Availability, affordability, and prescribing pattern of medicines in Sudan.

Objective: To evaluate availability, affordability and prescribing pattern of medicines in both public and private health sectors of Sudan.

Setting: Availability, affordability, and rational use of medicines were evaluated in primary health care centers in six states of Sudan.

Methods: The survey followed the WHO guidelines for monitoring and assessing the pharmaceutical situation in countries. For this survey, a total of 36 public health facilities selected from the six geographic areas were identified.

Main Outcome Measure: The survey confirmed the good availability and acceptable affordability of essential medicines in the public health centers and private pharmacies. Despite acceptable stocking of the medicines in these facilities, storage quality of medicines was low.

Results: On average, 82% of the core medicines monitored were available in the centers and 85% of the medicines prescribed by the physician were dispensed to the patients. The average score for quality of storage in store room and dispensing were 56% and 65%, respectively. On average, a complete course of treatment of malaria in public centers costs 0.62 and for treatment of pneumonia in adults and children costs 3.13 and 0.57 days of the lowest government salary, respectively. The average number of medicines per prescription was 2.3. On average, the number of prescriptions containing at least one antibiotic was 66% and 27% of the prescriptions containing an injectable medicine. Adherence of prescribers to standard treatment guidelines for treating uncomplicated diarrhea and diarrhea was 45% and 64%, respectively. The acceptable medicine labeling criteria were met only in 50% of the prescriptions.

Conclusion: The overall availability of essential medicines in the public health centers and private pharmacies of Sudan was acceptable. Although affordability of medicines for some common diseases such as malaria and child pneumonia could be considered acceptable, it was much higher for some other conditions including adult pneumonia. Prescription of antibiotics was high and adherence to standard treatment guidelines for managing common and widely spread diseases such as diarrhea and malaria was low.