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

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  • 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
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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. World Bank, 2010. "Delivering Better Health Services to Pakistan's Poor," World Bank Publications - Reports 12369, The World Bank Group.
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    Cited by:

    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.

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