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Open AccessArticle

Sub-Standard Pharmaceutical Services in Private Healthcare Facilities Serving Low-Income Settlements in Nairobi County, Kenya

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Department of Pharmaceutical Chemistry, University of Nairobi, P.O. Box 19676, Nairobi 00202, Kenya
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Division of Health Products and Technologies, Ministry of Health, P.O. Box 30016, Nairobi 00100, Kenya
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PharmAccess Foundation, P.O. Box 6711, Nairobi 00100, Kenya
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Stichting PharmAccess International, AHTC, Tower 4C, Paasheuvelweg 25, 1105 BP Amsterdam, The Netherlands
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Administration, Planning and Development, Egerton University, Njoro, P.O. Box 536, Egerton 20115, Kenya
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Author to whom correspondence should be addressed.
Pharmacy 2019, 7(4), 167; https://doi.org/10.3390/pharmacy7040167
Received: 24 October 2019 / Revised: 16 November 2019 / Accepted: 25 November 2019 / Published: 5 December 2019
Background: Quality pharmaceutical services are an integral part of primary healthcare and a key determinant of patient outcomes. The study focuses on pharmaceutical service delivery among private healthcare facilities serving informal settlements within Nairobi County, Kenya and aims at understanding the drug procurement practices, task-shifting and ethical issues associated with drug brand preference, competition and disposal of expired drugs. Methods: Forty-five private facilities comprising of hospitals, nursing homes, health centres, medical centres, clinics and pharmacies were recruited through purposive sampling. Structured electronic questionnaires were administered to 45 respondents working within the study facilities over an 8-week period. Results: About 50% of personnel carrying out drug procurement belonged to non-pharmaceutical cadres namely; doctors, clinical officers, nurses and pharmacy assistants. Drug brand preferences among healthcare facilities and patients were mainly pegged on perceived quality and price. Unethical business competition practices were recorded, including poor professional demeanour and waiver of consultation fees veiled to undercut colleagues. Government subsidized drugs were sold at 100% profit in fifty percent of the facilities stocking them. In 44% of the facilities, the disposal of expired drugs was not in conformity to existing government regulatory guidelines. Conclusions: There is extensive task-shifting and delegation of pharmaceutical services to non-pharmaceutical cadres and poor observance of ethical guidelines in private facilities. Strict enforcement of regulations is required for optimal practices. View Full-Text
Keywords: pharmaceutical service; brand preference; drug order; competition; drug disposal pharmaceutical service; brand preference; drug order; competition; drug disposal
MDPI and ACS Style

Abuga, K.; Ongarora, D.; Karumbi, J.; Olulo, M.; Minnaard, W.; Kibwage, I. Sub-Standard Pharmaceutical Services in Private Healthcare Facilities Serving Low-Income Settlements in Nairobi County, Kenya. Pharmacy 2019, 7, 167.

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