Performance of village pharmacies and patient compliance after implementation of an essential drug programme in rural Burkina Faso

Krause, Gérard; Benzler, Justus; Heinmüller, Rolf; Borchert, Matthias; Koob, E; Ouattara, K.; Diesfeld, Hans Jochen

doi:10.1093/heapol/13.2.159

Cited by 16 publications

(10 citation statements)

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“…31 McPake and Hongoro, 1995; Kravosec et al, 2000;Connor, 2000;Soeters and Griffiths, 2000. 32 Dong et al, 1999;Von Massow et al, 1998;Krause et al, 1998;Foster, 1991. 33 Bhat, 1996Bhat, 1999;DFID Health Systems Resource Center, 2000.…”

Section: Monitoring and Health Information Systemsmentioning

confidence: 99%

Approaches to overcoming constraints to effective health service delivery: a review of the evidence

Oliveira-Cruz

Hanson

Mills

2003

J of Intl Development

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This paper reviews the current evidence base regarding efforts to overcome constraints to effective health service delivery in low and middle-income countries. A systematic literature review was chosen as the approach to gather and analyse existing knowledge about how to improve the 'close-to-client' health system. We focused on three levels of constraints: community and household, the health services delivery level itself, and health sector policy and strategic management. In total, 116 studies were reviewed and their main findings presented. The results should be interpreted with caution due to the considerable limitations in the existing evidence base. Copyright © 2003 John Wiley & Sons, Ltd.

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Section: Monitoring and Health Information Systemsmentioning

confidence: 99%

Approaches to overcoming constraints to effective health service delivery: a review of the evidence

Oliveira-Cruz

Hanson

Mills

2003

J of Intl Development

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“…Several health care reforms have been implemented in order to improve the health status of the population, but the impact on the wellbeing of the population was low [3,4]. Most depressing, the utilisation of health services has decreased during the last 15 years [5,6]. There is an ongoing debate about the reasons for this decline.…”

Section: Introductionmentioning

confidence: 99%

Expanding access to primary care without additional budgets? A case study from Burkina Faso

Marschall

Fleßa

2008

Eur J Health Econ

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The aim of this study is to demonstrate the impact of increased access to primary care on provider costs in the rural health district of Nouna, Burkina Faso. This study question is crucial for health care planning in this district, as other research work shows that the population has a higher need for health care services. From a public health perspective, an increase of utilisation of first-line health facilities would be necessary. However, the governmental budget that is needed to finance improved access was not known. The study is based on data of 2004 of a comprehensive provider cost information system. This database provides us with the actual costs of each primary health care facility (Centre de Santé et de Promotion Sociale, CSPS) in the health district. We determine the fixed and variable costs of each institution and calculate the average cost per service unit rendered in 2004. Based on the cost structure of each CSPS, we calculate the total costs if the demand for health care services increased. We conclude that the total provider costs of primary care (and therefore the governmental budget) would hardly rise if the coverage of the population were increased. This is mainly due to the fact that the highest variable costs are drugs, which are fully paid for by the customers (Bamako Initiative). The majority of other costs are fixed. Consequently, health care reforms that improve access to health care institutions must not fear dramatically increasing the costs of health care services.

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“…[7][8][9][10] In studies on the quality of drug prescription in rural health centres in Burkina Faso, only 33% of the patients received information on the duration of the treatment and 68% of the patients could recall the correct dosage of the drugs prescribed. 11 Lebitsa et al 12 found that only 11% and 21% of drugs dispensed at clinics and health posts, respectively, in Botswana had been adequately labelled, and sufficient knowledge about the drugs had been obtained by 56% and 57% of patients, respectively. This study concluded that, while the patterns of drug use in Botswana were not very different from those in other developing countries, a major problem exists with the dispensing process.…”

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Labelling and patient knowledge of dispensed drugs as quality indicators in primary care in Botswana

Boonstra

Lindbæk²,

Ngome³

et al. 2003

Quality and Safety in Health Care

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Objectives:To assess the quality of dispensing and patient knowledge of drugs dispensed in primary care in Botswana. Setting: Thirty randomly assigned primary healthcare facilities in three districts of Botswana. Participants: Patients visiting clinics and health posts. Design: Analysis of data from prospective participative observations of the drug dispensing process and interview of patients about their knowledge of drugs received immediately after dispensing. The quality of drug labelling was assessed by calculating mean labelling scores composed of five dispensing attributes: name of patient, and name, strength, dosage, and volume of the drug (incorrect or no labelling=0, 1 point for each correct labelling attribute; maximum score=5). Mean knowledge scores were obtained immediately after dispensing from patient recall of name and dosage of drug, duration of treatment, and reason for prescription (incorrect recall=0, 1 point for each correct recall attribute; maximum score=4). Results: 2994 consecutive patient consultations were analysed. The mean labelling score was 2.75. Family welfare educators and pharmacy technicians scored highest (3.15 and 2.98, respectively) and untrained staff lowest (2.60). Factors independently associated with the labelling score were analgesics v other drugs, district, health posts v clinics, education of prescriber (nurse best), and years of experience of prescriber (4-11 years best). The mean patient knowledge score was 2.50. The reason for prescription of the drug(s), dosage, duration of treatment, and name of the drug(s) was recalled by 92%, 83%, 44%, and 31% of patients, respectively. The qualification level of the dispenser was the strongest factor independently associated with the knowledge score. Antibiotics had the second lowest score, both for labelling (2.39) and patient knowledge (2.39). Conclusion: Only trained dispensing staff provided satisfactory quality of labelling. Patients had a fair knowledge of the drugs dispensed. The knowledge of drugs dispensed by family welfare educators was less than satisfactory. The labelling score is a useful indicator of the quality of dispensing, and the knowledge score of both the quality of prescribing and of dispensing. These indicators should be added to the WHO list of patient care indicators. R ational prescription and use of drugs has been a concern in both developed and developing countries during the last two decades and has been promoted by WHO and others.

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Performance of village pharmacies and patient compliance after implementation of an essential drug programme in rural Burkina Faso

Cited by 16 publications

References 0 publications

Approaches to overcoming constraints to effective health service delivery: a review of the evidence

Approaches to overcoming constraints to effective health service delivery: a review of the evidence

Expanding access to primary care without additional budgets? A case study from Burkina Faso

Labelling and patient knowledge of dispensed drugs as quality indicators in primary care in Botswana

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