Private retail drug shops: what they are, how they operate, and implications for health care delivery in rural Uganda.
Private retail drug shops: what they are, how they operate, and implications for health care delivery in rural Uganda.
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DOI：
10.1186/s12913-018-3343-z
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发表时间：
2018-07-09
影响因子：
2.8
通讯作者：
Wamani H
中科院分区：
文献类型：
--
作者：
Mayora C;Kitutu FE;Kandala NB;Ekirapa-Kiracho E;Peterson SS;Wamani H
在乌干达农村地区，零售药店在管理儿科发烧方面发挥着重要作用。改善药品销售者行为的有针对性的干预措施需要了解零售药店市场和影响行为的动机。这项研究的目的是描述与乌干达国家药品管理局关于设立药店的指导方针有关的经营环境；私营零售药店在管理乌干达西部农村五岁以下儿童发烧情况方面的特点和配药做法。对74家注册药店的横断面调查、观察清单和428次离职访谈，使用半结构问卷对在调查期间到药店寻求护理的五岁以下儿童的寻求照顾者进行调查。这项调查于2013年5月在乌干达西南部的姆巴拉拉和布申伊地区进行。在姆巴拉拉和布申伊接受调查的药店中，高达90%和79%的药店基本上是在符合国家药监局关于操作适宜性和确保药品安全和质量的要求的场所经营的。药店服务员接受过一些与健康或医疗相关的培训，姆巴拉拉60%的人和布申伊59%的人是护士或助产士。其余的是临床官员和药剂师。药店最常见的库存药物是扑热息痛、奎宁、咳嗽糖浆、ORS/锌、阿莫西林糖浆、Septrin®糖浆、青蒿素联合疗法和多种维生素等。关于储存哪些药品的决定受到以下因素的影响：卫生部的推荐药品、消费者需求、最有利可图的药品和季节性疾病模式。配药决定受到以下因素的影响：客户提供的处方、患者的财务状况和患者的偏好等。大多数接受调查的药店都有卫生部推荐的临床指南、ICCM指南、疟疾和腹泻治疗算法和图表。一些药店提供额外的服务，如免疫接种，并出售非医疗商品，以此作为多样化的机制。大部分药店均遵守建议的指引。市场因素，包括客户需求和偏好、定价和盈利能力，以及季节性，在很大程度上影响了配药和库存实践。改善零售药店的做法和服务质量，需要设计和实施供给方和需求方的战略。本文的在线版本(10.1186/s12913-0183343-z)包含补充材料，可供授权用户使用。
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. 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. 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. 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. The online version of this article (10.1186/s12913-018-3343-z) contains supplementary material, which is available to authorized users.
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DOI：
10.4269/ajtmh.2012.11-0791
发表时间：
2012-11-01
影响因子：
3.3
作者：
Awor, Phyllis;Wamani, Henry;Peterson, Stefan
通讯作者：
Peterson, Stefan
影响因子：
3.7
作者：
Cohen J;Fink G;Berg K;Aber F;Jordan M;Maloney K;Dickens W
通讯作者：
Dickens W
影响因子：
5.4
作者：
Goel, P;RossDegnan, D;Soumerai, S
通讯作者：
Soumerai, S
影响因子：
10.8
作者：
Bloom G;Henson S;Peters DH
通讯作者：
Peters DH
影响因子：
2.1
作者：
Goodman, Catherine;Kachur, S. Patrick;Mills, Anne
通讯作者：
Mills, Anne