scholarly journals Evaluation of rational prescribing and dispensing of medicines in Mali

Author(s):  
Yaya Coulibaly ◽  
Fanta Sangho ◽  
Aboubacar Alassane Oumar

Objective: The drug policy of Mali is based on the concept of essential generic drugs. The adoption of generic drugs in a program is often accompanied by irrational use of these drugs precisely because of the availability of these drugs. Thus, this study was initiated to assess the quality of prescribing and dispensing drugs in Mali. Methods: This is a descriptive cross-sectional study was conducted from 2004 to 2013, the survey was conducted in 20 primary health centers and 20 private pharmacies in three regions of the country. In each of these structures, 30 prescriptions filled at the time of the survey were collected. Results: The average number of drugs per prescription was 3.0 ± 1.3 and 2.4 ± 1.2, respectively, in the public and private sectors. Prescription of drugs under international name was 91.6% in the public sector and 37.2% in the private sector. The public sector prescribed 33.7% of injectable drug against 16.2% in the private sector (p <0.001). The average cost of a prescription was lower in the public sector (3415.3 FCFA or 5.21euros) than in the private sector (7111 FCFA or 10.85 euros).Conclusion: Generic drugs are commonly used in the public, but much less in the private sector. The treatment guidelines are already available, should be introduced interactively to medical practitioners, through visits and intensive supervision by more experienced managers in the hierarchy, it would be likely to improve the quality of prescribing practitioners.

2013 ◽  
Vol 1 (2) ◽  
pp. 68-75
Author(s):  
AK Nepal ◽  
A Shrestha ◽  
SC Baral ◽  
R Bhattarai ◽  
Y Aryal

INTRODUCTION: Although the evidences suggest that more than one third tuberculosis (TB) cases are being managed in private sector, the quality of care in private sector is major concern. However, the information regarding the private practices were lacking. Therefore the study was conducted to gain insights on current practices of TB management at private sectors. MATERIALS AND METHODS: A descriptive cross sectional study, applying quantitative method, was conducted at two cities of Kaski among all private practitioners, private pharmacies and private laboratories through self administered questionnaire and structured interview schedule. RESULTS: Nearly one fourth of the TB suspects in the district were found to have consulted private providers with about 20.0% of the total smear positive cases diagnosed in private laboratories. Beside sputum microscopy, Private Medical Practitioners (PMPs) were also found to prefer other tests like X-ray, culture for TB diagnosis. Similarly, PMPs’ varying prescription of anti TB drugs beyond National TB Programme (NTP) recommendation along with their weak recording and case holding were noteworthy, and the cost of TB treatment seemed higher in private sector. Only one third of private institution had their staff trained in TB. Except some informal linkage, no collaboration between public and private sector was noted. CONCLUSIONS: Private sector was managing many TB cases in the district. However, their practice of TB management was not much satisfactory. Therefore NTP should take effective measures for Public Private Mix and to make them aware of the standards through training and orientation in order to improve the quality of care. DOI: http://dx.doi.org/10.3126/ijim.v1i2.7085 Int J Infect Microbiol 2012;1(1):68-75


2019 ◽  
Vol 113 (12) ◽  
pp. 740-748
Author(s):  
Eunice W Mailu ◽  
Philip Owiti ◽  
Serge Ade ◽  
Anthony D Harries ◽  
Marcel Manzi ◽  
...  

Abstract Background Large numbers of tuberculosis (TB) patients seek care from private for-profit providers. This study aimed to assess and compare TB control activities in the private for-profit and public sectors in Kenya between 2013 and 2017. Methods We conducted a retrospective cross-sectional study using routinely collected data from the National Tuberculosis, Leprosy and Lung Disease Program. Results Of 421 409 patients registered and treated between 2013 and 2017, 86 894 (21%) were from the private sector. Data collection was less complete in the private sector for nutritional assessment and follow-up sputum smear examinations (p&lt;0.001). The private sector notified less bacteriologically confirmed TB (43.1% vs 52.6%; p&lt;0.001) and had less malnutrition (body mass index &lt;18.5 kg/m2; 36.4% vs 43.3%; p&lt;0.001) than the public sector. Rates of human immunodeficiency virus (HIV) testing and antiretroviral therapy initiation were &gt;95% and &gt;90%, respectively, in both sectors, but more patients were HIV positive in the private sector (39.6% vs 31.6%; p&lt;0.001). For bacteriologically confirmed pulmonary TB, cure rates were lower in the private sector, especially for HIV-negative patients (p&lt;0.001). The private sector had an overall treatment success of 86.3% as compared with the public sector at 85.7% (p&lt;0.001). Conclusions The private sector is performing well in Kenya although there are programmatic challenges that need to be addressed.


