AI Insight
A cross-sectional study conducted at two public primary health facilities in Accra, Ghana, assessed medicine availability, affordability, and quality against WHO Rational Use of Medicines (RUM) standards. Medicine availability fell well below the 100% WHO benchmark, with one facility meeting only 40% of targets, while treatment costs for common conditions like malaria and pneumonia reached up to three times the national daily minimum wage. Additionally, the average number of medicines prescribed per encounter (3.2) exceeded the WHO-recommended limit of two or fewer, and storage infrastructure at both facilities was found to be inadequate.
Why it matters
These findings highlight systemic barriers — including supply chain inefficiencies, unaffordable treatment costs, and substandard storage conditions — that undermine safe and equitable access to essential medicines in low- and middle-income country primary healthcare settings, pointing to the urgent need for stronger procurement systems and financial protection policies in Ghana and similar contexts.
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Rational use of medicines (RUM) is a global health priority, yet significant challenges persist in low- and middle-income countries (LMICs), particularly around medicine access, affordability, and quality. While RUM studies often focus on prescribing practices, systemic barriers such as supply chain inefficiencies and pricing receive less attention. This study assessed three key health system components of RUM (availability, affordability, and quality of essential medicines) at two public primary health facilities in Ghana and examined patient care practices against WHO RUM standards. A quantitative, cross-sectional study was conducted at Kekele Polyclinic and Rawlings Circle Polyclinic in Accra. Retrospective data were extracted from prescription sheets, medicine tally cards, and ledgers to evaluate WHO Level II core drug use indicators. Fifteen essential medicines were selected based on the Ghana Essential Medicines List, Standard Treatment Guidelines, and municipal disease burden data. Exit interviews with 107 patients assessed dispensing and counselling practices, and structured observation covered storage conditions and pharmaceutical handling. Availability of key medicines fell significantly short of WHO targets, with Rawlings Circle meeting only 40% and Kekele 73.3% of the 100% benchmark. Treatment of malaria and pneumonia cost patients up to three times the national daily minimum wage, indicating poor affordability. The average number of medicines prescribed per encounter (3.2) exceeded the WHO recommended standard ([≤]2). Storage and handling infrastructure was inadequate, with both facilities falling short of recommended conservation standards. Gaps in medicine availability, affordability, and infrastructure undermine rational medicine use in primary healthcare. Strengthening procurement systems, enforcing storage protocols, and implementing financial protection mechanisms are essential for equitable and safe medicine use within Ghanas health system.