The role of drug vendors in improving basic health-care services in Nigeria.

Abstract:

OBJECTIVE:To characterize patent and proprietary medicine vendors and shops in Nigeria and to assess their ability to help improve access to high-quality, primary health-care services. METHODS:In 2013 and 2014, a census of patent and proprietary medicine shops in 16 states of Nigeria was carried out to determine: (i) the size and coverage of the sector; (ii) the basic characteristics of shops and their staff; and (iii) the range of products stocked for priority health services, particularly for malaria, diarrhoea and family planning. The influence of the medical training of people in charge of the shops on the health-care products stocked and registration with official bodies was assessed by regression analysis. FINDINGS:The number of shops per 100,000 population was higher in southern than in northern states, but the average percentage of people in charge with medical training across local government areas was higher in northern states: 52.6% versus 29.7% in southern states. Shops headed by a person with medical training were significantly more likely to stock artemisinin-based combination therapy, oral rehydration salts, zinc, injectable contraceptives and intrauterine contraceptive devices. However, these shops were less likely to be registered with the National Association of Patent and Proprietary Medicine Dealers and more likely to be registered with the regulatory body, the Pharmacist Council of Nigeria. CONCLUSION:Many patent and proprietary medicine vendors in Nigeria were medically trained. With additional training and oversight, they could help improve access to basic health-care services. Specifically, vendors with medical training could participate in task-shifting interventions. OBJECTIF:Caractériser les vendeurs et magasins de spécialités pharmaceutiques et de médicaments brevetés au Nigéria et évaluer leur capacité de contribuer à l'amélioration de l'accès à des services de soins primaires de qualité. En 2013 et 2014, un recensement des magasins de spécialités pharmaceutiques et de médicaments brevetés a été réalisé dans 16 États du Nigéria afin de déterminer: (i) la taille et l'offre de ce secteur; (ii) les caractéristiques de base des magasins et de leur personnel; et (iii) la gamme de produits en stock pour les soins prioritaires, en particulier pour le paludisme, la diarrhée et la planification familiale. L'influence de la formation médicale des personnes responsables des magasins sur les produits en stock et l'inscription auprès d'organismes officiels a été évaluée au moyen d'une analyse de régression. Le nombre de magasins pour 100 000 habitants était plus élevé dans les États du Sud que dans ceux du Nord, mais le pourcentage moyen de personnes chargées de la formation médicale dans les zones de gouvernement local était supérieur dans les États du Nord: 52,6% contre 29,7% dans les États du Sud. Les magasins dirigés par une personne ayant une formation médicale étaient sensiblement plus nombreux à avoir en stock des associations médicamenteuses comportant de l'artémisinine, des sels de réhydratation orale, du zinc, des contraceptifs injectables et des dispositifs intra-utérins. Cependant, ces magasins étaient moins nombreux à être inscrits auprès de l'Association nationale des distributeurs de médicaments brevetés et de