availability of drugs what does it mean in ugandan primary care
Download
Skip this Video
Download Presentation
AVAILABILITY OF DRUGS: WHAT DOES IT MEAN IN UGANDAN PRIMARY CARE?

Loading in 2 Seconds...

play fullscreen
1 / 12

AVAILABILITY OF DRUGS: WHAT DOES IT MEAN IN UGANDAN PRIMARY CARE? - PowerPoint PPT Presentation


  • 213 Views
  • Uploaded on

AVAILABILITY OF DRUGS: WHAT DOES IT MEAN IN UGANDAN PRIMARY CARE?. Jessica Jitta, S. R Whyte, N. Nshakira Child Health Development Center Makerere University Uganda & Institute of Anthropology University Copenhagen Denmark. ABSTRACT. Presentation covers areas below:

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'AVAILABILITY OF DRUGS: WHAT DOES IT MEAN IN UGANDAN PRIMARY CARE?' - poppy


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
availability of drugs what does it mean in ugandan primary care

AVAILABILITY OF DRUGS: WHAT DOES IT MEAN IN UGANDAN PRIMARY CARE?

Jessica Jitta, S. R Whyte, N. Nshakira

Child Health Development Center Makerere University Uganda & Institute of Anthropology University Copenhagen Denmark

abstract
ABSTRACT

Presentation covers areas below:

  • Introduction/background
  • Objectives
  • Methods
  • Findings
  • Conclusions
introduction
INTRODUCTION
  • Uganda public- 40%, PNFP 25% and PP 35%
  • Health reforms Ugandan HS initiated 1990s as central efforts to rebuild the health system
  • Reforms assume rational drug management ensures drug availability &quality care
  • Tension assumption- reality HWs responsive to users’ demands& being rational drug manager
  • Introduction user fees -health as commodity and users demanding value for money
objectives
OBJECTIVES
  • To examine drug availability at primary health care level, with a focus on the inconsistencies in drug supply policy and the gap between policy and practice.
methodology
METHODOLOGY
  • Cross-sectional qualitative and quantitative KI, FGD,observe consultations and records review
  • 6 units- a public rural hospital OPD, 3 HCs, a sub-dispensary and an church NGO dispensary
  • Policy makers/administrators (KI 67); users (54FGD)observed consult(140) exit interviews (160) entries patient registers (600)
  • Analysis -significance drug availability HCW, users and planners/administrators

-realities that HCWs and their patients face -district context national policy

  • Supply, utilization and expectations/demand for inj chloroq, penicillin & availability of needles/syringes.
findings sources of drugs
FINDINGS- Sources of drugs
  • Public units- EDMP pre-packed kits quarterly to districts , district buy suppl drugs, special vertical programs (TB, STD) & h/units procure drugs &needles and syringes
  • Patients referred to drugshops buy drugs- 40%
  • NGO depend only procuring drugs-not limited
  • Planners concerned EDMP, no policy on drug supplements by units
  • To users most important- obtain needed drugs
findings types drugs available
FINDINGS- Types drugs available
  • Volume and range services at unit determine EDMP kits supplied and National Standard Guide available for rational drug use
  • Most used drugs anti-malaria, antibiotics and analgesics
  • Inj medicines on high demand, went o/s first
  • Units put user fees to supplement stocks to overcome chronic o/s & increase range of drugs, needles & syringes and IV fluids
  • Health unit records on supplements poor
findings diagnosis prescript
FINDINGS- Diagnosis & prescript
  • Varied with cadre and number of h/providers- skills vary with level health units
  • Symptomatic diagnosis lack of support facilities
  • Very sick patients (children vomiting) injections prescribed
  • High rate use of combination antibiotics and anti-malaria- many drugs (poly-pharmacy)
  • Very high injection rates 35-85% compared to recommended 15%-providers respond users demands- previous oral form taken no response
findings drug suff adequacy
FINDINGS- Drug suff/adequacy
  • New kits open only exhausting contents
  • Drugs used at different rates
  • Injection drugs run out first unit supp
  • 40% exit interviews referred drug shop
  • Planners/admin EDMP adequate in units
  • Providers unsatisfied injection drugs antibiotics and anti-malaria
  • Users concerns drug availability at unit,get injections, affordable and adequate dosage
findings availability issues
FINDINGS- Availability issues
  • Health sector reforms have changed the conditions for managing, supplying and using drugs through decentralization, user fees and privatization.
  • Injection drugs in kits ran out quickly and were purchased by the unit or the patient at nearby drug shops.
  • Government health units both compete with & use local commercial sources of drugs undermining technical premise rational drug use and supply built into kit system.
findings quality care perspt
FINDINGS- Quality care perspt
  • Drugs availability is fundamental quality of care by all 3 categories of actors PHC, perspective differ& shifting
  • Plan/admin- securing suppl EDMP kits-delivery, records account/stocktaking, mism’gment/leakages at HU-control & security of drugs-manuals&guidelines rational use drug
  • H/workers not relate insuff to drug to diagnosis prescription but-inadequate supplies in kits, large numbers infectious diseases and need to satisfy pts with injections- purchase suppl drugs, refer pts buy p/shops
  • Users- in terms whether all prescribed drugs are good obtainable at HU regardless source, inj preferred form
conclusions
CONCLUSIONS
  • Problem of drug availability interlinked, so is perspectives and interests of actors
  • Dialogue and realism are needed in order to create policies that respect both good medical treatment standards and the concerns of frontline health workers and their patients.
  • Rethinking of the meaning of drug availability in PHC calls for methodologies examining the changing context of h/care & position of diff actors, at national and district levels, to address gaps existing between drug policy and practice
ad