Accessibility of medicines and primary health care: the impact of the RDF in Khartoum state

Ali, G.K.M., 2006. Accessibility of medicines and primary health care: the impact of the RDF in Khartoum state. PhD, Nottingham Trent University.

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This thesis presents a comprehensive evaluation of an experience where a Revolving Drug Fund (RDF) lasts for fifteen years and serves more than three million patients annually, with more than SDD2.8 billion (US$11.1 million) annual turnover. Various studies of user fees in various countries in general have focused particularly on the revenues, and on community financing and community participation. Little is known regarding the accessibility of essential medicines and their impact on the utilization of public health facilities in areas where the RDF programmes have been or are being implemented, despite the fact that the supply of medicines and improvement in public health facilities utilization are among the main objectives of such policy. While the health literature is seriously lacking in empirical studies that specifically demonstrate the benefits of the RDF and examine the factors explaining success in achieving its objectives, it is widely accepted, based on theoretical grounds and personal experience, that RDF facilitates access to essential medicines. This thesis has used qualitative and quantitative research techniques to collect data from different stakeholders (i.e. health care providers and users) in order to evaluate the experience of the RDF operating in Khartoum State (KS). The findings are based on an analysis of forty-one semi-structured interviews with health care providers and 186 structured interviews with users. In addition, the data from my personal observations, and from archival and statistical records were also analysed. This doctoral study suggests that the unique RDF project implemented by the KS managed to make essential medicines available at its health facilities and consequently increases their utilization compared to non-RDF ones. Sustained availability of low cost medicines near to where people live through the RDF, is clearly benefiting previously disadvantaged poor population, particularly vulnerable rural groups. This doctoral study has made a meaningful contribution to Cost-Sharing Policy in Sudan in finding that the RDF could be successfully implemented as a self-sustainable medicine supply system in other states in Sudan. It also makes a significant contribution in exploring factors that make the RDF achieves its objectives. This study, therefore, presents empirical evidence suggesting that a RDF project could be designed and implemented to maintain a regular, self-financing medicines supply system, if certain prerequisites were put in place. Finally, the thesis will enrich the long debate about the effectiveness of RDFs as mechanisms for financing medicines in developing countries, particularly in Sub-Saharan Africa, by presenting the findings of a comprehensive evaluation study of the largest RDF in the world.

Item Type: Thesis
Creators: Ali, G.K.M.
Date: 2006
ISBN: 9781369316292
Divisions: Schools > School of Social Sciences
Record created by: Linda Sullivan
Date Added: 25 Sep 2020 15:09
Last Modified: 07 Sep 2023 09:24

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