spécialités pharmaceutiques et plus nombreux à l'être auprès de l'organisme de règlementation, le Conseil des pharmaciens du Nigéria. CONCLUSION:De nombreux vendeurs de spécialités pharmaceutiques et de médicaments brevetés au Nigéria avaient reçu une formation médicale. Un contrôle et une formation complémentaire leur permettraient de contribuer à améliorer l'accès aux services médicaux de base. Les vendeurs ayant une formation médicale pourraient notamment participer aux interventions de transfert des tâches. OBJETIVO:Caracterizar los proveedores y establecimientos de medicamentos patentados y de venta libre en Nigeria y evaluar su capacidad de ayudar a mejorar el acceso a servicios sanitarios primarios de alta calidad. MÉTODOS:En 2013 y 2014, se llevó a cabo un censo de los establecimientos de medicamentos patentados y de venta libre de 16 estados de Nigeria con el objetivo de de determinar: (i) el tamaño y cobertura del sector; (ii) las características básicas de los establecimientos y el personal; y (iii) la gama de productos destinados a servicios sanitarios prioritarios, en concreto para la malaria, la diarrea y la planificación familiar. Un análisis de regresión evaluó la influencia de la formación médica de las personas a cargo de los establecimientos de productos sanitarios almacenados y el registro en los organismos oficiales. RESULTADOS:El número de establecimientos por cada 100 000 habitantes era mayor en los estados del sur que en los del norte, aunque el porcentaje medio de personas con formación médica en ámbitos gubernamentales locales era superior en los estados del norte: un 52,6% frente a un 29,7% en los estados del sur. Los establecimientos dirigidos por una persona con formación médica tenían almacenados más productos para tratamientos combinados basados en la artemisinina, sales de rehidratación oral, zinc, anticonceptivos inyectables y dispositivos anticonceptivos intrauterinos. No obstante, era menos probable que estos establecimientos estuvieran registrados en la Asociación Nacional de Comerciantes de Medicamentos Patentados y de Venta Libre, pero sí en el organismo regulador, el Consejo de Farmacéuticos de Nigeria. CONCLUSIÓN:Se proporcionó formación médica a varios proveedores de medicamentos patentados y de venta libre en Nigeria. Con mayor formación y supervisión, podrían ayudar a mejorar el acceso a servicios sanitarios básicos. En concreto, los proveedores con formación médica podrían participar en intervenciones de rotación de tareas. الغرض:توصيف منافذ ومتاجر بيع الدواء التي تحمل اسم الشركات الدوائية أو المسجلة لحسابها في نيجيريا وتقييم قدرتها على المساعدة في تحسين الوصول إلى خدمات الرعاية الصحية الأساسية وعالية الجودة. الطريقة:تم في عامي 2013 و2014 إجراء تعداد لمتاجر بيع الأدوية التي تحمل اسم الشركات الدوائية أو المسجلة لحسابها في 16 ولاية في نيجيريا لتحديد ما يلي: (أ) حجم القطاع والنطاق الذي يغطيه؛ و(ب) الخصائص الأساسية لمتاجر بيع الأدوية والموظفين العاملين بها؛ و(جـ) مجموعة المنتجات المخزنة لاستخدامها في الخدمات الصحية ذات الأولوية، وخاصة لمكافحة الملاريا والإسهال وتنظيم الأسرة. تم تقييم تأثير التدريب الطبي للموظفين المسؤولين عن إدارة متاجر بيع الدواء على مخزون منتجات الرعاية الصحية والتسجيل لدى الجهات الرسمية عن طريق تحليل التحوف. النتائج:كان عدد متاجر بيع الدواء في نطاق يبلغ 100,000 من السكان في الولايات الجنوبية أكبر مما كان عليه في الولايات الشمالية، ولكن كان متوسط النسبة المئوية للأشخاص الذين