Life & Peace Institute, Somalia Programme, Nairobi, Kenya.
BMC Public Health. 2010 Feb 24;10:93. doi: 10.1186/1471-2458-10-93.
Kenya has experienced a number of retail sector initiatives aimed at improving access to antimalarial medicines. This study explored stakeholders' perceptions of the role of private medicine retailers (PMRs), the value and feasibility of programme goals, perceived programme impact, factors influencing implementation and recommendations in three districts of Kenya.
This study was part of a larger evaluation of PMR programmes, including quantitative and qualitative components. The qualitative research was conducted to assess implementation processes and actors' experiences in the programmes, through focus group discussions with trained PMRs and mothers of children under five years, and in-depth interviews with programme managers, trainers and co-trainers.
PMRs were perceived to provide rapid cheap treatment for non-serious conditions and used as a deliberate and continuously evaluated choice between different treatment sources. All stakeholders supported programme goals and most PMRs described increased customer satisfaction, more rational purchasing of medicine stock and increased medicine sales after participation. Factors undermining programme implementation included a lack of MoH resources to train and monitor large numbers of PMRs, the relative instability of outlets, medicines stocked and retail personnel, the large number of proprietary brands and financial challenges to retailers in stocking antimalarial medicines, and their customers in buying them. Unambiguous national support and a broad range of strategies are important to strengthen the feasibility of change in OTC antimalarial use.
Understanding the context and implementation processes of PMR programmes and the perspectives of key actors are critical to identifying measures to support their effective implementation. Financial barriers underlie many described challenges, with important implications for policies on subsidies in this sector. In spite of barriers to implementation, increased exposure to programme activities promoted trust and improved relationships between PMRs and their clients and trainers, strengthening feasibility of such interventions. Public information can strengthen PMR training programmes by engaging local communities and may facilitate performance monitoring of PMRs by their clients.
肯尼亚已经实施了多项零售行业倡议，旨在改善抗疟药物的可及性。本研究探讨了利益攸关方对私营医药零售商（PMR）的作用、项目目标的价值和可行性、感知项目影响、影响实施的因素以及在肯尼亚三个地区的建议的看法。
本研究是对 PMR 项目的更广泛评估的一部分，包括定量和定性部分。定性研究是通过与经过培训的 PMR 和五岁以下儿童的母亲进行焦点小组讨论，以及与方案管理人员、培训人员和共同培训人员进行深入访谈，评估方案的实施过程和参与者的经验。
PMR 被认为可以快速廉价地治疗非严重疾病，并被视为在不同治疗来源之间的刻意和持续评估的选择。所有利益攸关方都支持项目目标，大多数 PMR 描述了客户满意度的提高、对药品库存的更理性采购以及参与后药品销售的增加。破坏项目实施的因素包括卫生部缺乏资源来培训和监测大量的 PMR、网点的相对不稳定、储存的药品和零售人员、大量的专利品牌以及零售商储存抗疟药物和客户购买这些药物的财务挑战。国家的明确支持和广泛的战略对于加强 OTC 抗疟药物使用变革的可行性至关重要。
了解 PMR 项目的背景和实施过程以及关键行为者的观点，对于确定支持其有效实施的措施至关重要。财政障碍是许多描述的挑战的基础，对该部门的补贴政策有重要影响。尽管存在实施障碍，但增加对项目活动的接触促进了 PMR 与其客户和培训师之间的信任和关系的改善，从而增强了此类干预措施的可行性。公共信息可以通过吸引当地社区来加强 PMR 培训计划，并可能促进客户对 PMR 的绩效监测。
