Regulatory inspection of registered private drug shops in East-Central Uganda—what it is versus what it should be: a qualitative study

Abstract

Background Regulatory inspection of private drug shops in Uganda is a mandate of the Ministry of Health carried out by the National Drug Authority. This study evaluated how this mandate is being carried out at national, district, and drug shop levels. Specifically, perspectives on how the inspection is done, who does it, and challenges faced were sought from inspectors and drug sellers. Methods Six key informant interviews (KIIs) were held with inspectors at the national and district level, while eight focus group discussions (FGDs) were conducted among nursing assistants, and two FGDs were held with nurses. The study appraised current methods of inspecting drug sellers against national professional guidelines for licensing and renewal of class C drug shops in Uganda. Transcripts were managed using Atlas ti version 7 (ATLAS.ti GmbH, Berlin) data management software where the thematic content analysis was done. Results Five themes emerged from the study: authoritarian inspection, delegated inspection, licensing, training, and bribes. Under authoritarian inspection, drug sellers decried the high handedness used by inspectors when found with expired or no license at all. For delegated inspection, drug sellers said that sometimes, inspectors send health assistants and sub-county chiefs for inspection visits. This cadre of people is not recognized by law as inspectors. Inspectors trained drug sellers on how to organize their drug shops better and how to use new technologies such as rapid diagnostic tests (RDTs) in diagnosing malaria. Bribes were talked about mostly by nursing assistants who purported that inspectors were not interested in inspection per se but collecting illicit payments from them. Inspectors said that the facilitation they received from the central government were inadequate for a routine inspection. Conclusion The current method of inspecting drug sellers is harsh and instills fear among drug sellers. There is a need to establish a well-recognized structure of inspection as well as establish channels of dialogue between inspectors and drug sellers if meaningful compliance is to be achieved. The government also needs to enhance both human and financial resources if meaningful inspection of drug sellers is to take place.

Online medication purchasing during the Covid-19 pandemic: A pilot study from the United Arab Emirates

“…As Internet pharmacies vary in quality, the legislation appears to be lagging behind in terms of the regulation of this complicated and fast-moving market as regulation of various private drug sellers is still a global challenge contributing to inappropriate treatments particularly at a time when health regulators globally are emphasizing that the population should quarantine themselves at home to restrict the spread of Covid-19 [19] This research is intended to gather information and discover the extent to which consumers in the UAE are using the Internet for the purchase of medication and to assess the factors that motivating the purchase of medications from the internet. This research may be helpful in developing interventions focused on patients through the identification of consumer patterns.…”

Adherence to malaria management guidelines by health care workers in the Busoga sub-region, eastern Uganda

“…Efforts must be cross-cutting and sustainable, promoting understanding of benefits of adherence to malaria case management guidelines by providers and also clients. Regulation and oversight of the private sector remains paramount, as the desire to profit from patient visits often conflicts with adherence to guidelines [ 25 , 50 ]. Non-coercive methods of regulation including training, supervision and provision of guidelines, factors that were associated with appropriate malarial care in this study (Table 3 ), should be considered as strategies for improving performance at PFPs.…”

Self-Reporting of Risk Pathways and Parameter Values for Foot-and-Mouth Disease in Slaughter Cattle from Alternative Production Systems by Kenyan and Ugandan Veterinarians

“…The role of such decisions was highlighted and exemplified by the suggestion, made independently by multiple individuals in each country, to include a variable that accounts for the action taken by the inspector after diagnosing an animal as positive or suspect for FMD. Corruption is a barrier to health care access in many countries [65], has been described during regulatory inspection of pharmacies in Uganda [66], and may be incentivized among livestock producers by quarantine measures and disease control policies that restrict access to markets [67]. Actor motivations and incentives to make a decision in a given situation should be considered when building the structure of a model for risk assessment or economic analysis, especially where there may be feedback loops that could qualitatively change the conclusions of an analysis [10,68,69].…”