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Private retail drug shops: what they are, how they operate, and implications for health care delivery in rural Uganda.
BMC Health Serv Res. 2018 07 09; 18(1):532.BH

Abstract

BACKGROUND

Retail drug shops play a significant role in managing pediatric fevers in rural areas in Uganda. Targeted interventions to improve drug seller practices require understanding of the retail drug shop market and motivations that influence practices. This study aimed at describing the operational environment in relation to the Uganda National Drug Authority guidelines for setup of drug shops; characteristics, and dispensing practices of private retail drug shops in managing febrile conditions among under-five children in rural western Uganda.

METHODS

Cross sectional survey of 74 registered drug shops, observation checklist, and 428 exit interviews using a semi-structured questionnaire with care-seekers of children under five years of age, who sought care at drug shops during the survey period. The survey was conducted in Mbarara and Bushenyi districts, South Western Uganda, in May 2013.

RESULTS

Up to 90 and 79% of surveyed drug shops in Mbarara and Bushenyi, largely operate in premises that meet National Drug Authority requirements for operational suitability and ensuring medicines safety and quality. Drug shop attendants had some health or medical related training with 60% in Mbarara and 59% in Bushenyi being nurses or midwives. The rest were clinical officers, pharmacists. The most commonly stocked medicines at drug shops were Paracetamol, Quinine, Cough syrup, ORS/Zinc, Amoxicillin syrup, Septrin® syrup, Artemisinin-based combination therapies, and multivitamins, among others. Decisions on what medicines to stock were influenced by among others: recommended medicines from Ministry of Health, consumer demand, most profitable medicines, and seasonal disease patterns. Dispensing decisions were influenced by: prescriptions presented by client, patients' finances, and patient preferences, among others. Most drug shops surveyed had clinical guidelines, iCCM guidelines, malaria and diarrhea treatment algorithms and charts as recommended by the Ministry of Health. Some drug shops offered additional services such as immunization and sold non-medical goods, as a mechanism for diversification.

CONCLUSION

Most drug shops premises adhered to the recommended guidelines. Market factors, including client demand and preferences, pricing and profitability, and seasonality largely influenced dispensing and stocking practices. Improving retail drug shop practices and quality of services, requires designing and implementing both supply-side and demand side strategies.

Authors+Show Affiliations

School of Public Health, University of Witwatersrand, 27 St. Andrews Road, Parktown, Johannesburg, 2193, South Africa. cmayora@musph.ac.ug. Department of Health Policy Planning and Management, Makerere University School of Public Health, PO Box 7072, Kampala, Uganda. cmayora@musph.ac.ug.Department of Pharmacy, Makerere University College of Health Sciences, P.O. Box 7062, Kampala, Uganda. Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, SE-751 85, Uppsala, Sweden.School of Public Health, University of Witwatersrand, 27 St. Andrews Road, Parktown, Johannesburg, 2193, South Africa. Department of Mathematics, Physics and Electrical Engineering, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.Department of Health Policy Planning and Management, Makerere University School of Public Health, PO Box 7072, Kampala, Uganda.Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, SE-751 85, Uppsala, Sweden. Karolinska Institutet, Department of Public Health Sciences, Health System and Policy Research Group, SE-171 77, Stockholm, Sweden.Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, PO Box 7072, Kampala, Uganda.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29986729

Citation

Mayora, Chrispus, et al. "Private Retail Drug Shops: what They Are, How They Operate, and Implications for Health Care Delivery in Rural Uganda." BMC Health Services Research, vol. 18, no. 1, 2018, p. 532.
Mayora C, Kitutu FE, Kandala NB, et al. Private retail drug shops: what they are, how they operate, and implications for health care delivery in rural Uganda. BMC Health Serv Res. 2018;18(1):532.
Mayora, C., Kitutu, F. E., Kandala, N. B., Ekirapa-Kiracho, E., Peterson, S. S., & Wamani, H. (2018). Private retail drug shops: what they are, how they operate, and implications for health care delivery in rural Uganda. BMC Health Services Research, 18(1), 532. https://doi.org/10.1186/s12913-018-3343-z
Mayora C, et al. Private Retail Drug Shops: what They Are, How They Operate, and Implications for Health Care Delivery in Rural Uganda. BMC Health Serv Res. 2018 07 9;18(1):532. PubMed PMID: 29986729.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Private retail drug shops: what they are, how they operate, and implications for health care delivery in rural Uganda. AU - Mayora,Chrispus, AU - Kitutu,Freddy Eric, AU - Kandala,Ngianga-Bakwin, AU - Ekirapa-Kiracho,Elizabeth, AU - Peterson,Stefan Swartling, AU - Wamani,Henry, Y1 - 2018/07/09/ PY - 2017/10/10/received PY - 2018/06/28/accepted PY - 2018/7/11/entrez PY - 2018/7/11/pubmed PY - 2019/1/11/medline KW - Drug shops KW - Health care KW - Private sector KW - Retail market KW - Under-five children SP - 532 EP - 532 JF - BMC health services research JO - BMC Health Serv Res VL - 18 IS - 1 N2 - BACKGROUND: Retail drug shops play a significant role in managing pediatric fevers in rural areas in Uganda. Targeted interventions to improve drug seller practices require understanding of the retail drug shop market and motivations that influence practices. This study aimed at describing the operational environment in relation to the Uganda National Drug Authority guidelines for setup of drug shops; characteristics, and dispensing practices of private retail drug shops in managing febrile conditions among under-five children in rural western Uganda. METHODS: Cross sectional survey of 74 registered drug shops, observation checklist, and 428 exit interviews using a semi-structured questionnaire with care-seekers of children under five years of age, who sought care at drug shops during the survey period. The survey was conducted in Mbarara and Bushenyi districts, South Western Uganda, in May 2013. RESULTS: Up to 90 and 79% of surveyed drug shops in Mbarara and Bushenyi, largely operate in premises that meet National Drug Authority requirements for operational suitability and ensuring medicines safety and quality. Drug shop attendants had some health or medical related training with 60% in Mbarara and 59% in Bushenyi being nurses or midwives. The rest were clinical officers, pharmacists. The most commonly stocked medicines at drug shops were Paracetamol, Quinine, Cough syrup, ORS/Zinc, Amoxicillin syrup, Septrin® syrup, Artemisinin-based combination therapies, and multivitamins, among others. Decisions on what medicines to stock were influenced by among others: recommended medicines from Ministry of Health, consumer demand, most profitable medicines, and seasonal disease patterns. Dispensing decisions were influenced by: prescriptions presented by client, patients' finances, and patient preferences, among others. Most drug shops surveyed had clinical guidelines, iCCM guidelines, malaria and diarrhea treatment algorithms and charts as recommended by the Ministry of Health. Some drug shops offered additional services such as immunization and sold non-medical goods, as a mechanism for diversification. CONCLUSION: Most drug shops premises adhered to the recommended guidelines. Market factors, including client demand and preferences, pricing and profitability, and seasonality largely influenced dispensing and stocking practices. Improving retail drug shop practices and quality of services, requires designing and implementing both supply-side and demand side strategies. SN - 1472-6963 UR - https://www.unboundmedicine.com/medline/citation/29986729/Private_retail_drug_shops:_what_they_are_how_they_operate_and_implications_for_health_care_delivery_in_rural_Uganda_ L2 - https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3343-z DB - PRIME DP - Unbound Medicine ER -