Forty years after Alma-Ata: primary health-care preparedness for chronic diseases in Mozambique, Nepal and Peru

Figures & data

Table 1. General information of Mozambique, Nepal and Peru

Indicator	Mozambique	Nepal	Peru
Country income group ^(1)	Low income	Low income	Upper middle income
Population (in thousands, year 2018) ^(1)	29,496	28,088	31,989
Gross Domestic Product (GDP) per capita in US current dollars (year 2018) ^(1)	503.3	1,038.7	6,941.2
Life expectancy at birth (year 2018) ^(1)	60.2	70.5	76.5
Current health expenditure (% of GDP, year 2018) ^(2)	8.2	5.8	5.2
Physicians (per 10,000 people, year 2018) ^(2)	0.8	7.5	8.2
Age-standardized NCD mortality rate (per 100,000 population, year 2018) ^(2)	783.6	602.3	305.5
Districts with PHC facilities included in the study (population)	Moamba (83,879) [25] Nlhamankulu (129,306) [25]	Baniyani (6,458) [26] Itahari (140,517) [27]	Montero (6,179) [28] Ayabaca (30,852) [28]

(1) World Development Indicators [29]; (2) Global Health Observatory data repository [30].

Table 2. Number of interviews conducted per type of informant at the macro, meso and micro-level

Health system level	Mozambique	Nepal	Peru
Macro-level interviews: Ministry of Health, disease-specific national associations or organizations and key opinion leaders	9	9	25
Meso-level interviews: Regional and local health offices, heads of PHC facilities, public/private laboratories and pharmacies	20	16	19
Micro-level interviews: Health-care workers (physicians, nurses, obstetricians, etc.) and people with NCDs or NTDs	28	46	54
Total number of interviews:	57	72	98
Number of PHC facilities:	4	2	4

Table 3. Availability of medicines in the selected PHC facilities

	Mozambique					Nepal				Peru
Medicines by disease	Public (n = 4)			Private (n = 5)		Public (n = 2)		Private (n = 4)		Public (n = 4)		Private (n = 2)
	n		%	n	%	N	%	N	%	n	%	n	%
Diabetes
Human insulin (DNA recombinant origin)	0		0%	0	0%	0	0%	0	0%	1	25%	1	50%
Isophane insulin (NPH)	0		0%	0	0%	0	0%	0	0%	1	25%	0	0%
Metformin	4		100%	5	100%	2	100%	0	0%	2	50%	2	100%
Glibenclamide	4		100%	5	100%	0	0%	0	0%	2	50%	1	50%
Hypertension
Calcium channel blockers
Amlodipine	4		100%	0	0%	2	100%	4	100%	2	50%	1	50%
Nifedipine	4		100%	0	0%	0	0%	4	100%	3	75%	0	0%
Beta-blockers
Atenolol	2		50%	5	100%	2	100%	4	100%	0	0%	0	0%
Carvelidol	0		0%	0	0%	0	0%	0	0%	1	25%	0	0%
Angiotensin-converting enzyme inhibitors
Captopril	0		0%	2	40%	0	0%	0	0%	4	100%	2	100%
Enalapril	4		100%	4	80%	0	0%	4	100%	3	75%	2	100%
Thiazide diuretic
Hydrochlorothiazide	4		100%	3	60%	0	0%	4	100%	3	75%	0	0%
Schistosomiasis
Praziquantel	4		100%	3	60%	-	-	-	-	-	-	-	-
Leprosy
Clofazimine	-		-	-	-	2	100%	0	0%	-	-	-	-
Dapsone	-		-	-	-	2	100%	0	0%	-	-	-	-
Rifampicin	-		-	-	-	2	100%	0	0%	-	-	-	-
Prednisolone	-		-	-	-	2	100%	4	100%	-	-	-	-
Neurocysticercosis
Antiparasitic drugs	-		-	-	-	-	-	-	-
Albendazole	-		-	-	-	-	-	-	-	4	100%	2	100%
Mebendazole	-		-	-	-	-	-	-	-	4	100%	2	100%
Niclosamide	-		-	-	-	-	-	-	-	0	0%	0	0%
Praziquantel	-		-	-	-	-	-	-	-	0	0%	0	0%
Pyrantel	-		-	-	-	-	-	-	-	0	0%	1	50%
Corticosteroids
Dexamethasone	-		-	-	-	-	-	-	-	4	100%	2	100%
Prednisone	-		-	-	-	-	-	-	-	2	50%	2	100%
Anticonvulsants
Carbamazepine	-		-	-	-	-	-	-	-	3	75%	2	100%
Phenobarbital	-		-	-	-	-	-	-	-	1	25%	0	0%
Phenytoin sodium	-		-	-	-	-	-	-	-	1	25%	0	0%
Valproate	-		-	-	-	-	-	-	-	0	0%	0	0%
Ethosuximide	-		-	-	-	-	-	-	-	0	0%	0	0%
Gabapentina	-		-	-	-	-	-	-	-	0	0%	2	100%
Lamotrigine	-		-	-	-	-	-	-	-	0	0%	0	0%
Other psychotropic/ benzodiazepines
Clonazepam		-	-	-	-	-	-	-	-	0	0%	1	50%
Diazepam		-	-	-	-	-	-	-	-	4	100%	0	0%
Lorazepam		-	-	-	-	-	-	-	-	0	0%	0	0%

*Analysis includes all doses and forms combined.

** The hyphen means that the fieldworkers did not ask about this medicine because it was not for one of the target diseases in that country.

Figure 1. Affordability of medicines for diabetes in the selected sites

Figure 2. Affordability of medicines for hypertension in the selected sites

Figure 3. Affordability of drugs for schistosomiasis (Mozambique) and neurocysticercosis (Peru), in number of days’ wages

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