Measuring Medicines Situations in Households
Since 2003, DPM faculty members have provided technical support to the World Health Organization to develop and test a household survey measuring access to and use of medicines at the community level. Administered in geographic areas surrounding health care facilities, the household survey collects data on health-seeking behaviors, as well as the availability, sources, cost, affordability, and use of medicines. Jointly-conducted health facility and household surveys help identify economic and geographic disparities and socio-cultural barriers in accessing medicines, as well as consumers’ information gaps. The methodology has been tested in several middle- and low-income countries and was adopted by the Medicines Transparency Alliance (MeTA) to evaluate the baseline pharmaceutical sector situation in pilot countries.
In addition, DPM faculty members have led work supported by the World Health Organization and the UK Department for International Development using data from the 2002-2003 WHO World Health Survey conducted in 70 low and middle-income countries. Their analyses have examined assess to care and medicines for acute and chronic illness, affordability, financial risk protection, and gender equity. DPM faculty members also continue collaborations with international colleagues and research fellows to evaluate household patterns of medicines utilization.
Drs. Dennis Ross-Degnan and Catherine Vialle-Valentin have collaborated with WHO and MeTA colleagues to develop a standardized household survey methodology which includes sample design, questionnaires, procedures for collecting data during field visits to households, data entry templates, and reporting of results in a document populated with graphs and tables that are automatically generated by an electronic workbook created to facilitate data analysis. Dr. Anita Wagner has led work using the World Health Survey to evaluate access to care, affordability, and gender equity.
- Emmerick ICM, Luiza VL, Camacho LAB, Ross-Degnan D. Predictors of access to medicines for acute illness in the formal and informal sectors in three middle income countries in Central America. Revista de Saúde Pública 2013 Dec;47(6):1069-79.
- Reddy SK, Ross-Degnan D, Zaslavsky AM, Soumerai SB, Wagner AK. Health Care Payments in the Asia Pacific: Validation of Five Survey Measures of Economic Burden. International Journal for Equity in Health 2013;12:49. PMID: 23822552: PMCID: PMC3716807.
- Wagner AK, Graves AJ, Fan Z, Walker S, Zhang F, Ross-Degnan D. Need for and Access to Health Care and Medicines: Are there Gender Inequities? PLoS One. 2013;8(3):e57228. PMID: 23505420; PMCID: PMC3591435.
- Vialle-Valentin CE, LeCates RF, Zhang F, Desta AT, Ross-Degnan D. Predictors of antibiotic use in African communities: evidence from medicines household surveys in five countries. Tropical Medicine and International Health. 2012;17:211–222. PMID: 21999394.
- Bertoldi AD, Barros AJ, Camargo AL, Hallal PC, Vandoros S, Wagner A, Ross-Degnan D. Household expenditures for medicines and the role of free medicines in the Brazilian public health system. Am J Public Health. 2011 May; 101 (5) :916-21. PMID: 20724692.
- Pharmaceutical Situation in Barbados. WHO Assessment of Level II – Health Facilities and Household Survey. (ISBN 978-92-75-13158-9) Washington; Pan-American Health Organization. 2011.
- Wagner AK, Graves AJ, Reiss SK, Lecates R, Zhang F, Ross-Degnan D. Access to care and medicines, burden of health care expenditures, and risk protection: Results from the World Health Survey. Health Policy. 2011 May; 100 (2-3) :151-8. PMID: 20828854.
- Bertoldi AD, Barros AJ, Wagner A, Ross-Degnan D, Hallal PC. A descriptive review of the methodologies used in household surveys on medicine utilization. BMC Health Serv Res. 2008 Oct 31; 8:222. PMID:18976465; PMCID: PMC2584639.
Principal Investigator: Dennis Ross-Degnan
Funders have included European Community, UK Department for International Development (DFID), World Health Organization, and Pan-American Health Organization.