[Prescribing and dispensing generic drugs in the Mambéré-Kadéï health district of the Central African Republic].

Good drug prescription and distribution practices are pre-requisites for rational use of essential generic medications. However few studies have been conducted on this topic in sub-Saharan Africa especially in rural areas. The purpose of this study in the Mambéré-Kadei health district of the Central African Republic was to evaluate drug use patterns with special attention to prescribing and dispensing, as a basis for assisting policy makers in planning and identifying intervention strategies. The transverse descriptive survey was undertaken in 14 public health facilities in the Mambéré-Kadéï health district. Data were collected by interviewing care providers and patients immediately after consultation and at the exit of the dispensary. The indicators recommended by the World Health Organization (WHO) for investigating drug use patterns in Communities were used for data collection. A total of 512 prescriptions were analysed. The average number of drugs prescribed per consultation was 3.5. Most drugs (68.6%) were prescribed by generic name. Antibiotic use (31.4% of consultations) was frequent and 29% of patients received injections. 82.1% of the drugs were compliant with the national essential drug list. The distribution survey showed that 79.46% of prescriptions were completely filled. No serious distribution errors occurred but 21.5% of the dispensed drugs were inadequately labelled. Patients understood the modalities of use for 69.6% of prescribed drugs. The average consultation and distribution times were 8.3 and 5 minutes respectively. Excessive use of antibiotics and injections and blunderbuss therapy is still observed in Mambéré-Kadei. Many drugs not included on the essential drug list and non-generics are prescribed. Other prescription and distribution problems identified in this survey include poor information on drug use, inadequate labelling of dispensed drugs, and lack of access to standard drug use tools such as a locally adapted essential drug list, formularies and standard treatment guidelines. To improve the system, caregivers must receive more training on the rational use of essential generic drugs and the population must be better informed.