Health system effects of implementing integrated community case management (iCCM) intervention in private retail drug shops in South Western Uganda: a qualitative study

Simple item page
dc.contributor.authorKitutu, Freddy Eric
dc.contributor.authorMayora, Chrispus
dc.contributor.authorJohansson, Emily White
dc.contributor.authorPeterson, Stefan
dc.contributor.authorWamani, Henry
dc.contributor.authorBigdeli, Maryam
dc.contributor.authorShroff, Zubin Cyrus
dc.date.accessioned2022-02-03T09:51:34Z
dc.date.available2022-02-03T09:51:34Z
dc.date.issued2017
dc.description.abstractIntervening in private drug shops to improve quality of care and enhance regulatory oversight may have health system effects that need to be understood before scaling up any such interventions. We examine the processes through which a drug shop intervention culminated in positive unintended effects and other dynamic interactions within the underlying health system. Methods A multifaceted intervention consisting of drug seller training, supply of diagnostics and subsidised medicines, use of treatment algorithms, monthly supervision and community sensitisation was implemented in drug shops in South Western Uganda, to improve paediatric fever management. Focus group discussions and in-depth interviews were conducted with stakeholders (drug sellers, government officials and community health workers) at baseline, midpoint and end-line between September 2013 and September 2015. Using a health market and systems lens, transcripts from the interviews were analysed to identify health system effects associated with the apparent success of the intervention. Findings Stakeholders initially expressed caution and fears about the intervention's implications for quality, equity and interface with the regulatory framework. Over time, these stakeholders embraced the intervention. Most respondents noted that the intervention had improved drug shop standards, enabled drug shops to embrace patient record keeping, parasite-based treatment of malaria and appropriate medicine use. There was also improved supportive supervision, and better compliance to licensing and other regulatory requirements. Drug seller legitimacy was enhanced from the community and client perspective, leading to improved trust in drug shops. conclusion The study showed how effectively using health technologies and the perceived efficacy of medicines contributed to improved legitimacy and trust in drug shops among stakeholders. The study also demonstrated that using a combination of appropriate incentives and consumer empowerment strategies can help harmonise common practices with medicine regulations and safeguard public health, especially in mixed health market contexts.en_US
dc.identifier.citationKitutu FE, Mayora C, Johansson EW, et al. Health system effects of implementing integrated community case management (iCCM) intervention in private retail drug shops in South Western Uganda: a qualitative study. BMJ Glob Health 2017;2:e000334. doi:10.1136/ bmjgh-2017-000334en_US
dc.identifier.other10.1136/ bmjgh-2017-000334
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/1816
dc.language.isoenen_US
dc.publisherBMJ Glob Healthen_US
dc.subjectHealth systemen_US
dc.subjectIntegrated community case management (iCCM)en_US
dc.subjectPrivate retail drug shopsen_US
dc.subjectSouth Western Ugandaen_US
dc.titleHealth system effects of implementing integrated community case management (iCCM) intervention in private retail drug shops in South Western Uganda: a qualitative studyen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Health system effects of implementing.pdf
Size:
485.21 KB
Format:
Adobe Portable Document Format
Description:
Article
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medical and Health Sciences