The Prevalence of Essential Drug Supply Among Non-Communicable Diseases Elderly Attending Public Health Facilities in Nyarugenge District, Kigali, Rwanda

VALENS MANIRIHO; Maurice B Silali

doi:10.36948/ijfmr.2026.v08i04.82999

The Prevalence of Essential Drug Supply Among Non-Communicable Diseases Elderly Attending Public Health Facilities in Nyarugenge District, Kigali, Rwanda

Author(s)	Mr. VALENS MANIRIHO, Dr. Maurice B Silali
Country	Rwanda
Abstract	Background: Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally, disproportionately affecting elderly populations in low- and middle-income countries (LMICs). Globally regionally and locally, essential medicines play a vital role in managing non-communicable diseases (NCDs), which account for 73% of global deaths and morbidities. 41 million annually, 86% occur in low- and middle-income countries. In Rwanda, NCDs cause 45% of all deaths, yet essential medicines face stock-outs in up to 77% of facilities. Effective NCD management requires consistent access to essential medicines, systemic supply constraints, socio-economic barriers, and behavioral factors frequently impede access and adherence. Objective: To assess the prevalence of NCDs, availability, utilization of essential medicines, and determinants of drug supply among elderly patients (≥60 years) in Nyarugenge District, Kigali, Rwanda. This study investigated the determinants influencing the availability, accessibility, and utilization of essential medicines for NCD management among elderly patients in Nyarugenge District, Rwanda. This research adopted a descriptive cross-sectional design and employed a triangulation approach that combined quantitative and qualitative methods to obtain a holistic understanding of the phenomenon under investigation. integrating cross-sectional survey data from 231/235 participants (response rate: 98.3%), retrospective facility records from ten health facilities (2020–2024), and qualitative insights from key informant interviews and focus group discussions, sample was determined by data saturation and Data were collected through approximately 20 key informant interviews and three focus group discussions involving 6–10 participants each while quantitative sample size was determined by Fisher et al., 1998. Data analysis was done by SPSS version 26 and thematic analysis for qualitative. Ethical consideration: MKU School of Post-Graduate approve the proposal, and ethical clearance was obtained from the MKU ethical committee with the Ministry of Health (MOH), Kigali city-Nyarugenge. Instruments were pre-tested for validity and reliability (Cronbach’s α ≥ 0.7). Results: The study achieved a high response rate of 98.3% (231/235), minimizing non-response bias and strengthening representativeness. Overall, essential medicine availability was suboptimal, with only 47.4% of tracer medicines meeting the WHO recommended threshold of ≥80% availability. Severe stock-outs were observed for insulin formulations and aminophylline injection, with stock-out rates reaching 94–98%, while antihypertensive and oral antidiabetic medicines such as amlodipine, metformin, and hydrochlorothiazide showed relatively stable availability (>90% availability and <10% stock-outs). Inferential analysis identified socio-economic factors as the strongest determinants of access. Education was significantly associated with adherence (χ² = 8.23, p = 0.041), while employment increased the likelihood of accessing medicines during stock-outs (OR = 2.1; p = 0.012). Income level (χ² = 11.22, p = 0.001) and affordability (χ² = 9.84, p = 0.007) were strongly associated with access, and health insurance (CBHI) significantly improved access during shortages (χ² = 6.74, p = 0.012). In contrast, age (χ² = 6.14, p = 0.19), marital status (p = 0.754), and living arrangement (p = 1.000) showed no significant association with medicine availability. Qualitative findings confirmed persistent system-level constraints, including weak forecasting based on historical consumption, procurement delays, and inadequate adaptation to a 34.8% increase in NCD burden (711 to 958 cases). Triangulation revealed a structural mismatch between rising demand and supply capacity, with regression analysis showing that NCD burden significantly predicted stock-outs (β = 0.72, R² = 0.52, p < 0.001).In conclusion, despite a high response rate and relatively stable availability of some first-line medicines, essential NCD drug supply remains critically constrained, primarily driven by supply chain inefficiencies and socio-economic inequalities rather than demographic factors, necessitating strengthened forecasting systems and integrated pharmaceutical supply chain reforms.
Keywords	Non-communicable diseases, essential medicines, availability, elderly, adherence, supply chain, Rwanda, hypertension, diabetes.
Field	Medical / Pharmacy
Published In	Volume 8, Issue 4, July-August 2026
Published On	2026-07-21
DOI	https://doi.org/10.36948/ijfmr.2026.v08i04.82999

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The Prevalence of Essential Drug Supply Among Non-Communicable Diseases Elderly Attending Public Health Facilities in Nyarugenge District, Kigali, Rwanda

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