IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0063515.html
   My bibliography  Save this article

Access to Essential Medicines in Pakistan: Policy and Health Systems Research Concerns

Author

Listed:
  • Shehla Zaidi
  • Maryam Bigdeli
  • Noureen Aleem
  • Arash Rashidian

Abstract

Introduction: Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i) gaps related to access to essential medicine in Pakistan; and ii) prioritization of emerging policy and research concerns. Methods: An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder’s Roundtable. Findings: A synthesis of evidence found major gaps in essential medicine access in Pakistan driven by weaknesses in the health care system as well as weak pharmaceutical regulation. 7 major policy concerns and 11 emerging research concerns were identified through consultative Roundtable. These related to weaknesses in medicine registration and quality assurance systems, unclear and counterproductive pricing policies, irrational prescribing and sub-optimal drug availability. Available research, both locally and globally, fails to target most of the identified policy concerns, tending to concentrate on irrational prescriptions. It overlooks trans-disciplinary areas of policy effectiveness surveillance, consumer behavior, operational pilots and pricing interventions review. Conclusion: Experience from Pakistan shows that policy concerns related to essential medicine access need integrated responses across various components of the health systems, are poorly addressed by existing evidence, and require an expanded health systems research agenda.

Suggested Citation

  • Shehla Zaidi & Maryam Bigdeli & Noureen Aleem & Arash Rashidian, 2013. "Access to Essential Medicines in Pakistan: Policy and Health Systems Research Concerns," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-10, May.
  • Handle: RePEc:plo:pone00:0063515
    DOI: 10.1371/journal.pone.0063515
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063515
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0063515&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0063515?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Ranson, Kent & Law, Tyler J. & Bennett, Sara, 2010. "Establishing health systems financing research priorities in developing countries using a participatory methodology," Social Science & Medicine, Elsevier, vol. 70(12), pages 1933-1942, June.
    2. World Bank, 2010. "Delivering Better Health Services to Pakistan's Poor," World Bank Publications - Reports 12369, The World Bank Group.
    3. Nizami, S. Q. & Khan, I. A. & Bhutta, Z. A., 1996. "Drug prescribing practices of general practitioners and paediatricians for childhood diarrhoea in Karachi, Pakistan," Social Science & Medicine, Elsevier, vol. 42(8), pages 1133-1139, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Amna Saeed & Hamid Saeed & Zikria Saleem & Yu Fang & Zaheer-Ud-Din Babar, 2019. "Evaluation of prices, availability and affordability of essential medicines in Lahore Division, Pakistan: A cross-sectional survey using WHO/HAI methodology," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-16, April.
    2. Ayeesha Kamran Kamal & Wardah Khalid & Abdul Muqeet & Anum Jamil & Kashfa Farhat & Sehar Rahim Ali Gillani & Maryam Zulfiqar & Mehreen Saif & Aliya Amin Muhammad & Fabiha Zaidi & Mohammad Mustafa & Am, 2018. "Making prescriptions “talk” to stroke and heart attack survivors to improve adherence: Results of a randomized clinical trial (The Talking Rx Study)," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-24, December.
    3. Mehmood, Shahid, 2022. "Regulating the Pharmaceutical Industry: An Analysis of the Drug Regulatory Authority of Pakistan (DRAP)," MPRA Paper 113416, University Library of Munich, Germany.
    4. Muhammad Atif & Iram Malik, 2020. "Why is Pakistan vulnerable to COVID‐19 associated morbidity and mortality? A scoping review," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(5), pages 1041-1054, September.
    5. De Guzman, Eleanora & Fausto, Maria Adoracion, 2014. "The Impact of the Cheaper Medicines Act on Households in Metro Manila: A Qualitative Study," Discussion Papers DP 2014-20, Philippine Institute for Development Studies.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pratt, Bridget & Merritt, Maria & Hyder, Adnan A., 2016. "Towards deep inclusion for equity-oriented health research priority-setting: A working model," Social Science & Medicine, Elsevier, vol. 151(C), pages 215-224.
    2. Lim, David & Emery, Jon & Lewis, Janice & Sunderland, V Bruce, 2009. "A systematic review of the literature comparing the practices of dispensing and non-dispensing doctors," Health Policy, Elsevier, vol. 92(1), pages 1-9, September.
    3. Smaldone, Francesco & Ippolito, Adelaide & Ruberto, Margherita, 2020. "The shadows know me: Exploring the dark side of social media in the healthcare field," European Management Journal, Elsevier, vol. 38(1), pages 19-32.
    4. Jeffrey, Scott R. & Pannell, David J., 2013. "Economics of Prioritising Environmental Research: An Expected Value of Partial Perfect Information (EVPPI) Framework," Working Papers 144944, University of Western Australia, School of Agricultural and Resource Economics.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0063515. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.