Accessibility of medicines used in the management of substance use disorders in two hospitals in Nairobi

Abstract

Background Substance use disorder (SUD) is a complex chronic disease that requires a multidisciplinary approach in treatment. Pharmacotherapy is one of the components in the treatment of this condition. Accessibility to treatment is a universal right and this study sought to assess the accessibility of medicines used in the treatment of substance use disorders in selected hospitals in Nairobi. Objectives The main objective of this study was to determine the accessibility of pharmaceutical commodities used in the treatment of patients with substance use disorders in selected hospitals in Nairobi. Methods This descriptive cross-sectional study with both qualitative and quantitative components was carried out in April and May 2015 at two hospitals in Nairobi, Mathari Mental hospital and Chiromo Lane Medical Centre, that provide pharmacotherapy. Data on availability and affordability was collected from the two sites and the World Health Organization performance indicators for health facilities were used to assess availability. Affordability was determined using the daily wage of the lowest paid government worker. Key findings About 50% of medicines on the Kenya Essential Medicines List (KEML 2010) for management of SUDs were available in Mathari while Chiromo Lane had all of them. The mean stock out duration was 8 months and 0.5 months in Mathari and Chiromo Lane, respectively. About 70% of the medicines required less than a single day‘s wage to buy a month‘s supply in Mathari while in Chiromo Lane all the medicines required more than a single day‘s wage to purchase. The cheapest medicine required 0.3 days wage to purchase while the most expensive required 50 days wage to purchase. Conclusions Medicines for the treatment of SUDs had limited availability but were relatively affordable in Mathari while their availability was better in Chiromo Lane but with limited affordability. Key words: Substance Use Disorders, Pharmacotherapy, Availability, Affordability.