Open Access
Subscription or Fee Access
PRESCRIBING HABITS IN CHURCH-OWNED PRIMARY HEALTH CARE FACILITIES IN DAR ES SALAAM AND OTHER TANZANIAN COAST REGIONS
Abstract
Objective: To assess prescribing practice of Primary Health Care (PHC) workers in church
owned health care facilities using WHO drug use indicators.
Design: Across-!iectional study in which twenty primary health care facilities were randomly
selected. Prescribing indicators were obtained by analysing outpatient records retrospectively
for the past 14 months between January 1997 and February 1998. This period was chosen
because of compete records of outpatient attendances. Patient care and facility indicators
were recorded prospectively during the study period.
Setting: The study was conducted in the Coast and Dar es Salaam regions of Tanzania. Six
districts were randomly selected from both regions. The selected districts included llala,
Temeke and Kinondoni in Dar es Salaam, Kibiti, Bagamoyo and Kisarawe in Coast region.
Subjects/materiaCs: Twenty primary health care facilities were randomly selected from the
chosen districts. Patient registers were collected and patients' characteristics including age,
sex, diagnosis, ;and drugs prescribed for the period January 1997 to February 1998 were
recorded on data collection forms. Patient care indicators were measured by recording
consultation tirne, dispensing time, per cent of drugs actually dispensed and adequately
labelled whereas patients' knowledge of correct drug dosage was obtained using exit
interviews. Verification of facility indicators was done by direct observation.
Results: The average number of drugs per prescription was 2.3 (range 1.8 - 2.8). Generic
prescribing prevailed with a mean of 75.W0 of all drugs. Antibiotic and injection encounters per
prescription was 35.4 and 19%, respectively. Most drugs were prescribed according to the
essential drug Ikt of Tanzania (NEDLIT). Patient's average consultation time was 3.6 minutes
whereas average dispensing time was 39.9 seconds. On average, 87% of all drugs dispensed were
adequately labelled and patients' knowledge of correct dose was adequate. All facilities possessed
drugs for treating important illnesses, all had reference educational materials.
Conclusion: The study shows that there is an overuse of injections 19% + 1.7 (range 0-73% )
compared to the recommended figure of 15%. The use of antibiotics appears appropriate
when compared with the morbidity patterns in the study areas. A focus group discussion with
prescribers in these facilities to address the question of overuse of injections is needed in order
to plan an appropriate intervention.
owned health care facilities using WHO drug use indicators.
Design: Across-!iectional study in which twenty primary health care facilities were randomly
selected. Prescribing indicators were obtained by analysing outpatient records retrospectively
for the past 14 months between January 1997 and February 1998. This period was chosen
because of compete records of outpatient attendances. Patient care and facility indicators
were recorded prospectively during the study period.
Setting: The study was conducted in the Coast and Dar es Salaam regions of Tanzania. Six
districts were randomly selected from both regions. The selected districts included llala,
Temeke and Kinondoni in Dar es Salaam, Kibiti, Bagamoyo and Kisarawe in Coast region.
Subjects/materiaCs: Twenty primary health care facilities were randomly selected from the
chosen districts. Patient registers were collected and patients' characteristics including age,
sex, diagnosis, ;and drugs prescribed for the period January 1997 to February 1998 were
recorded on data collection forms. Patient care indicators were measured by recording
consultation tirne, dispensing time, per cent of drugs actually dispensed and adequately
labelled whereas patients' knowledge of correct drug dosage was obtained using exit
interviews. Verification of facility indicators was done by direct observation.
Results: The average number of drugs per prescription was 2.3 (range 1.8 - 2.8). Generic
prescribing prevailed with a mean of 75.W0 of all drugs. Antibiotic and injection encounters per
prescription was 35.4 and 19%, respectively. Most drugs were prescribed according to the
essential drug Ikt of Tanzania (NEDLIT). Patient's average consultation time was 3.6 minutes
whereas average dispensing time was 39.9 seconds. On average, 87% of all drugs dispensed were
adequately labelled and patients' knowledge of correct dose was adequate. All facilities possessed
drugs for treating important illnesses, all had reference educational materials.
Conclusion: The study shows that there is an overuse of injections 19% + 1.7 (range 0-73% )
compared to the recommended figure of 15%. The use of antibiotics appears appropriate
when compared with the morbidity patterns in the study areas. A focus group discussion with
prescribers in these facilities to address the question of overuse of injections is needed in order
to plan an appropriate intervention.
Refbacks
- There are currently no refbacks.
