- freely available
Pharmacy 2019, 7(4), 167; https://doi.org/10.3390/pharmacy7040167
2. Materials and Methods
2.1. Study Design, Area, Sites and Sampling
2.2. Recruitment and Informed Consent of Participants
2.3. Pharmaceutical Services
2.4. Data Collection and Management
2.5. Data Analysis
2.6. Ethical Approval
3.1. Characteristics of Facilities
3.2. Drugs Procurement Behaviour
3.2.1. Licenses Used for Drug Orders
3.2.2. Cadres Placing Drugs Orders
3.2.3. Methods of Making Drugs Orders
3.2.4. Quality Perceptions of Supplier Services
3.2.5. Brand Preference
3.3. In Situ Practices
3.3.1. Sale of Government Subsidised Drugs
3.3.2. Influence of Competition on Practice
3.3.3. Prescription Substitution
3.3.4. Prescription and Dispensing Practices
3.3.5. Use of Rapid Diagnostic Test Kits
3.3.6. Disposal of Expired Drugs
5. Study Limitations
Conflicts of Interest
References and Notes
- National Council for Law Reporting. CAP 244, Pharmacy and Poisons Act. 1956 (Revised in 2015). n.d. Government Printer: Nairobi, Kenya.
- National Council for Law Reporting. CAP 253, The Medical Practitioners And Dentists Act. 1983 (Revised in 2012). n.d. Government Printer: Nairobi, Kenya.
- National Council for Law Reporting. CAP 257, Nurses Act. 1985 (Revised in 2012). n.d. Government Printer: Nairobi, Kenya.
- National Council for Law Reporting. CAP 260, The Clinical Officers (Training, Registration and Licensing) Act. 2017. n.d. Government Printer: Nairobi, Kenya.
- Ecumenical Pharmaceutical Network. Pharmacy practice in church health institutions. In Minimum Standards for Hospitals; Ecumenical Pharmaceutical Network: Nairobi, Kenya, 2011. [Google Scholar]
- Wafula, F.N.; Goodman, C.A. Are interventions for improving the quality of services provided by specialized drug shops effective in sub-Saharan Africa? A systematic review of the literature. Int. J. Qual. Health Care 2010, 22, 316–323. [Google Scholar] [CrossRef] [PubMed]
- Seidman, G.; Atun, R. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Hum. Resour. Health 2017, 15, 29. [Google Scholar] [CrossRef] [PubMed]
- Dovlo, D.Y. Using mid-level cadres as substitutes for internationally mobile health professionals in Africa. A desk review. Hum. Resour. Health 2004, 2, 7. [Google Scholar] [CrossRef] [PubMed]
- Wieldenmayer, K.A.; Kapolowe, N.; Charles, J.; Chilunda, F.S.M. The reality of task shifting in medicines management- a case study from Tanzania. J. Pharm. Policy Pract. 2015, 8, 13. [Google Scholar] [CrossRef]
- Wafula, F.N.; Miriti, E.M.; Goodman, C.A. Examining characteristics, knowledge and regulatory practices of specialized drug shops in Sub-Saharan Africa: A systematic review of the literature. BMC Health Serv. Res. 2012, 12. [Google Scholar] [CrossRef]
- Kwena, Z.; Sharma, A.; Wamae, N.; Muga, C.; Bukusi, E. Provider characteristics among staff providing care to sexually transmitted infection self-medicating patients in retail pharmacies in Kibera slum, Nairobi, Kenya. Sex. Transm. Dis. 2008, 35, 480–483. [Google Scholar] [CrossRef]
- Mutisya, E.; Yarime, M. Understanding the Grassroots Dynamics of Slums in Nairobi: The Dilemma of Kibera Informal Settlements. Int. Trans. J. Eng. Manag. Appl. Sci. Technol. 2011, 2, 197–213. [Google Scholar] [CrossRef]
- Prahalad, C. The Fortune at the Bottom of the Pyramid: Eradicating Poverty Through Profits; Pearson Education Inc. Publishing as Wharton School Publishing: Upper Saddle River, NJ, USA, 2005. [Google Scholar]
- Keesara, S.R.; Juma, P.A.; Harper, C.C. Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya. BMC Health Serv. Res. 2015, 15, 335. [Google Scholar] [CrossRef]
- Ongarora, K.; Minnaard, A.; Okungu, K. Medicine Prices, Availability, and Affordability in Private Health Facilities in Low-Income Settlements in Nairobi County, Kenya. Pharmacy 2019, 7, 40. [Google Scholar] [CrossRef]
- Ministry of Health. Guidelines for Safe Management of Pharmaceutical Waste; Ministry of Health: Nairobi, Kenya, 2018.
- Varkevisser, M.; van der Geest, S.A. Why do patients bypass the nearest hospital? An empirical analysis for orthopaedic care and neurosurgery in the Netherlands. Eur. J. Health Econ. 2007, 8, 287–295. [Google Scholar] [CrossRef]
- DFID. Overview of Experiences in the Pharmaceutical Supply Chain: Implications for the poor in Kenya Private Sector Innovation Programme for Health (PSP4H); DFID: London, UK, 2014.
- Okyere, E.; Mwanri, L.; Ward, P. Is task-shifting a solution to the health workers’ shortage in Northern Ghana? PLoS ONE 2017, 12, e0174631. [Google Scholar] [CrossRef] [PubMed]
- World Bank. World Development Indicators 2013; World Bank: Washington, DC, USA, 2013. [Google Scholar]
- Stephen, G.-S. Examining the Role of New Technology in Pharmacy: Now and in the Future. Available online: https://www.pharmaceutical-journal.com/examining-the-role-of-new-technology-in-pharmacy-now-and-in-the-future/11134174.article?firstPass=false (accessed on 1 December 2019).
