Access to essential drugs in 11 Brazilian cities: a community-based evaluation and action method.

The Brazilian Institute for Defense of Consumers' (IDEC) health and legal professionals gathered with partner associations and researchers from the University of Brasilia shaped this study to develop and apply simple methods for community and consumer organizations to monitor the availability of essential drugs for primary care in their local public health services. A cross-sectional study was conducted in 11 Brazilian cities. The instrument gave priority to the feasibility of use by community organizations over statistically representative designs. It also worked from the assumption that all Health Centers should stock the drugs recommended for ambulatory care on Brazil's national list of essential drugs, in agreement to federal legislation. The instrument was found to be feasible for use by the participating organizations, and its utilization revealed a picture of severe deficiency of essential medicines in the Brazilian public health system, expressed as an overall availability of only 55.4% of the 61 drugs investigated. Models for legal action in support of individual and community access to essential drugs were developed by IDEC's legal staff to assist community organization in following up the results with an action program. These models were made available on the organization's web-site and widely disseminated nationally.