abastecimiento de medicamentos en unidades de primer nivel de atención de la secretaría de salud de méxico drug supplies at ministry of health primary health care units in mexico
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2001
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Abstract
Objetivo. Conocer el nivel de disponibilidad de algunos medicamentos esenciales (ME) en las unidades de primer nivel de atención de la Secretaría de Salud de México (SSA), a partir de una investigación realizada en 1996-1997. Material y métodos. Del universo de jurisdicciones sanitarias de los 18 estados participantes en el Programa de Ampliación de Cobertura (PAC) se construyó una muestra de manera aleatoria. Todas las unidades de primer nivel de atención ubicadas en las jurisdicciones seleccionadas fueron evaluadas mediante una inspección que utilizó una guía que contenía una lista de 36 ME. En una primera fase del análisis se calcularon el número absoluto y la proporción de unidades que no contaban con un solo ejemplar de alguno de los ME de la lista. En las unidades con disponibilidad de medicamentos se calculó la mediana de la distribución. En una segunda fase se realizó la sumatoria por separado de los 36 medicamentos y de los 10 insumos, y se obtuvieron las medias diferenciadas por tipo de centro de salud y por estado. El estadístico utilizado para la comparación de las medias fue la prueba de Scheffé mediante el análisis de varianza de una vía. Posteriormente se agruparon los medicamentos de acuerdo con sus principales tipos de indicación, y se calcularon las medias y las proporciones de medicamentos disponibles. Las diferencias de proporciones se evaluaron con el estadístico ji cuadrada. Resultados. En el momento de la inspección, las unidades visitadas contaban en promedio, con sólo 18 de los 36 medicamentos incluidos en el estudio. Los problemas de abastecimiento de antibióticos, antifímicos y antipalúdicos fueron particularmente graves. En contraste, el abasto de sales de rehidratación oral, métodos de planificación familiar y biológicos fue relativamente aceptable. En general, los estados clasificados como PAC3 presentaron las mejores cifras de abastecimiento. Conclusiones. La SSA de México, en general, y el Programa de Ampliación de Cobertura, en particular, deberán redoblar esfuerzos para acabar con los cuellos de botella que impiden un abastecimiento adecuado de medicamentos esenciales en las unidades de primer nivel de atención. De otra manera, todas las demás actividades dirigidas a atender las necesidades de salud de las poblaciones más marginadas del país resultarán inútiles, ya que el acceso a los medicamentos constituye la pieza final indispensable de la enorme cadena de la atención a la salud. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html
Objective. To identify the availability of some essential drugs (ED) at primary health care units of the Mexican Ministry of Health (SSA), using data from a research work conducted in 1996 and 1997. Materials and methods. A random sample of the 18 sanitary jurisdictions of states participating in the Extension of Coverage Program (ECP) was drawn. All primary care units from selected jurisdictions were evaluated through an inspection visit, using a checklist that included 36 ED. In phase I of the analysis, the absolute number and proportion of units without a single item of any of the 36 drugs were calculated. In the units with available drugs, the median of the distribution was also calculated. In phase II, the medians according to the type of health unit and state was obtained. The statistic utilized for the comparison of the medians was the Scheffé test with one way variance anlysis. In addition, the drugs were classified according to their therapeutic indication and the medians and proportion of available drugs were calcultaed. The differences in proportion were evaluated with the statistic chi². Results. During the visits, on average, 18 of the 36 drugs included in the list of the study were found in the health units. The availability of antibiotics, antituberculosis drugs, and antimalarial drugs was particularly poor. In contrast, oral rehydration salts, family planning methods and vaccines were usually available. In general, the PAC3 states presented the best availability figures. Conclusions. The Ministry of Health of México will have to develop an enormous effort to overcome the obstacles related to the supply of essential drugs in primary health care units. Otherwise, all other efforts directed to meet the needs of the non-insured population will end up being useless, and enormous amounts of the already scarce resources of the health sector will be wasted since drugs are a vital component of the long chain of health care. The English version of this paper is available at: http://www.insp.mx/salud/index.html
Objective. To identify the availability of some essential drugs (ED) at primary health care units of the Mexican Ministry of Health (SSA), using data from a research work conducted in 1996 and 1997. Materials and methods. A random sample of the 18 sanitary jurisdictions of states participating in the Extension of Coverage Program (ECP) was drawn. All primary care units from selected jurisdictions were evaluated through an inspection visit, using a checklist that included 36 ED. In phase I of the analysis, the absolute number and proportion of units without a single item of any of the 36 drugs were calculated. In the units with available drugs, the median of the distribution was also calculated. In phase II, the medians according to the type of health unit and state was obtained. The statistic utilized for the comparison of the medians was the Scheffé test with one way variance anlysis. In addition, the drugs were classified according to their therapeutic indication and the medians and proportion of available drugs were calcultaed. The differences in proportion were evaluated with the statistic chi². Results. During the visits, on average, 18 of the 36 drugs included in the list of the study were found in the health units. The availability of antibiotics, antituberculosis drugs, and antimalarial drugs was particularly poor. In contrast, oral rehydration salts, family planning methods and vaccines were usually available. In general, the PAC3 states presented the best availability figures. Conclusions. The Ministry of Health of México will have to develop an enormous effort to overcome the obstacles related to the supply of essential drugs in primary health care units. Otherwise, all other efforts directed to meet the needs of the non-insured population will end up being useless, and enormous amounts of the already scarce resources of the health sector will be wasted since drugs are a vital component of the long chain of health care. The English version of this paper is available at: http://www.insp.mx/salud/index.html
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| Authors | ;Octavio Gómez-Dantés;Francisco Garrido-Latorre;Laura Leticia Tirado-Gómez;Dolores Ramírez;Claudia Macías |
| Journal | journal of anatomy |
| Year | 2001 |
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