يديرون المتاجر ولديهم خبرة التدريب الطبي في المناطق الحكومة المحلية أعلى في الولايات الشمالية: 52.6% في مقابل 29.7% في الولايات الجنوبية. كانت المتاجر التي يديرها شخص حاصل على التدريب الطبي الأكثر احتمالاً في تخزين العلاج المشترك المرتكز على الأرتيميزينين، وأملاح الإماهة الفموية، والزنك، ومانعات الحمل القابلة للحقن، ووسائل منع الحمل داخل الرحم. ومع ذلك، كانت هذه المتاجر أقل احتمالاً أن تكون مسجلة لدى الجمعية الوطنية لمنافذ توزيع الأدوية التي تحمل اسم الشركات الدوائية أو المسجلة لحسابها والأرجح أن تكون مسجلة لدى الهيئة التنظيمية، مجلس الصيادلة في نيجيريا. الاستنتاج:كان العديد من المسؤولين عن إدارة منافذ بيع الأدوية التي تحمل اسم الشركات الدوائية أو المسجلة لحسابها حاصلين على التدريب الطبي. ومن خلال المزيد من التدريبات الإضافية والإشراف، يمكنهم المساعدة في تحسين الوصول إلى خدمات الرعاية الصحية الأساسية. وعلى وجه التحديد، يمكن للقائمين على منافذ بيع الدواء الحاصلين على التدريب الطبي المشاركة في تدخلات تحويل المهام. 目的:旨在分析尼日利亚专利和专有药品供应商和商店的特征以及评估他们在提供高质量初级医疗卫生服务方面的能力。. 方法:2013 年至 2014 年中,尼日利亚对其 16 个州展开了专利和专有药品商店普查,以确定:(1) 该行业部门的规模和覆盖面;(2) 商店及其员工的基本特征;和 (3) 为主要卫生服务,尤其是疟疾、腹泻以及生育计划存储的产品范围。采用回归分析法分析了针对商店负责人员进行医疗培训对医疗卫生产品存储和官方机构注册的影响。. 结果:南部地区每十万人的商店数高于北部地区的数量,但是在北部地区,整个当地政府区域,负责医疗培训的人员平均比例较高:为 52.6%,而在南部地区为 29.7%。由经过医疗培训的人员负责的商店存储青蒿素为基础的联合疗法、经口补液盐、锌、注射式避孕药和子宫环的可能性显著更大。然而,这些商店在国家专利和专有医药经销商处注册的可能性更小,而在尼日利亚药剂师理事会这一监管机构注册的可能性更大。. 结论:尼日利亚许多专利和专有药品供应商都经过医疗培训。通过额外的培训和监督,他们能够帮助改善基本医疗卫生服务的普及率。具体而言,经过医疗培训的供应商能够参与重新分工的干预措施。. Цель:Охарактеризовать продавцов патентованных лекарственных средств и соответствующие магазины в Нигерии и дать оценку их способности увеличить доступ к высококачественному первичному медико-санитарному обслуживанию. Методы:В 2013 и 2014 гг. была проведена перепись магазинов, реализующих патентованные лекарственные средства, в 16 штатах Нигерии с целью определить: (i) размер и охват сектора, (ii) основные характеристики магазинов и их персонала и (iii) ассортимент имеющихся в наличии товаров для оказания первичной медико-санитарной помощи при лечении малярии, диареи и планировании семьи. Для оценки того, как влияет наличие медицинского образования у заведующих магазинами на наличие товаров медицинского назначения и постановку на учет в официальных органах, использовался регрессионный анализ. Результаты:Количество магазинов на 100 000 жителей было больше в южных штатах, чем в северных, однако в среднем процент заведующих магазином с медицинским образованием на различных территориях местного управления был гораздо выше в северных штатах: 52,6% по сравнению с 29,7% в южных штатах. В магазинах, которыми заведовали лица с медицинским образованием, вероятность наличия в продаже комбинированной терапии на базе артемизинина, солей для пероральной регидратации, цинка, инъецируемых контрацептивов и внутриматочных противозачаточных средств была значительно выше. Однако эти магазины проходили регистрацию с меньшей вероятностью в Национальной ассоциации торговцев патентованными лекарственными средствами и с большей вероятностью в регулятивном органе — Совете фармацевтов Нигерии. Вывод:Большинство продавцов патентованных лекарственных средств в Нигерии получили медицинское образование. При дополнительной подготовке и надзоре они могли бы поспособствовать увеличению доступа к базовому медико-санитарному обслуживанию. В частности, продавцы с медицинским образованием могли бы принимать участие в мероприятиях по перераспределению обязанностей.

