Stephen E D Nsimba1. 1. Department of Clinical Pharmacology, Muhimbili University College of Health Sciences, Dar-es-Salaam, Tanzania. snsimba@muchs.ac.tz
Abstract
OBJECTIVE: The study was carried out to evaluate short term effects of one to one educational intervention approach, conducted with 40 drug sellers in order to improve the private sector's practices, compliance and performance in using the national treatment guidelines for malaria and other common childhood (diarrhoea, acute respiratory tract infection-ARI) illnesses in Kibaha district-Tanzania. METHODS: The training took place one month after baseline data collection. Data collection was undertaken eight months after training and the effects of training was evaluated. The 40 drug stores were divided into 20 intervention and 20 control facilities. Trained nurses were used as clients who posed as caretakers of sick under-five children needing medication. The drug dispensers/sellers knowledge of anti-malarials and other drugs and their dispensing practices was assessed. RESULTS: The intervention seemed to have had a significant impact on knowledge pattern for prescribing and dispensing practices of drug stores for some common childhood illnesses but not in other control drug stores/shops. About 90% (n=18) of shops prescribed to clients, the approved first-line anti-malarial drug for uncomplicated malaria (sulfadoxine-pyrimethamine), as compared to only 55% (n=11) of the control shops. CONCLUSION: Changing the private sectors' knowledge, behaviour and practices/performance may be a slow and difficult process. The intervention approach applied in this study seems to be feasible at district-level. This strategy can be applied in all districts of Tanzania with the aim of achieving significant improvements in knowledge, behaviour, compliance, improving performance and practices of drug sellers in drug stores/shops. However, other alternative strategies are needed to influence drug sellers'/dispensers' compliance and performance. Thus, the overall impact on performance and practices in these facilities will remain at moderate level for quite sometime unless national policies, other programs and stakeholders are involved actively.
OBJECTIVE: The study was carried out to evaluate short term effects of one to one educational intervention approach, conducted with 40 drug sellers in order to improve the private sector's practices, compliance and performance in using the national treatment guidelines for malaria and other common childhood (diarrhoea, acute respiratory tract infection-ARI) illnesses in Kibaha district-Tanzania. METHODS: The training took place one month after baseline data collection. Data collection was undertaken eight months after training and the effects of training was evaluated. The 40 drug stores were divided into 20 intervention and 20 control facilities. Trained nurses were used as clients who posed as caretakers of sick under-five children needing medication. The drug dispensers/sellers knowledge of anti-malarials and other drugs and their dispensing practices was assessed. RESULTS: The intervention seemed to have had a significant impact on knowledge pattern for prescribing and dispensing practices of drug stores for some common childhood illnesses but not in other control drug stores/shops. About 90% (n=18) of shops prescribed to clients, the approved first-line anti-malarial drug for uncomplicated malaria (sulfadoxine-pyrimethamine), as compared to only 55% (n=11) of the control shops. CONCLUSION: Changing the private sectors' knowledge, behaviour and practices/performance may be a slow and difficult process. The intervention approach applied in this study seems to be feasible at district-level. This strategy can be applied in all districts of Tanzania with the aim of achieving significant improvements in knowledge, behaviour, compliance, improving performance and practices of drug sellers in drug stores/shops. However, other alternative strategies are needed to influence drug sellers'/dispensers' compliance and performance. Thus, the overall impact on performance and practices in these facilities will remain at moderate level for quite sometime unless national policies, other programs and stakeholders are involved actively.
Authors: Beth P Kangwana; Sarah V Kedenge; Abdisalan M Noor; Victor A Alegana; Andrew J Nyandigisi; Jayesh Pandit; Greg W Fegan; Jim E Todd; Robert W Snow; Catherine A Goodman Journal: Malar J Date: 2013-03-01 Impact factor: 2.979