Nsimba Stephen E D
Department of Clinical Pharmacology, Muhimbili University College of Health Sciences, Dar-es-Salaam, Tanzania.
East Afr J Public Health. 2007 Apr;4(1):5-11.
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.
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.
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.
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.
本研究旨在评估一对一教育干预方法的短期效果，该方法针对坦桑尼亚基巴哈区的40名药品销售商开展，以改善私营部门在使用国家疟疾及其他常见儿童疾病（腹泻、急性呼吸道感染-ARI）治疗指南方面的做法、合规性和表现。
培训在基线数据收集一个月后进行。在培训八个月后进行数据收集并评估培训效果。40家药店被分为20家干预药店和20家对照药店。经过培训的护士假扮成需要为五岁以下患病儿童购药的看护人作为顾客。评估了药品配发人员/销售商对抗疟疾药物和其他药物的知识及其配发做法。
干预似乎对一些常见儿童疾病的药店处方和配发做法的知识模式产生了显著影响，但对照药店/商店则没有。约90%（n = 18）的商店为顾客开具了用于治疗非复杂性疟疾的获批一线抗疟疾药物（磺胺多辛-乙胺嘧啶），而对照商店只有55%（n = 11）开具了该药物。
改变私营部门的知识、行为和做法/表现可能是一个缓慢且困难的过程。本研究采用的干预方法在地区层面似乎是可行的。这一策略可应用于坦桑尼亚的所有地区，旨在显著改善药店/商店药品销售商在知识、行为、合规性、表现和做法方面的情况。然而，需要其他替代策略来影响药品销售商/配发人员的合规性和表现。因此，除非国家政策、其他项目和利益相关者积极参与，否则在相当长一段时间内，这些机构在表现和做法方面的总体影响仍将处于中等水平。
