Experience of healthcare personnel on Co-payment mechanism and the implications on its use in private drug outlets in Uganda

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dc.contributor.authorOcan, Moses
dc.contributor.authorBakubi, Racheal
dc.contributor.authorNakalembe, Loyce
dc.contributor.authorEkusai-Sebatta, Deborah
dc.contributor.authorSam, Nsobya
dc.date.accessioned2024-05-30T10:03:04Z
dc.date.available2024-05-30T10:03:04Z
dc.date.issued2024-05
dc.description.abstractMalaria treatment is faced with the challenge of access, affordability, availability, and quality of antimalarial medicines. Affordable medicines facility-malaria (AMFm) program and subsequently Co-payment mechanism were developed to help increase access to quality assured Artemisinin-based combination therapies (ACTs) in seven countries in sub-Saharan Africa. We explored through a qualitative study, experience of healthcare personnel on Co-payment mechanism and the implication on its use in private drug outlets in Uganda. Private drug outlets that reported stocking antimalarial agents in moderate-to-high and low malaria transmission settings were purposively selected for inclusion in the study. In each drug outlet, data was collected from a pharmacist/dispenser through key informant interview. The interview was done using a key informant interview guide which covered the following areas, (i) sociodemographic characteristics, ii) awareness of healthcare personnel on the co-payment mechanism, (iii) awareness of healthcare personnel on quality assured artemisinin combination therapies (QAACT), (iv) antimalarial stocking in private drug outlets, (v) antimalarial dispensing prices, (vi) considerations made while stocking, and pricing antimalarial agents, vii) challenges in antimalarial dispensing, and (viii) access to antimalarial agents in private drug outlets. Data was managed using Atlas.ti and analyzed using framework methodology. Data was collected from 25 key informants (12 pharmacists and 13 dispensers). Five themes emerged following data analysis, (i) antimalarial stocking influenced by price and client demand, (ii) access and purchasing behavior of drug outlet clients, (iii) basis of dispensing antimalarial agents in private drug outlets, (iv) awareness of QAACT, and (v) awareness of Co-payment mechanism. None of the study participants was aware of the existence of Co-payment mechanism and QAACT in the private sector. Duocotecin brand of ACTs was the most mentioned and dispensed ACT among the study participants in private drug outlets. Nearly all the pharmacists/dispensers said that many clients who request to purchase ACTs don't come with a prescription and prefer buying cheaper antimalarial agents. Study participants reported stocking and selling both ACTs and non-ACT antimalarial agents in the drug outlets. Pharmacists/dispensers in the drug outlets reported that most clients could not afford buying a full dose of an ACT. None of the study participants considered using Co-payment mechanism while stocking ACTs in the drug outlets. There is lack of awareness and utilization of Co-payment mechanism in stocking, pricing, and dispensing of ACTs among pharmacists/dispensers in private drug outlets in Uganda. The antimalarial dispensing in drug outlets was mostly based on prescriptions, clients' preferences, and medicine affordability. The Ministry of Health needs to create demand for Co-payment mechanism through public awareness campaigns, training of healthcare personnel and behavior change communication in the private sector.en_US
dc.description.sponsorshipThis study is part of the EDCTP2 programme supported by the European Union (TMA2019CDF-2662- Pfkelch13 emergence). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscripen_US
dc.identifier.citationOcan, Moses, Racheal Bakubi, Loyce Nakalembe, et al. 'Experience of Healthcare Personnel on Co-Payment Mechanism and the Implications on its use in Private Drug Outlets in Uganda', PloS One, vol. 19/no. 5, (2024), pp. e0297416-e0297416.en_US
dc.identifier.issnISSN 1932-6203
dc.identifier.issnEISSN 1932-6203
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/9554
dc.language.isoenen_US
dc.publisherPublic Library of Scienceen_US
dc.subjecthealthcare personnel; co-payment mechanism; private drug outlets; Ugandaen_US
dc.titleExperience of healthcare personnel on Co-payment mechanism and the implications on its use in private drug outlets in Ugandaen_US
dc.typeArticleen_US
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