A Novel Global Health Drug Subsidy AMFm: Assessment of Deployment in Southern Ghana

The Affordable Medicines Facility – malaria (AMFm) is a financing mechanism designed to make artemisinin-based combination therapies (ACTs) a more accessible treatment for malaria(Laspinall 2008). This study assessed the deployment of ACTm in southern Ghana.

The study made a census of functional pharmacies, licensed chemical shops and private health facilities in the southern part of Ghana. Structured questionnaires were used to interview attendants at the facilities on knowledge, availability; cost, patronage of the ACTm and training about the program.

Overall, 78% of the facilities stocked the ACTm. Dome had 86.5% and Taifa, 71.1%.  The cost per treatment of ACTm ranged between GHC 1.00-6.00(0.66-3.96USD). Whilst 59.2% sold ACTm within the recommended range (GHC 1.00-1.50), 40.8% sold it between GHC 2.00-6.00(1.32-3.96USD). At Dome, cost range was GHC 1.00-6.00 with GHC 2.45(1.62USD), and 2.00(1.32USD) as the mean and median prices. Taifa, had range GHC 1.00-4.00, with GHC 1.50 as mean and GHC 1.70(1.12USD) as the median prices. While at Taifa 78.1% of ACTm stocked facilities sold it between GHC 1.00-1.50, only 40.6% did so at Dome (p-value less than 0.001).

Seventy seven percent of respondents had good knowledge of the program. The main channels of communication were audio and visual.

Thirty seven percent of respondents were trained about the program. Whilst 96.3% of the trained stocked ACTm, 67.5% of untrained stocked the drugs (p-value < 0.001). Majority (93.3 %) of the trained preferred ACTm first choice antimalarial, to non-ACTm, compared to 50% of untrained (p-value < 0.001). Overall, 62.2% of respondents reported good patronage.

The results underscore initial observation that knowledge and availability of ACTm was poor. The ACTm though well deployed in the southern Ghana, it is more financially accessible in Taifa than the Dome sub-district hence, difference in patronage.