Publicação
Availability of psychotropic medications in primary health care facilities in the Gambia
| Resumo: | ABSTRACT: Background: Medication is a significant component in the implementation of mhGAP in the Gambia. There is growing emphasis on health systems strengthening in the Gambia and the preparedness of facilities to deliver accessible, affordable, acceptable and quality mental health services. Objective: Assess the availability of essential Psychotropic medications at PHC facilities and identify facilitators/barriers to their availability. Design: A questionnaire adapted from the 2015 WHO Essential Drugs List was used to assess the availability of the core psychotropic medications. Setting: 106 facilities have been assessed in the three levels through which PHC is delivered in the Gambia; the primary, secondary and tertiary levels which comprise of Hospitals, Major and Minor Health Facilities, Village Health Post, NGOs and Private Clinics and Major pharmacy Chains. Results: The National availability of psychotropic medicines is 30%, with 27.7% availability in public facilities compared to 32.8% in Private facilities. Monthly treatment costs ranged from US$10.7 for Midazolam (15mg daily) to US$5 for carbamazepine (200mg daily). 1% of facilities have a psychiatric specialist (2 Technical Aid Cuban Psychiatrists and 8 Gambian Psychiatric Nurses). In 14% of the facilities, Auxiliary (untrained) nurses prescribe psychotropic medications. In some cases up to 28% of a monthly earning can go into the purchase of a single antidepressant drug. Conclusion: Availability of psychotropic medicines is low across all the regions in the Gambia and the gap/disparity between public and private sector availability is very apparent. The low availability and high cost of psychiatric treatment, poses significant barriers to patient care and does not correspond with the burden of mental and substance abuse problems at 6.5% of the adult population having mental or substance abuse problems. The private sector medication prices are exorbitant considering the average earning power of a Gambian civil servant. |
|---|---|
| Autores principais: | Samba, Dawda |
| Assunto: | Psychotropic Medications Anticonvulsants Antidepressants Antipsychotics Medicamentos psicotrópicos Anticonvulsivantes Antidepressivos Antipsicóticos Gâmbia |
| Ano: | 2017 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade Nova de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório Institucional da UNL |
| Resumo: | ABSTRACT: Background: Medication is a significant component in the implementation of mhGAP in the Gambia. There is growing emphasis on health systems strengthening in the Gambia and the preparedness of facilities to deliver accessible, affordable, acceptable and quality mental health services. Objective: Assess the availability of essential Psychotropic medications at PHC facilities and identify facilitators/barriers to their availability. Design: A questionnaire adapted from the 2015 WHO Essential Drugs List was used to assess the availability of the core psychotropic medications. Setting: 106 facilities have been assessed in the three levels through which PHC is delivered in the Gambia; the primary, secondary and tertiary levels which comprise of Hospitals, Major and Minor Health Facilities, Village Health Post, NGOs and Private Clinics and Major pharmacy Chains. Results: The National availability of psychotropic medicines is 30%, with 27.7% availability in public facilities compared to 32.8% in Private facilities. Monthly treatment costs ranged from US$10.7 for Midazolam (15mg daily) to US$5 for carbamazepine (200mg daily). 1% of facilities have a psychiatric specialist (2 Technical Aid Cuban Psychiatrists and 8 Gambian Psychiatric Nurses). In 14% of the facilities, Auxiliary (untrained) nurses prescribe psychotropic medications. In some cases up to 28% of a monthly earning can go into the purchase of a single antidepressant drug. Conclusion: Availability of psychotropic medicines is low across all the regions in the Gambia and the gap/disparity between public and private sector availability is very apparent. The low availability and high cost of psychiatric treatment, poses significant barriers to patient care and does not correspond with the burden of mental and substance abuse problems at 6.5% of the adult population having mental or substance abuse problems. The private sector medication prices are exorbitant considering the average earning power of a Gambian civil servant. |
|---|