Availability and Prices of Antimalarials and Staffing Levels in Health Facilities in Embu County, Kenya

Stanley N. Ndwigah; Andy Stergachis; Kennedy O. Abuga; Hannington Mugo; Isaac O. Kibwage

Stanley N. Ndwigah 1Department of Pharmaceutical Chemistry, School of Pharmacy, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya
Andy Stergachis Department of Pharmacy, School of Pharmacy, University of Washington, P.O. Box 357236, Seattle, WA 98105
Kennedy O. Abuga 1Department of Pharmaceutical Chemistry, School of Pharmacy, University of Nairobi, P.O. Box 19676-00202, Nairobi, Keny
Hannington Mugo 1Department of Pharmaceutical Chemistry, School of Pharmacy, University of Nairobi, P.O. Box 19676-00202, Nairobi, Keny
Isaac O. Kibwage 1Department of Pharmaceutical Chemistry, School of Pharmacy, University of Nairobi, P.O. Box 19676-00202, Nairobi, Ken

Keywords: Antimalarials, artemisinin-based combination therapy, staffing level, Embu County

Abstract

Effective treatment of malaria relies on the availability of quality medicines while pricing is a major determinant of affordability. In addition, adequate numbers of competent staff of different cadres is essential for a well-functioning health system and effective health service delivery. The aim of the study was to determine the availability and prices of antimalarial medicines as well as staffing levels in healthcare facilities located in Embu County, Kenya. Antimalarials were sampled from 11 public (government owned) facilities, 29 private pharmacies, 5 private-for-profit and 3 not-for-profit mission health facilities in May-June 2014. The majority of public facilities (91%) had artemether-lumefantrine (AL) tablets in stock. Government and mission facilities did not stock second line antimalarials or sulfonamide-pyrimethamine (SP). All public facilities provided antimalarials free-of-charge to patients. Private pharmacies stocked a wider variety of antimalarials. The facilities studied were stocked with recommended antimalarials both in the private and public domains. No oral artemisinin monotherapies were encountered during the study. Only 45% percent of public facilities employed pharmacists. Of the remaining facilities, 27% employed pharmaceutical technologists while in the rest of the facilities pharmaceuticals were in the custody of nurses. Notably, none of the private-for-profit or mission facilities had pharmacists employed in their establishments; one facility employed a pharmaceutical technologist, while the rest were staffed by nurses. The number of private pharmacies superintended by pharmacists and pharmaceutical technologists were 7 (24%) and 22 (76%), respectively.