Análisis de las políticas de acceso a medicamentos esenciales en países en desarrollo

Abstract

Abstract: This research aimed to analyze essential medicines access policies in developing countries, with emphasis on Ecuador and Latin America, evaluating their effectiveness in three dimensions: availability, affordability and quality, and identifying the factors that conditioned their implementation. From 40 records identified in seven databases PubMed, Scopus, Web of Science, LILACS, SciELO, Google Scholar and institutional repositories 23 documents published between 2019 and 2026 were selected through predefined eligibility criteria. The results showed that the most frequent barrier in the region was stockout in the public sector. For Ecuador, a 20% deficit was described in 2023, associated with institutional instability, state debt and fragmentation in procurement processes. Affordability was compromised by regressive out-of-pocket expenditure and quality was the least documented dimension. Political and institutional factors were identified as the most frequent conditioners of access. The methodological variability of the studies and the limited number of sources specific to Ecuador constituted the main limitations. The present research represented a documentary contribution to the guidance of pharmaceutical policies and the practice of pharmaceutical care in Ecuador and Latin America.