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A Study of Drug Shortages in Satara District
Of
the more than Rs. 9000/- crores of drugs that are consumed
every year in India, it is acknowledged that a substantial
part of these drugs are irrational combinations which
are also wrongly used. In the Government sector, there
is a great deal of shortage of drugs. A study by Phadke,
et al. examined the supply and use of drugs in an average
district in Maharashtra with the specific objective
of studying the amount and the pattern of drug supply
to the public and private sector in Satara district,
and the shortages in the public sector. The study illustrated
the urgent need for implementing a national programme
for essential drugs to avoid unnecessary expenditure
due to irrational prescribing. The conclusions of the
study are probably applicable almost to all districts
of India:
Based
on socio-economic indicators of development Centre for
Monitoring Indian Economy (CMIE index), drug supply
and OPD attendance in public health facilities,
Satara district was
chosen as an average district in Maharashtra. Based
on socio-economic considerations, the talukas in Satara
district were divided into developed, average and drought-prone
zones. Three Primary Health Centres (PHCs), one Rural
Hospital (RH) from each zone (nine out of 69 PHCs and
three out of 10 RHs), one Cottage Hospital (out of two)
and the District Civil Hospital were selected to study
the amount of each drug indented and supplied to the
Government health facilities, shortages, if any, and
the dynamics of supply, utilisation and shortages. The
total number of drugs and their formulations supplied,
were recorded in physical terms as well as their prices
to arrive at the drug-expenditure. All these data were
re-arranged as per the categories of the WHO essential
drugs list.
To
study the regularity of availability of drugs, the date
of supply and the date of nil stock were recorded for
each drug. Depending upon the availability in days,
of different drugs, they were grouped into six categories
(i) Always Available, (ii) Regularly Available, (ii)
Irregular, (iv) Very Irregular, (v) Effectively Not
Available, (vi) Never Available.
An
estimate of the total sale of drugs in the private sector
was made on the basis of informal yet very reliable
sources of information.
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