2013 ◽  
Vol 2 (2) ◽  
pp. 32-37
Author(s):  
Mahmooda Naqvi ◽  
Maryum Zehra ◽  
Ghazala Noor Nizami

To compare the frequency of common musculoskeletal disorders due to prolong sitting among private and public sector bankers. This study was a cross-sectional study. Participants between 25-50 years of age, working in banks for more than one year were inducted in the study. All bankers were divided into private and public sector groups. Employees were selected from private sector and public sector banks of Karachi. Self-administered questionnaire was used to collect data from bankers of both sectors. The study shows that 44.6% government employees were suffering from shoulder pain, while 36.9% private sector bankers having this problem. Among them 18.2% of public sector bankers suffered from neck pain. However, only 9% of public sector bankers perform gym activity regularly. The result of the study shows that, participants who work for prolong period of time adapted poor posture while sitting have high frequency of musculoskeletal disorders. The study also shows that private sector bankers are more vigilant about their health and posture as compared to the public sector bankers.


2013 ◽  
Vol 29 (5) ◽  
pp. 1451 ◽  
Author(s):  
Barbara Caemmerer ◽  
Alistair Dewar

In the past, public sector organizations have been used as examples of service atrocities but in light of unstable overall customer satisfaction levels across countries and industries the purpose of this research note is to investigate whether their private counterparts fare much better in terms of service performance. A quantitative, quasi-experimental study was carried out with 200 respondents. The survey tool was based on the SERVQUAL framework to compare recipients service expectations and perceptions in private and public service settings. The results reveal no significant differences between expectations towards and perceptions of private and public services. The traditional SERVQUAL dimensions explain 74% of overall satisfaction in the public, and 87% in the private sector. As this is a cross-sectional study more research is necessary to understand whether the results are due to an amelioration in the public and a deterioration in the private sector, or vice versa, or neither. The study stimulates debate and further research into the underlying reasons for customers similar expectations and perceptions across sectors. Is actual service performance across sectors assimilating? Or do perceptions in one sector setting impact on expectations and perceptions in another?


2021 ◽  
pp. 223386592110117
Author(s):  
Robert Davidson ◽  
Alexander Pacek ◽  
Benjamin Radcliff

While a growing literature within the study of subjective well-being demonstrates the impact of socio-political factors on subjective well-being, scholars have conspicuously failed to consider the role of the size and scope of government as determinants of well-being. Where such studies exist, the focus is largely on the advanced industrial democracies of the Organization for Economic Co-Operation and Development. In this study, we examine the size of the public sector as a determinant of cross-national variation in life satisfaction across a worldwide sample. Our findings strongly suggest that as the public sector grows, subjective well-being increases as well, conditional on the extent of quality of government. Using cross-sectional data on 84 countries, we show this relationship has an independent and separable impact from other economic and political factors.


Author(s):  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Nikhat Iftikar ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...


2012 ◽  
Vol 19 (02) ◽  
pp. 162-167
Author(s):  
MUHAMMAD AYAZ BHATTI ◽  
MAHMOOD UR RAHMAN

Objectives: To measure the current status of preventive activities in civil and military hospitals. To compare the quantum ofpreventive and curative activities in the hospitals. To make recommendations for promotion of preventive activities to reduce the curative burdenfrom the hospitals. Study Design: This was a cross-sectional study. Sampling Technique: Universal sampling. All the major military and publicsector hospitals having bed strength more than 400 in Rawalpindi were included in the study. All the preventive and curative work was taken intoaccount. Methodology: A structured questionnaire was developed and data regarding the quantum of work was collected from all the fourmajor Military and civil hospitals having bed strength more than 400 beds through registers and annual reports of the hospital and was analyzedin the form of frequencies, tabulation, cross tabulation, percentages and was displayed in tables and graphs using SPSS (10.5), Microsoft Exceland calculus. Results: Only seven percent work is preventive and ninety three percent is curative. In the preventive activity MH is marginallyhigher than the rest of the hospitals. In all the hospitals among the preventive activities 31% are antenatal visits, 20 % tetanus toxoid injection,19% BCG, Growth monitoring 13%, Measles injection 11% and family planning 6% in all the hospitals. Ante natal activities in the army sectorhospitals are more prominent 39-44% and also in the public sector 17-26%. Next to the antenatal are tetanus toxoids to pregnant ladies whichrange from 16-35% in military and 16-20 % in the public sector hospitals. Growth monitoring is more efficiently carried out in the RawalpindiGeneral Hospital i.e. 17% while in others 7-12%. Family Planning services are delivered very poorly only 9% in RGH and 6% in DHQ, zero % inCMH and 5% in MH. Measles vaccination is carried out efficiently in DHQ 27%, 11% in RGH and 8% in MH and again poorly 3% in CMH. BCG is27% in DHQ, 20% in MH, 17% in RGH and 10% in CMH. Conclusions: The study show that hospitals are showing very poor performance inpreventive aspect and this is the reason that countries like Pakistan are facing economic burden on the national exchequer and this burden willkeep on increasing if no appropriate action is taken.


