title: Availability and utilization of the WHO recommended priority lifesaving medicines for under five-year old children in public health facilities in Uganda: a cross-sectional survey.
abstract: OBJECTIVE
  To explore the availability and utilization of the World Health Organization (WHO) recommended priority life-saving medicines for children under five in public health facilities in Uganda.
  
  
  METHODS
  We conducted a cross sectional survey in 32 lower level public facilities in Jinja district of Uganda. A proportionate number of facilities were randomly selected in each stratum following a hierarchy of Health Centers (HC) defined according to the level of care they provide: 17 HC IIs, 10 HC IIIs and 5 HC IVs. In the facilities, we verified the availability of the WHO recommended priority medicines for diarrhea, sepsis, pneumonia and malaria. 81 health workers from the facilities reported what they prescribed for children with the above diseases.
  
  
  RESULTS
  Oral rehydration salt (ORS) and zinc sulphate dispersible tablets for diarrhea were available in all HC IIs and IIIs and in only 60% of HC IVs. Procaine benzyl penicillin injection powder for treatment of sepsis was available in the majority of all HCs with: 100% of HC of IVs, 83% of HC IIIs and 82% of HC IIs. Medicines for pneumonia were limited across all the HCs with: Amoxicillin dispersible tablets in only 30% of the HC IIs and 40% of the HC IVs. The most uncommon were child-friendly priority medicines for malaria with: Artesunate injection in only 6% of HC IIs, 14% of HC IIIs and 20% of HC IVs; Artemether lumefantrine dispersible tablets and rectal artesunate were missing in all the 32 HCs. Less than a third of the health workers reported prescribing zinc sulphate and ORS for diarrhea, 86% reported procaine benzyl penicillin injection powder for sepsis, and 57% reported amoxicillin dispersible tablets for pneumonia. None reported prescribing Artemether lumefantrine dispersible tablets and rectal artesunate for malaria.
  
  
  CONCLUSIONS
  There is low availability and utilization of life-saving priority medicines for pneumonia and malaria in public health facilities in Uganda. However, the priority medicines for diarrhea and sepsis are available and highly prescribed by the health workers.
authors.affiliation: Child Health and Development Center, College of Health Sciences, Makerere University, P.O. Box 6717, Kampala, Uganda.
authors.forename: Xavier
authors.initials: X
authors.lastname: Nsabagasani
authors.affiliation: Department of Pharmacology and Therapeutics, Gulu University, Gulu Municipality, Uganda.
authors.forename: Jasper
authors.initials: J
authors.lastname: Ogwal-Okeng
authors.affiliation: Ministry of Health Uganda and Department of Health, Uganda Christian University, Kampala, Uganda.
authors.forename: Anthony
authors.initials: A
authors.lastname: Mbonye
authors.affiliation: School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Freddie
authors.initials: F
authors.lastname: Ssengooba
authors.affiliation: Child Health and Development Center, College of Health Sciences, Makerere University, P.O. Box 6717, Kampala, Uganda.
authors.forename: Simon
authors.initials: S
authors.lastname: Muhumuza
authors.affiliation: Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ebba Holme
authors.initials: EH
authors.lastname: Hansen
keywords: Children under five; Lifesaving priority medicines; Public health facilities; Uganda