Private retail drug shops: what they are, how they operate, and implications for health care delivery in rural Uganda
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Health Services Research
Abstract
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.
Description
Keywords
Private sector, Retail market, Drug shops, Under-five children, Health care
Citation
Mayora, C., Kitutu, FE, Kandala, NB, Ekirapa-Kiracho, E., Peterson, SS, & 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), 1-12. https://doi.org/10.1186/s12913-018-3343-z