authors

Liu J,Prach LM,Treleaven E,Hansen M,Anyanti J,Jagha T,Seaman V,Ajumobi O,Isiguzo C

doi

10.2471/BLT.15.154666

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

267-75

issue

4

eissn

0042-9686

issn

1564-0604

pii

BLT.15.154666

journal_volume

94

pub_type

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    authors: Tin F,Hlaing N,Tun T,Win S,Lasserre R

    更新日期:1985-01-01 00:00:00

  • Blood-level duration limit test of procaine benzylpenicillin in sheep.

    abstract::Rabbits have commonly been used for testing the blood-level duration limit of penicillin, but have proved not to be entirely suitable. Experiments reported in this paper on the use of sheep suggest that these animals can be successfully used for the testing of procaine benzylpenicillin with aluminium monostearate (PAM...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: AGARWAL SC,DUDANI AT,SHRIVASTAV JB,SETHI SK

    更新日期:1961-01-01 00:00:00

  • Rates, timing and causes of neonatal deaths in rural India: implications for neonatal health programmes.

    abstract:OBJECTIVE:To assess the rates, timing and causes of neonatal deaths and the burden of stillbirths in rural Uttar Pradesh, India. We discuss the implications of our findings for neonatal interventions. METHODS:We used verbal autopsy interviews to investigate 1048 neonatal deaths and stillbirths. FINDINGS:There were 43...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:10.2471/blt.05.026443

    authors: Baqui AH,Darmstadt GL,Williams EK,Kumar V,Kiran TU,Panwar D,Srivastava VK,Ahuja R,Black RE,Santosham M

    更新日期:2006-09-01 00:00:00

  • Antibiotic resistance of nasopharyngeal isolates of Streptococcus pneumoniae from children in Lesotho.

    abstract::Villages associated with the Lesotho Highlands Development Agency were randomized with a bias in favour of larger villages, and children < 5 years of age from cluster-randomized households in these villages were chosen for the assessment of antibiotic resistance in pneumococci. Children of the same age group attending...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Mthwalo M,Wasas A,Huebner R,Koornhof HJ,Klugman KP

    更新日期:1998-01-01 00:00:00

  • Catastrophic health expenditure on acute coronary events in Asia: a prospective study.

    abstract:OBJECTIVE:To estimate out-of-pocket costs and the incidence of catastrophic health expenditure in people admitted to hospital with acute coronary syndromes in Asia. METHODS:Participants were enrolled between June 2011 and May 2012 into this observational study in China, India, Malaysia, Republic of Korea, Singapore, T...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:10.2471/BLT.15.158303

    authors: Jan S,Lee SW,Sawhney JP,Ong TK,Chin CT,Kim HS,Krittayaphong R,Nhan VT,Itoh Y,Huo Y

    更新日期:2016-03-01 00:00:00

  • Perspectives on stimulating industrial research and development for neglected infectious diseases.

    abstract::This paper summarizes recent thinking on stimulating industrial research and development (R&D) for neglected infectious diseases and argues that it is critical to enlarge the value of the market for medicines and vaccines through, for example, global purchase funds. The most important economic barriers to R&D are that...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Webber D,Kremer M

    更新日期:2001-01-01 00:00:00

  • Nozzles of insecticide sprayers; comments from the point of view of malaria control.

    abstract::Certain performance characteristics of the insecticide-sprayer nozzle tip and its relationship to the pressure regulator are discussed.After analysing the effectiveness of residual spraying at various pressures, the author concludes that low-pressure application would best attain the pattern and rate of insecticide di...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: KNIPE FW

    更新日期:1955-01-01 00:00:00

  • A bedside test for methemoglobinemia, Sri Lanka.

    abstract:PROBLEM:Propanil is an aniline herbicide that is widely used for rice cultivation, but is also used for self-poisoning. Toxicity from propanil is largely due to methemoglobinemia. In resource-poor settings, the capacity to determine methemoglobin concentration is insufficient and prevents effective case management, whi...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:10.2471/BLT.15.158147

    authors: Shihana F,Dawson AH,Buckley NA

    更新日期:2016-08-01 00:00:00

  • Japanese encephalitis: current worldwide status.

    abstract::The changing epidemiological and distribution patterns of Japanese encephalitis in various southern and east Asian countries are described. Immunization is considered to be the only practical way to control the infection. Several vaccines have been developed and two types of inactivated vaccine are now available for u...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Umenai T,Krzysko R,Bektimirov TA,Assaad FA

    更新日期:1985-01-01 00:00:00