Coping with access barriers to non‐communicable disease medicines: qualitative patient interviews in eight counties in Kenya
| العنوان: | Coping with access barriers to non‐communicable disease medicines: qualitative patient interviews in eight counties in Kenya |
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| المؤلفون: | Elizabeth Raskin, Monica Adhiambo Onyango, Gloria Ng, Kathleen P. Banks, Peter C. Rockers, Zana Wangari Kiragu, Richard Laing, Veronika J. Wirtz |
| المصدر: | BMC Health Services Research, Vol 21, Iss 1, Pp 1-10 (2021) BMC Health Services Research |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Coping (psychology), medicine.medical_specialty, Health informatics, Health Services Accessibility, Health administration, 03 medical and health sciences, Indirect costs, 0302 clinical medicine, Environmental health, Adaptation, Psychological, medicine, Humans, 030212 general & internal medicine, Noncommunicable Diseases, business.industry, 030503 health policy & services, Health Policy, Nursing research, Public health, Non-communicable disease, medicine.disease, Kenya, Public aspects of medicine, RA1-1270, Drugs, Essential, 0305 other medical science, business, Research Article, Qualitative research |
| الوصف: | Background There is rich literature on barriers to medicines access for the treatment of non-communicable diseases (NCDs) in high-income countries. Less is known about low- and middle-income countries, in particular the differences in coping with medicines access barrier by household wealth and disease. The aim of this study was to compare the coping mechanisms of patients with the lack of availability and affordability of cardio-vascular diseases, diabetes and asthma medicines in Kenya. Methods This qualitative study was part of a larger mixed methods evaluation study conducted in eight counties of Kenya from 2016 to 2019. Forty-nine patient interviews at study end line explored their NCD journey, perceptions of availability, stockouts and affordability of NCD medicines, their enrollment in health insurance, and their relationship with the private chemists. Transcribed interviews were coded using Nvivo software. A two-step thematic approach was used, first conducting a priority coding which was followed by coding emerging and divergent themes. Results Overall, we found that patients across all disease types and wealth level faced frequent medicine stock-outs at health facilities. In the absence of NCD medicines at health facilities, patients coped by purchasing medicines from local chemists, switching health facilities, requesting a different prescription, admitting oneself to an inpatient facility, establishing connections with local staff to receive notifications of medicine stock, stocking up on medicines, utilizing social capital to retrieve medicines from larger cities and obtaining funds from a network of friends and family. Categorizing by disease revealed patterns in coping choices that were based on the course of the disease, severity of the symptoms and the direct and indirect costs incurred as a result of stockouts of NCD medicines. Categorizing by wealth highlight differences in households’ capacity to cope with the unavailability and unaffordability of NCD medicines. Conclusions The type of coping strategies to access barriers differ by NCD and wealth group. Although Kenya has made important strides to address NCD medicines access challenges, prioritizing enrollment of low wealth households in county health insurance programs and ensuring continuous availability of essential NCD medicines at public health facilities close to the patient homes could improve access. |
| تدمد: | 1472-6963 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3ad25aa8695a1d402b62b35b52bab428 https://doi.org/10.1186/s12913-021-06433-0 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....3ad25aa8695a1d402b62b35b52bab428 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14726963 |
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