Regulatory inspection of registered private drug shops in East-Central Uganda-what it is versus what it should be: a qualitative study
Regulatory inspection of registered private drug shops in East-Central Uganda-what it is versus what it should be: a qualitative study
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DOI：
10.1186/s40545-020-00265-9
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发表时间：
2020-09-10
影响因子：
4.2
通讯作者：
Kitutu, Freddy Eric
中科院分区：
文献类型：
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作者：
Bagonza, Arthur;Peterson, Stefan;Kitutu, Freddy Eric
背景：对乌干达私人药店的监管检查是由国家药物管理局执行的卫生部的一项任务。本研究评估了在国家、地区和药店各级执行这项任务的情况。具体来说，他们从检查员和药品销售商那里寻求了关于如何进行检查、由谁进行检查以及面临的挑战的观点。方法对国家和地区两级检查人员进行6次关键信息提供者访谈（KIIs），对护理助理进行8次焦点小组讨论（fgd），对护士进行2次焦点小组讨论。该研究评估了目前针对乌干达C类药店颁发许可证和续期的国家专业指导方针对药品销售者进行检查的方法。转录本使用Atlas ti version 7 （Atlas）进行管理。ti GmbH，柏林)数据管理软件，其中专题内容分析完成。研究中出现了五个主题：权威检查、委托检查、许可、培训和贿赂。在权威检查下，药品销售者谴责检查人员在发现过期或根本没有许可证时使用的高压手段。对于委托检查，药商说，有时检查人员会派卫生助理和副县长进行检查。这个干部队伍不被法律承认为监察员。检查员就如何更好地组织药店以及如何在诊断疟疾时使用快速诊断测试（RDTs）等新技术对药品销售商进行了培训。谈论贿赂的主要是护理助理，他们声称检查人员对检查本身不感兴趣，而是从他们那里收取非法报酬。检查人员说，他们从中央政府得到的便利不足以进行例行检查。结论现行的检查药品销售者的方法过于严厉，使销售者产生了恐惧心理。如果要实现有意义的遵守，就需要建立一个公认的检查结构，并建立检查员和药品销售商之间的对话渠道。如果要对药品销售者进行有意义的检查，政府也需要加强人力和财力。
Background Regulatory inspection of private drug shops in Uganda is a mandate of the Ministry of Health carried out by the National Drug Authority. This study evaluated how this mandate is being carried out at national, district, and drug shop levels. Specifically, perspectives on how the inspection is done, who does it, and challenges faced were sought from inspectors and drug sellers. Methods Six key informant interviews (KIIs) were held with inspectors at the national and district level, while eight focus group discussions (FGDs) were conducted among nursing assistants, and two FGDs were held with nurses. The study appraised current methods of inspecting drug sellers against national professional guidelines for licensing and renewal of class C drug shops in Uganda. Transcripts were managed using Atlas ti version 7 (ATLAS.ti GmbH, Berlin) data management software where the thematic content analysis was done. Results Five themes emerged from the study: authoritarian inspection, delegated inspection, licensing, training, and bribes. Under authoritarian inspection, drug sellers decried the high handedness used by inspectors when found with expired or no license at all. For delegated inspection, drug sellers said that sometimes, inspectors send health assistants and sub-county chiefs for inspection visits. This cadre of people is not recognized by law as inspectors. Inspectors trained drug sellers on how to organize their drug shops better and how to use new technologies such as rapid diagnostic tests (RDTs) in diagnosing malaria. Bribes were talked about mostly by nursing assistants who purported that inspectors were not interested in inspection per se but collecting illicit payments from them. Inspectors said that the facilitation they received from the central government were inadequate for a routine inspection. Conclusion The current method of inspecting drug sellers is harsh and instills fear among drug sellers. There is a need to establish a well-recognized structure of inspection as well as establish channels of dialogue between inspectors and drug sellers if meaningful compliance is to be achieved. The government also needs to enhance both human and financial resources if meaningful inspection of drug sellers is to take place.