- El Mahalli, A.; El-Khafif, S.H.; Yamani, W. Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia. Perspect. Health Inf. Manag. 2016, 13, 1b. [Google Scholar] [PubMed]
- Sharif, H.; Sharif, S.; Zaighum, I. Reasons of brand switching and preference in prescription medicines: A comparison between physicians and pharmacists of Karachi. Pharma Innov. J. 2016, 5, 99–103. [Google Scholar]
- Albadr, Y.; Khan, T.M. Factors influencing community pharmacist decision to dispense generic or branded medicines; Eastern Province, Alahsa, Saudi Arabia. Saudi. Pharm. J. SPJ Off. Publ. Saudi. Pharm. Soc. 2015, 23, 143–146. [Google Scholar] [CrossRef] [PubMed]
- Sarpatwari, A.; Choudhry, N.K.; Avorn, J.; Kesselheim, A.S. Paying physicians to prescribe generic drugs and follow-on biologics in the United States. PLoS Med. 2015, 12, e1001802. [Google Scholar] [CrossRef] [PubMed]
- Goel, P.; Ross-Degnan, D.; Berman, P.; Soumerai, S. Retail pharmacies in developing countries: A behavior and intervention framework. Soc. Sci. Med. 1996, 42, 1155–1161. [Google Scholar] [CrossRef]
- Toverud, E.-L.; Hartmann, K.; Hakonsen, H. A Systematic Review of Physicians’ and Pharmacists’ Perspectives on Generic Drug Use: What are the Global Challenges? Appl. Health Econ. Health Policy 2015, 13 (Suppl. 1), S35–S45. [Google Scholar] [CrossRef]
- Guttier, M.C.; Silveira, M.P.T.; Luiza, V.L.; Bertoldi, A.D. Factors influencing the preference for purchasing generic drugs in a Southern Brazilian city. Rev. Saude Publica 2017, 51, 59. [Google Scholar] [CrossRef]
- Sansgiry, S.S.; Bhosle, M.; Pope, N. Consumer Perceptions Regarding Generic Drug Substitution: An Exploratory Study. J. Pharm. Mark. Manag. 2005, 17, 77–91. [Google Scholar] [CrossRef]
- Taner, N. Brand Loyalty as a Strategy for the Competition with Generic Drugs:Physicians Perspective. J. Dev. Drugs 2016, 5. [Google Scholar] [CrossRef]
- American Academy of Pediatrics Committee on Drugs: Generic prescribing, generic substitution, and therapeutic substitution. Pediatrics 1987, 79, 835.
- Pharmaceutical Society of Kenya. Code of Ethics and Standards for Pharmacy Practice in Kenya, 2nd ed.; Pastex Business Solutions: Nairobi, Kenya, 2005. [Google Scholar]
- Smith, N.; Obala, A.; Simiyu, C.; Menya, D.; Khwa-Otsyula, B.; O’Meara, W.P. Accessibility, availability and affordability of anti-malarials in a rural district in Kenya after implementation of a national subsidy scheme. Malar. J. 2011, 10, 316. [Google Scholar] [CrossRef] [PubMed]
- Group, P. Diagnostic Assessment of Kenya’s Family Planning Market—SUPPORT for ESHE Program; Cardno: Nairobi, Kenya, 2015. [Google Scholar]
- Department of Health Republic of Ireland. Report of the Pharmacy Review Group; OECD: Dublin, Ireland, 2004.
- Omondi, C.J.; Kamau, L.M.; Njaanake, H.K.; Anyona, D.; Onguru, D.; Estambale, B. Evaluation of Three Rapid Diagnostic Test Kits in the Diagnosis of Plasmodium Species Infections among Primary School Children in Baringo County, Kenya. Open J. Clin. Diagn. 2017, 7, 31–44. [Google Scholar] [CrossRef]
|Service Indicator||Parameter Values||Total|
|Cadres/License||Pharmacist (%)||Pharm. Tech. (%)||Doctor (%)||Clinical Officer (%)||Nurse (%)||Other cadres (%)|
|Respondent (person)||2 (4)||9 (20)||3 (7)||8 (18)||20 (44)||3 (7)||45 (100)|
|License used to order drugs||8 (18)||13 (29)||10 (22)||4 (9)||9 (20)||1 (2)||45 (100)|
|Person ordering drugs||9 (20)||13 (29)||9 (20)||4 (9)||8 (18)||2 (4)||45 (100)|
|Methods of Ordering *||HCP Phone||Supplier Phone||HCP Visit to Supplier||SREP Visit to Facility||IT-Automated|
|165 (56)||81 (27)||33 (11)||2 (1)||12 (4)||4 (1)||297 (100)|
|Choice of New Supplier *||Price||Quality||Variety||Reliability of Supply||Speed of Delivery||Others|
|166 (27)||130 (21)||76 (12)||70 (11)||669(11)||108 (18)||616 (100)|
|Brand Preference||Price||Brand||Quality||Efficacy||Availability||Patient Preference|
|Facility *||129 (27)||38 (8)||139 (29)||80 (16)||45 (9)||52 (11)||483 (100)|
|Patient *||142 (30)||40 (9)||110 (24)||69 (15)||66 (14)||39 (8)||466 (100)|
|Rapid Diagnostic Test Kits *||Stock RDT Kits||Perform Diagnostic Test||Use Results as Basis for Prescription|
|Disposal of Expired Drugs *||Return to Supplier||Throw Away||Pass on to other Facilities||No Expiries Occurred||Other Methods|
|57 (25)||42 (18)||12 (5)||72 (32)||46 (20)||229 (100)|
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).