Private Pharmacy Practice and Regulation

Stenson, Bo; Syhakhang, Lamphone; Lundborg, Cecilia Stålsby; Eriksson, Bo; Tomson, Göran

doi:10.1017/s0266462301107129

Cited by 49 publications

(50 citation statements)

References 25 publications

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“…The same study population was used for our study as for the randomised trial 19 . From all 214 licensed private pharmacies in the 14 districts in Savannakhet, 115 pharmacies were selected at random.…”

Section: Methodsmentioning

confidence: 99%

“…Since 1996, Savannakhet has been one of the five pilot provinces in the National Drug Policy Programme (NDPP) supported by the Swedish International Development Cooperation Agency (Sida). Drug quality is an essential part of the NDPP and the present study was carried out in the ongoing NDPP implementation, which also included a randomised trial on regulatory enforcement, focusing on private pharmacy services 19 . Due to the opportunity that arose to collect drugs in the field, it was decided to undertake the drug-quality study reported here with drug samples from the same pharmacies.…”

Section: Introductionmentioning

confidence: 99%

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The quality of drugs in private pharmacies in Lao PDR: a repeat study in 1997 and 1999

et al. 2004

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The quality of drugs in private pharmacies in Lao PDR: a repeat study in 1997 and 1999

et al. 2004

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“…Even when regulations exist, effective enforcement mechanisms are often absent in low- and middle-income countries [125,133]. Therefore, good legislation is not enough.…”

Section: Dual Practicementioning

confidence: 99%

Dual practice in the health sector: review of the evidence

et al. 2004

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This paper reports on income generation practices among civil servants in the health sector, with a particular emphasis on dual practice. It first approaches the subject of public–private overlap. Thereafter it focuses on coping strategies in general and then on dual practice in particular.To compensate for unrealistically low salaries, health workers rely on individual coping strategies. Many clinicians combine salaried, public-sector clinical work with a fee-for-service private clientele. This dual practice is often a means by which health workers try to meet their survival needs, reflecting the inability of health ministries to ensure adequate salaries and working conditions.Dual practice may be considered present in most countries, if not all. Nevertheless, there is surprisingly little hard evidence about the extent to which health workers resort to dual practice, about the balance of economic and other motives for doing so, or about the consequences for the proper use of the scarce public resources dedicated to health.In this paper dual practice is approached from six different perspectives: (1) conceptual, regarding what is meant by dual practice; (2) descriptive, trying to develop a typology of dual practices; (3) quantitative, trying to determine its prevalence; (4) impact on personal income, the health care system and health status; (5) qualitative, looking at the reasons why practitioners so frequently remain in public practice while also working in the private sector and at contextual, personal life, institutional and professional factors that make it easier or more difficult to have dual practices; and (6) possible interventions to deal with dual practice.

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“…Private pharmacies and clinics represent the most recent types of providers [35]. Little is known about the scope or quality of informal providers but studies on licensed and unlicensed pharmacies indicate that there is considerable room for improvement in not only staff knowledge but also drug quality [38-40]. How these providers are perceived by users and the importance ascribed to biomedical drugs as a treatment option are poorly documented.…”

Section: Introductionmentioning

confidence: 99%

Coping with uncertainty during healthcare-seeking in Lao PDR

Alvesson

Lindelöw²,

Khanthaphat³

et al. 2013

BMC Int Health Hum Rights

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BackgroundUncertainty is regarded as a central dimension in the experience of illness and in the processes of alleviating it. Few studies from resource-poor settings have investigated this and how it interacts with other factors. This study aims to shed light on how healthcare-seeking develops in the context of multiple medical alternatives and to understand what bearing uncertainty has on this process.MethodsThe study was conducted in six purposively selected rural communities in Lao PDR. In each community, two focus group discussions were held: first with mothers and then with fathers of children younger than five years old. Eleven in-depth interviews with caregivers of severely sick children were conducted. Subsequently, traditional healers, drug vendors, community health workers, nurses and medical doctors were recruited for interviews or group discussions. The data were transcribed and key themes and similarities were identified. Additional readings were conducted to better understand the interactions of factors during which uncertainty was identified as one of several factors mentioned during interviews and focus group discussions.ResultsCare-seekers expressed a strong preference for initially seeking local providers. Subsequently, multiple providers were consulted to increase the chances of recovery. This resulted in patients leaving the health facilities before recovery and in ending the recommended treatment regime prematurely. These healthcare-seeking decisions reflect the social significance of being a responsible caregiver and of showing respect for household norms. In general, healthcare-seeking was shrouded in uncertainty when it came to selecting the right provider, the likelihood of finding the real cause of the illness, spending savings on treatments and ultimately the likelihood of recovery.ConclusionsCare-seekers’ initial strong preference for local providers irrespective of the providers’ legitimacy indicates the need for a robust primary healthcare system. Care-seekers’ subsequent consultations must be understood in the light of their uncertainty regarding the skills of the available providers. The social connotations of seeking healthcare including the vulnerability of poor households in public health facilities were taken into account to only a limited extent by health workers. Health workers should have greater awareness of the social and cultural aspects of seeking care.

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Private Pharmacy Practice and Regulation

Cited by 49 publications

References 25 publications

The quality of drugs in private pharmacies in Lao PDR: a repeat study in 1997 and 1999

The quality of drugs in private pharmacies in Lao PDR: a repeat study in 1997 and 1999

Dual practice in the health sector: review of the evidence

Coping with uncertainty during healthcare-seeking in Lao PDR

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