Can Medicine-sellers in Pharmacies of urban Bangladesh meet the needs of Clients with STD?

Rahman, Saifur; Ahmed, Mohsin

doi:10.12927/whp..17578

Cited by 6 publications

(11 citation statements)

References 2 publications

(1 reference statement)

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“…In six of 28 shops visited in Sri Lanka, tetracycline was not stored in a refrigerator as it should be ( Wolffers 1987 ). Appropriateness of dose and duration of treatmentSeveral studies report that medicine dosing was outside of the therapeutic range for a variety of conditions (both sub-therapeutic and over dose) ( Thamlikitkul 1988 ; Tuladhar et al 1998 ; Rahman et al 2000 ; Bista et al 2002 ). Saradamma et al (2000 ) study of antibiotic purchases in India found that those without a prescription were three times more likely to purchase an inadequate dose than those with a prescription (66% vs 40%).…”

Section: Resultsmentioning

confidence: 99%

Performance of retail pharmacies in low- and middle-income Asian settings: a systematic review

Miller

Goodman

2016

Health Policy Plan.

171

191

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In low- and middle-income countries (LMIC) in Asia, pharmacies are often patients’ first point of contact with the health care system and their preferred channel for purchasing medicines. Unfortunately, pharmacy practice in these settings has been characterized by deficient knowledge and inappropriate treatment. This paper systematically reviews both the performance of all types of pharmacies and drug stores across Asia’s LMIC, and the determinants of poor practice, in order to reflect on how this could best be addressed. Poor pharmacy practice in Asia appears to have persisted over the past 30 years. We identify a set of inadequacies that occur at key moments throughout the pharmacy encounter, including: insufficient history taking; lack of referral of patients who require medical attention; illegal sale of a wide range of prescription only medicines without a prescription; sale of medicines that are either clinically inappropriate and/or in doses that are outside of the therapeutic range; sale of incomplete courses of antibiotics; and limited provision of information and counselling. In terms of determinants of poor practice, first knowledge was found to be necessary but not sufficient to ensure correct management of patients presenting at the pharmacy. This is evidenced by large discrepancies between stated and actual practice; little difference in the treatment behaviour of less and more qualified personnel and the failure of training programmes to improve practice to a satisfactory level. Second, we identified a number of profit maximizing strategies employed by pharmacy staff that can be linked to poor practices. Finally, whilst the research is relatively sparse, the regulatory environment appears to play an important role in shaping behaviour. Future efforts to improve the situation may yield more success than historical attempts, which have tended to concentrate on education, if they address the profit incentives faced by pharmacy personnel and the regulatory system.

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Section: Resultsmentioning

confidence: 99%

Performance of retail pharmacies in low- and middle-income Asian settings: a systematic review

Miller

Goodman

2016

Health Policy Plan.

171

191

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“…There is still considerable room for improvement in MSs' knowledge, particularly in how STI/HIV transmission occurs and knowledge of antibiotic abuse and the development of drug resistance; perhaps a longer training program would have a greater impact. Study conducted among pharmacy workers [ 9 , 17 , 25 , 26 ] and unqualified “village doctors” [ 20 ] highlighted the importance of providing training to MSs to improve their skills considering their role as informal care providers in low- and middle-income countries. Our study reinforces the importance of such training targeting medical sellers and other informal providers in Bangladesh context to strengthen STI/HIV prevention campaign.…”

Section: Discussionmentioning

confidence: 99%

“…According to the Directorate of Drug Administration, there are approximately 70,000 registered drug retailers in Bangladesh and an additional 30,000 without licenses [ 15 ]. A study conducted among informal health providers in rural Bangladesh reported that only half of the MSs working in drug stores had any kind of training, leaving the other half without any kind of training whatsoever [ 16 , 17 ]. Previous studies in Bangladesh and other developing countries reported that MSs had difficulties in recognizing STI symptoms, offered medications not recommended, seldom referred clients to qualified physicians, and were less likely to counsel patients for condom use or partner treatment [ 5 , 7 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…A number of studies, mostly cross-sectional in nature, have been conducted among MSs in Bangladesh, while most of them called for training programs to improve their skills for the prevention and control of STIs/HIV in the country [ 17 , 19 , 20 ]. This study aims to evaluate the role of short training intervention for MSs in pharmacies in and near selected brothels and truck-stand areas in Bangladesh in improving their knowledge and skills in recognizing STIs, preventing STIs/HIV, and providing referrals to formal providers for better health management.…”

