Accessibility of esssential medicines for non-communicable diseases in a devolved government in Kenya – the case for trans Nzoia county of western Kenya

Abstract

Objective: The study sought to determine the accessibility (affordability and physical access) to essential medicines for the four major non communicable in Trans-Nzoia County.
Design: The design was a descriptive cross-sectional study carried out for three months among outpatients with non-communicable diseases.
Setting: The study was conducted in five hospitals within Trans Nzoia County western Kenya using qualitative and quantitative methods.
Participants and interventions: Patients and key informant personnel were interviewed. Secondary documents from the health facility were reviewed. The sample size used was 320 participants attending the medical outpatient clinics.
Data obtained was analyzed using descriptive and inferential statistics. The level of significance was p = 0.05.
Results: The study found the essential medicines for non-communicable diseases to be affordable on the basis of minimum daily wage calculation at 0.309 days’ wages, in contrast with the majority participant (78%) reported the medicines not affordable. Medicines for management of chronic obstructive pulmonary disease were found to be most costly with affordability rating of 0.449 days’ wages. Health facilities where participants received essential medicines for non-communicable diseases were geographically accessible with most participants at 92% using 1 hour or less to get to the facility. Cost of transport means was found to be 0.52 days’ wages constituting an impediment to accessibility.
Conclusion: With an epidemiological change in Kenya from communicable diseases to non-communicable diseases, there is need for renewed focus on access to essential medicines for these conditions as reflected by the formation of division of non-communicable disease in the ministry of Health. Based on the study findings, there is need to increase healthcare funding by the county governments for purchase of essential medicines for non-communicable diseases to improve accessibility and affordability by the general population.