The researcher explored the dynamic relationship between accessibility of medicines and the health systems building blocks by establishing the cultural factors that influenced demand and utilization of essential drugs to the marginalized in Tana River County. This cross-sectional descriptive survey selected 283 respondents by lottery approach simple random sampling across 27 villages in Tana River County and 30 health providers both in government and non-governmental owned dispensing health facilities. Culture (taboo) had an effect on the use of certain essential medicines among 133 (47%) of the respondents. Health-seeking behavior among minority 43 (15%) was determined by the head of the family. Predictions on the population indicated >23% chance that culture had an effect on acceptability and utilization of essential medicines. rs (283) = 0.604, p <0.001. To improve on demand for essential medicines, socio-cultural behavior change and communication strategies should be in use targeting improved acceptability of essential medicines