Section: Introductionmentioning

confidence: 99%

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Medicine Sellers for Prevention and Control of Sexually Transmitted Infections: Effect of a Quasi-Experimental Training Intervention in Bangladesh

Alam

Fournier

2015

BioMed Research International

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This study used a quasi-experimental pre-post design to test whether short training can improve medicine sellers' (MSs) practices and skills for prevention and control of sexually transmitted infections (STIs) in Bangladesh. The training included lectures, printed materials, and identification of referral sites. Difference-in-differences estimation was used to determine the effects of intervention on key primary and secondary outcomes. Advice given by the MSs in intervention group for partner treatment and condoms use increased significantly by 11% and 9%, respectively, after adjusting for baseline differences in education, religion, age, duration of training, and study site. Referral of clients to qualified service providers increased by 5% in the intervention group compared to the comparison group, but this change was not found to be statistically significant. Significantly higher proportion of MSs in the intervention group recognized the recommended medications as per the national syndromic management guidelines in Bangladesh for treatment of urethral discharge and genital ulcer symptoms. Short training intervention was found to be effective in improving MSs' practice of promoting condom use and partner treatment to the clients. We anticipate the need for broad based training programs of MSs to improve their skills for the prevention and control of STI/HIV in Bangladesh.

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“…The overwhelming majority of the rural population in Bangladesh seek medical care from rural medical practitioners (RMPs) also called ‘palli chikishok’ or ‘grammo dakter’, who use modern medicine but most of these practitioners were informally trained or self-trained without any formal medical education [15][16]. Though RMPs are often the only medical care providers for most of Bangladesh’s rural poor, there are no formal efforts to train them in disease management, including STIs, nor are there government regulations to monitor the quality of their practices [2]. RMPs are often not familiar with proper dosages of various medications and their potential side effects.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Skills for Management of Sexually Transmitted Infections by Rural Medical Practitioners in Bangladesh

Alam¹,

Mridha²,

Kristensen³

et al. 2015

OJPM

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Sexually transmitted infection (STI) management is considered rudimentary among rural medical practitioners (RMPs) in Bangladesh. We sought to understand the level of knowledge and skills in STI management and to assess the impact of a two-day training orientation among RMPs in Tangail district. Data were collected through a baseline survey of 225 practicing RMPs in the study area and a three-month follow-up survey of 99 RMPs who participated in a two-day STI/HIV orientation training. The level of formal training among RMPs ranged from none (22.7%), to paramedical training (14.7%) and local medical assistant training (62.6%). The baseline survey revealed a low level of STI/HIV knowledge and misconceptions about the transmission of STI/HIV among RMPs. RMPs mostly prescribed first line antibiotics for treatment of common reproductive tract infections (RTIs) including STIs, but they rarely prescribed the correct dosages according to the national RTI/STI management guidelines. Only 3% of RMPs were able to correctly answer all four HIV transmission (unprotected sexual intercourse, blood transfusion, needle sharing and mother to child transmission) questions at baseline, while 94.9% of RMPs answered all four correctly at three months following the training (p=0.001). Only 10% of RMPs reported suggesting the recommended drug (azithromycin) and only 2% mentioned about the recommended dosage (2gm single dose) for the treatment of urethritis/cervicitis; compared to 49.5% suggested azithromycin at follow-up with 39.4% mentioned the recommended 2gm single dose (p=0.001). Our study found low level of knowledge and poor practices related RTI/STI management among RMPs. Short orientation training and education intervention shown promise to increase knowledge and management skills for RTIs/STIs.

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Can Medicine-sellers in Pharmacies of urban Bangladesh meet the needs of Clients with STD?

Cited by 6 publications

References 2 publications

Performance of retail pharmacies in low- and middle-income Asian settings: a systematic review

Performance of retail pharmacies in low- and middle-income Asian settings: a systematic review

Medicine Sellers for Prevention and Control of Sexually Transmitted Infections: Effect of a Quasi-Experimental Training Intervention in Bangladesh

Knowledge and Skills for Management of Sexually Transmitted Infections by Rural Medical Practitioners in Bangladesh

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