rural district to assess the sustainability of the initial gains. Supply, stock-out and cost were explored. RESULTS: Of 62 shops in the district, 56 participated with 398, 388 and 442 brands of AMs in the shops during the 3 censuses. The proportion of ACTs increased over the period while monotherapies reduced. Herbal-based AM preparations comprised 40-45% of AMs in stock with minimal variation over the period. ACTs were the most sold AM type for all ages but overall buying and selling prices of Quality Assured-ACTs increased by 40-100%. CONCLUSIONS: Initial gains in ACT availability were sustained, but not improved on 2.5 years after AMFm. Widespread availability of unproven herbal medicines is a concern; AMFm had little impact on this. SN - 1876-3405 UR - https://www.unboundmedicine.com/medline/citation/27744327/Changes_in_the_availability_and_affordability_of_subsidised_artemisinin_combination_therapy_in_the_private_drug_retail_sector_in_rural_Ghana:_before_and_after_the_introduction_of_the_AMFm_subsidy_ L2 - https://academic.oup.com/inthealth/article-lookup/doi/10.1093/inthealth/ihw041 DB - PRIME DP - Unbound Medicine ER -