Availability of essential medicines and commodities

Number of facilities with essential medicines in stock.

Total number of health facilities.

Facility type, facility managing authority (public/private), specific type of medicine/commodity (e.g. priority medicines for women and children, vaccines, antiretroviral therapy (ART), family planning, essential noncommunicable disease (NCD) medicines).

WHO-recommended essential core list of medicines: bronchodilator inhaler, steroid inhaler, glibenclamide, metformin, insulin, angiotensinconverting-enzyme (ACE) inhibitor, calcium channel blocker, statin, aspirin, thiazide diuretic, beta-blocker, omeprazole tablet, diazepam injection, fluoxetine tablet, haloperidol tablet, carbamazepine tablet, amoxicillin tablet/capsule, amoxicillin suspension, ampicillin injection, ceftriaxone injection, gentamicin injection, oral rehydration salts, zinc sulfate.

Essential NCD medicines: at least aspirin, a statin, an ACE inhibitor, thiazide diuretic, a long-acting calcium channel blocker, metformin, insulin, a bronchodilator and a steroid inhalant.

Priority medicines for women and children: amoxicillin tablet/capsule, amoxicillin suspension, ampicillin injection, ceftriaxone injection, gentamicin injection, oral rehydration salts, zinc sulphate, oxytocin injection, magnesium sulphate injection.

Suggested core list of medicines for pricing/affordability surveys: Salbutamol inhaler 100 mcg per dose (200 doses); beclometasone inhaler 100 mcg/dose (200 doses); glibenclamide 5 mg tablet; metformin 500 mg tablet; insulin regular 100 IU/ml, 10 ml vial; enalapril 5 mg tablet; amlodipine 5 mg tablet; simvastatin 20 mg tablet; aspirin 100 mg tablet; hydrochlorothiazide 25 mg tablet; carvedilol 12.5 mg tablet; omeprazole 20 mg tablet; diazepam 10 mg/2 ml injection; fluoxetine 20 mg tablet; haloperidol 5 mg tablet; carbamazepine 200 mg tablet; amoxicillin 500 mg capsule/tablet; amoxicillin 250 mg/5 ml suspension; ampicillin 500 mg injection; ceftriaxone 1 G vial; gentamicin 80 mg/2 ml injection; oral rehydration salts (sachet for 1 litre); zinc sulfate 2 0mg tablet; oxytocin injection (5 or 10 iu); magnesium sulfate 50% injection 10 ml vial.

Stock out data may also refer to specific time period (1 month, 3 months).

Data on the availability of a specific list of medicines are collected from a survey of a sample of facilities. Availability is reported as the percentage of medicine outlets where a particular medicine was found on the day of the survey. Health facility reports may also include stockouts indicators but require regular independent verification.

See also:Service Availability and Readiness Assessment (SARA); Average availability of 14 selected essential medicines in public and private health facilities

Special facility surveys

Routine facility information systems

Essential medicines refer to those medicines that satisfy the priority health care needs of the population. They are intended to be available within the context of functioning health systems at all times, in adequate amounts, in the appropriate dosage, with assured quality, and at a price that individuals and the community can afford.

WHO and Health Action International (HAI) have developed a standardized methodology for facility-based surveys of medicine prices, availability, affordability and price components, collecting data on the availability and price of approximately 50 medicines, through visits to medicines outlets in the public sector, private sector and any other sectors that serve as important medicine dispensing points (e.g. NGOs, mission hospitals). The list of survey medicines includes 14 medicines in use worldwide as well as 16 regionally specific medicines, with recommendations for countries to collect data on a further 20 medicines of national importance. 

Access has been defined as “having medicines continuously available and affordable at public or private health facilities or medicine outlets that are within one hour’s walk of the population”. Given its complexity, an overall picture of access to medicines can only be generated using a range of indicators that provide data on medicine availability and price, in both public and private sectors, in combination with key policy indicators. 

In addition to the availability (and price) of medicines, it is also important to assess the quality of use aspects, such as appropriate prescription practices, rational medicine use and user adherence. This requires a more extensive assessment of practices in facilities, including record reviews, exit interviews and observation of patients and providers.

World Health Organization (WHO). Monitoring the Building Blocks of Health Systems: A Handbook of Indicators and Their Measurement Strategies.; 2010. http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf

World Health Organization (WHO). 2015 Global Reference List of 100 Core Health Indicators.; 2015. http://apps.who.int/iris/bitstream/10665/173589/1/WHO_HIS_HSI_2015.3_eng.pdf

World Health Organization. Monitoring, Evaluation, and Review of National Health Strategies: A Country-Led Platform for Information and Accountability.; 2011. http://www.who.int/healthinfo/country_monitoring_evaluation/1085_IER_131011_web.pdf

Further information and related links

Draft comprehensive global monitoring framework and targets for the prevention and control of noncommunicable diseases, including a set of indicators. Agenda item A66/8, Sixty-sixth World Health Assembly, 20–28 May 2013. Geneva: World Health Organization; 2013 (Retrieved from http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_8-en.pdf?ua=1 ).

Indicators for monitoring the Millennium Development Goals: definitions, rationale, concepts and sources. New York (NY): United Nations; 2012 (Retrieved from http://mdgs.un.org/unsd/mi/wiki/MainPage.ashx ).

Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneva: World Health Organization; 2010 (Retrieved from http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf?ua=1).

Framework of actions for the follow-up to the Programme of Action of the International Conference on Population and Development beyond 2014. Report of the Secretary-General. New York (NY): United Nations; 2014 (Retrieved from https://www.unfpa.org/webdav/site/global/shared/documents/ICPD/Framework%20of%20action%20for%20the%20follow-up%20to%20the%20PoA%20of%20the%20ICPD.pdf).