2006 ◽  
Vol 40 (2) ◽  
pp. 220-225 ◽  
Author(s):  
Humberto Rosa ◽  
Marcelo Zubaran Goldani ◽  
Thomas Scanlon ◽  
Antônio Augusto Moura da Silva ◽  
Elsa Justo Giugliani ◽  
...  

OBJECTIVE: To assess HIV testing rate and determine risk factors for not have been tested during pregnancy. METHODS: A cross-sectional study was carried out in Porto Alegre, Southern Brazil, from December 2000 to February 2001. Socioeconomic, maternal and healthcare variables were obtained by means of a standardized questionnaire. Crude and adjusted odds ratios and their 95% confidence intervals were obtained in logistic regression models. RESULTS: A total of 1,642 mothers were interviewed. Of them, 94.3% reported being offered HIV testing before or during pregnancy or during labor; 89 mothers (5.4%) were not tested or did not know if they were tested. Attending fewer than six prenatal visits, being single and younger than 18 years old were relevant barriers preventing HIV testing. There was found a relationship between maternal schooling and the category of prenatal care provider. Having low 22.20 (12.43-39.67) or high 3.38 (1.86-7.68). schooling and being cared in the private sector strongly reduced the likelihood of being HIV tested. CONCLUSIONS: The Brazilian Health Ministry's recommendation for universal counseling and HIV testing has been successfully implemented in the public sector. In order to improve HIV testing coverage, new strategies need to target women cared in the private sector especially those of low schooling.


Author(s):  
Ming Ming Wen ◽  
Heba Aref ◽  
Ahmad Abozaid ◽  
Nahla Hesham Kandil ◽  
Yasmin Hussein Elsobky

Objective: The first objective of this work was to examine the services provided by six drug information centers (DICs) in Alexandria, Egypt. The second objective was to evaluate the quality of the replies to the drug information query. The third objective was to assess the conceptual need of DICs from community pharmacists, other health care professionals and the general public.Methods: This study was conducted through three stages. Stage I was a field survey to assess predefined parameters in the current DICs in Alexandria. Stage II was a retrospective cross-sectional study to assess the quality of the drug information replies through an external expert review process. Stage III was a population survey and thematic analysis using questionnaires and interview recording.Results: Activities of DICs include: DIR answering service (100%), adverse drug reaction reporting (100%), issuing bulletins (83.3%), education (83.3%), drug use evaluation (50%) and participation in P and T committees (33.3%). The most frequent question categories asked were dosing, side effects, treatment guidelines and drug interactions. Half of the DICs were affiliated with hospitals; however, a general lacking confidence level of these DICs on the professionalism and the impact on patient care for the DIC services provided was identified. There was an obvious problem in formatting the ultimate question in a question format rather than a sentence format in all DICs. The most accurately answered request was adverse drug reactions. All surveyed groups considered that it is very important to have a DIC accessible to the community free of charge.Conclusion: It is necessary to establish an university-based DIC to incorporate training, education and research into the existing services. A DIC network with definitive standards of services in the future should provide safe and effective quality-assured pharmaceutical care to meet the needs and expectations of the community and improve its delivery to the public. The results and recommendations of this study can be inspired and generalized to other developing countries that have similar health systems as in Egypt. 


2018 ◽  
Vol 71 (suppl 2) ◽  
pp. 777-785 ◽  
Author(s):  
Vivian Carla de Castro ◽  
Leidyani Karina Rissardo ◽  
Lígia Carreira

ABSTRACT Objective: to identify the prevalence of physical aggression and neglect and abandonment in the hospitalizations of Brazilian elderly people for violence and assault from 2008 to 2013 and the association of these causes with socio-demographic variables related to hospitalization. Method: quantitative, descriptive, cross-sectional study with elderlies hospitalized for assault. Inclusion criteria: to be 60 years old or over, to have been hospitalized in the Unified Health System (SUS) for assault or neglect and abandonment, between 2008 and 2013. The data were collected in February 2016, in Datasus database and descriptive and inferentially, using the Chi-square distribution, in the Epi Info 3.5.4 program. Results: the prevalence of hospitalizations due to assaults and violence prevailed among 60 and 69 years old men in the public sector. For abandonment and neglect, there was a higher prevalence in women, over 80 years old, in the public sector. Conclusion: nurses must be able to identify and prevent violence against the elderly.


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