Publication: A comparison of the quality of care provided and the rational use of drugs in rural public health facilities and private shops
Date
1999
Authors
Article Type
Original Article
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Volume Title
Publisher
Institute of Medicine
Abstract
Abstract
The problem of insufficient funding undermining health care in Nepal has led to greater emphasis being placed on the private sector for service delivery. This study
compared the quality of service provided by primary health care public facilities and private shops (the main private primary health care alternative) in rural remote areas of hilly E. Nepal. A cross-sectional survey was done and WHO indicators used. It was found that public facilities provided better access and value for money than shops. Provided adequate levels of drug availability were maintained, public primary health care facilities offered better quality of care than private shops, where there was often misuse of drugs particularly antibiotics due to irrational self-medication or patients not buying what they had been prescribed. However, in many public facilities (not supported by any agency apart from HMG) drug availability was poorer than in the larger shops, leading to a similar misuse of drugs, especially antibiotics, as occurred in shops. When considering strategies to decrease the misuse of antibiotics it may be easier to address poor drug availability in public facilities than change patient-retailer behaviour in shops. The poor dispensing process and large number of people not knowing how to take their drugs are two serious problems, needing urgent action, in both the public and private sectors.
Keywords: public facilities, private drug shops, prescribing habits, quality of care, drug use
Description
K. A. Holloway
Former Drug Scheme Coordinator, Britain Nepal Medical Trust (BNMT), PO Box 9, Biratnagar, Morang 56601, Nepal.
B. R. Gautam
Personnel Manager (Former Drug Scheme Manager), BNMT
Keywords
public facilities, private drug shops, prescribing habits, quality of care, drug use
Identifier
https://doi.org/10.59779/jiomnepal.82