Essential medicines and access to primary health care in the medical district of Mambéré-Kadéï

Objective: to assess whether people in Mambéré-Kadéï have access to essential medicines for primary health care. Setting: The study was conducted in 14 public health care centres of the medical district of Mambéré-Kadéi (Central African Republic). Method: This cross-sectional study assessed the drugs prescribed for 40 randomly selected outpatients consulting in each of 14 randomly selected public health centres from June 1, 2000, through March 30, 2001. The methodology used was adapted from the World Health Organization study protocol (WHO indicators) and the International Network for Rational Use of Drugs (INRUD). Main outcome measure: accessibility and affordability of key medicines. Results: Complete data were available for 512 study consultations. A mean of 79.3%(95% Confidence Interval (CI): 77.5-81.7%) of the 14 essential generic drugs monitored were available in the health centre pharmacies. A median prescription cost 2800 Francs FCA ($4.5), a cost within the ability to pay of 73.2% (CI: 72.8-76.2). Conclusion: These results suggest that the population in Mambéré-Kadéï had access to affordable essential medicines. Although availability and accessibility of the generic essential drugs are good in this medical district, the study also showed the need for action to improve access to primary health care for the patients too poor to pay: 26.8% (95% CI: 23.8-28.2).