Perspectives of key decision makers on out-of-pocket payments for medicines in the Ethiopian healthcare system: a qualitative interview study
Objective This study aimed to explore the perspectives of key decision makers on out-of-pocket (OOP) payment for medicines and its implications in the Ethiopian healthcare system.Design A qualitative design that employed audiorecorded semistructured in-depth interviews was used in this study. The fr...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/7/e072748.full |
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| author | Eskinder Eshetu Ali Getahun Asmamaw Mekuria Daniel Legese Achalu Dinksew Tewuhibo Wondim Ayenew |
| author_facet | Eskinder Eshetu Ali Getahun Asmamaw Mekuria Daniel Legese Achalu Dinksew Tewuhibo Wondim Ayenew |
| author_sort | Eskinder Eshetu Ali |
| collection | DOAJ |
| description | Objective This study aimed to explore the perspectives of key decision makers on out-of-pocket (OOP) payment for medicines and its implications in the Ethiopian healthcare system.Design A qualitative design that employed audiorecorded semistructured in-depth interviews was used in this study. The framework thematic analysis approach was followed in the analysis.Setting Interviewees came from five federal-level institutions engaged in policymaking (three) and tertiary referral-level healthcare service provision (two) in Ethiopia.Participants Seven pharmacists, five health officers, one medical doctor and one economist who held key decision-making positions in their respective organisations participated in the study.Result Three major themes were identified in the areas of the current context of OOP payment for medicines, its aggravating factors and a plan to reduce its burden. Under the current context, participants’ overall opinions, circumstances of vulnerability and consequences on households were identified. Factors identified as aggravating the burden of OOP payment were deficiencies in the medicine supply chain and limitations in the health insurance system. Suggested mitigation strategies to be implemented by the health providers, the national medicines supplier, the insurance agency and the Ministry of Health were categorised under plans to reduce OOP payment.Conclusion The findings of this study indicate that there is widespread OOP payment for medicines in Ethiopia. System level constraints such as weaknesses in the supply system at the national and health facility levels have been identified as critical factors that undermine the protective effects of health insurance in the Ethiopian context. Ensuring steady access to essential medicines requires addressing health system and supply constraints in addition to a well-functioning financial risk protection systems. |
| first_indexed | 2024-03-12T15:22:58Z |
| format | Article |
| id | doaj.art-8f2776f4c0cd4f56809722daca9e7108 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T15:22:58Z |
| publishDate | 2023-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-8f2776f4c0cd4f56809722daca9e71082023-08-11T00:10:08ZengBMJ Publishing GroupBMJ Open2044-60552023-07-0113710.1136/bmjopen-2023-072748Perspectives of key decision makers on out-of-pocket payments for medicines in the Ethiopian healthcare system: a qualitative interview studyEskinder Eshetu Ali0Getahun Asmamaw Mekuria1Daniel Legese Achalu2Dinksew Tewuhibo3Wondim Ayenew4Department of Pharmaceutics and Social Pharmacy, Addis Ababa University College of Health Sciences, Addis Ababa, EthiopiaDepartment of Pharmacy, College of Health Sciences, Arba Minch University, Arba Minch, EthiopiaClinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, EthiopiaDepartment of Pharmacy, Madda Walabu University, Robe, EthiopiaDepartment of Social and Administrative Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaObjective This study aimed to explore the perspectives of key decision makers on out-of-pocket (OOP) payment for medicines and its implications in the Ethiopian healthcare system.Design A qualitative design that employed audiorecorded semistructured in-depth interviews was used in this study. The framework thematic analysis approach was followed in the analysis.Setting Interviewees came from five federal-level institutions engaged in policymaking (three) and tertiary referral-level healthcare service provision (two) in Ethiopia.Participants Seven pharmacists, five health officers, one medical doctor and one economist who held key decision-making positions in their respective organisations participated in the study.Result Three major themes were identified in the areas of the current context of OOP payment for medicines, its aggravating factors and a plan to reduce its burden. Under the current context, participants’ overall opinions, circumstances of vulnerability and consequences on households were identified. Factors identified as aggravating the burden of OOP payment were deficiencies in the medicine supply chain and limitations in the health insurance system. Suggested mitigation strategies to be implemented by the health providers, the national medicines supplier, the insurance agency and the Ministry of Health were categorised under plans to reduce OOP payment.Conclusion The findings of this study indicate that there is widespread OOP payment for medicines in Ethiopia. System level constraints such as weaknesses in the supply system at the national and health facility levels have been identified as critical factors that undermine the protective effects of health insurance in the Ethiopian context. Ensuring steady access to essential medicines requires addressing health system and supply constraints in addition to a well-functioning financial risk protection systems.https://bmjopen.bmj.com/content/13/7/e072748.full |
| spellingShingle | Eskinder Eshetu Ali Getahun Asmamaw Mekuria Daniel Legese Achalu Dinksew Tewuhibo Wondim Ayenew Perspectives of key decision makers on out-of-pocket payments for medicines in the Ethiopian healthcare system: a qualitative interview study BMJ Open |
| title | Perspectives of key decision makers on out-of-pocket payments for medicines in the Ethiopian healthcare system: a qualitative interview study |
| title_full | Perspectives of key decision makers on out-of-pocket payments for medicines in the Ethiopian healthcare system: a qualitative interview study |
| title_fullStr | Perspectives of key decision makers on out-of-pocket payments for medicines in the Ethiopian healthcare system: a qualitative interview study |
| title_full_unstemmed | Perspectives of key decision makers on out-of-pocket payments for medicines in the Ethiopian healthcare system: a qualitative interview study |
| title_short | Perspectives of key decision makers on out-of-pocket payments for medicines in the Ethiopian healthcare system: a qualitative interview study |
| title_sort | perspectives of key decision makers on out of pocket payments for medicines in the ethiopian healthcare system a qualitative interview study |
| url | https://bmjopen.bmj.com/content/13/7/e072748.full |
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