Sale of modern medicines by untrained peddlers, general merchants, and other drug sellers is common throughout the developing world. Community-based studies from Africa, Asia, and Latin America have found that up to 70% of illness episodes are self-treated with modern pharmaceuticals.
Public acceptance and appreciation of the private drug seller's role has been clearly recognized. Reasons given by consumers for using retailers include expediency (little time is spent waiting for service), convenience (drug sellers are nearby), efficacy (their drugs work), dependability of supply, and reasonable cost.
Ninety percent of drug expenditures in Nepal are private sector (Kafle, 1992). Community survey have found that drug retailers are often the first and only source of health care outside the home (Shrestha MP, 1982, 1985). Thus, retailers have an important role in recommending and dispensing drugs. They also have a potential role in preventive care and consumer education. In addition, they have the critical responsibility of ensuring drug quality.
Vector-borne diseases are increasing in Nepal. Malaria appears to be on the rise, and epidemics of P. falciparum malaria are occurring with increasing frequency. Kala-azar, which is usually fatal if untreated, has been increasing steadily since 1980, invariably causing panic due to the high case fatality (Wijeyaratne et.al, 1998).
The training intervention improved drug retailers recommendation for urethral discharge from 0.8 percent in the baseline to 45 percent after training. However, there was substantial decrease after three months of the training. (New ERA, 1997).
CONTENTS
I. ACKNOWLEDGEMENTS
II. PERSONNEL INVOLVED
III. EXECUTIVE SUMMARY
1. INTRODUCTION
2. OBJECTIVES
3. SIGNIFICANCE OF STUDY
4. STUDY DESIGN
5. DETAILED METHODOLOGY
- 5.1 Design
5.2 Sampling
5.3 Survey Instruments
5.4 Orientation and Field testing
5.5 Team Planning Meeting (TPM)
5.6 Data Analysis
5.7 Coding and Secondary Coding
6 RESULTS
- 6.1 Kala-azar (Sarlahi)
- 6.1.1 Respondents and Sick Persons Characteristics
6.1.2 Household Actual Treatment Practices
6.1.3 Drugs Received in the First Contact
6.1.4 Treatment Compliance
6.1.5 Sources of Information for the Contact Place
6.1.6 Reasons for Changing the Source of Treatment
6.1.7 Household Usual Practices in Kala-azar
6.1.8 Household Knowledge on Features of Kala-azar
6.1.9 Household Perception on Seriousness for Treatment of Kala-azar
6.1.10 Retailer Characteristics
6.1.11 History Taking, Drug Recommendation, Advice-giving and Referral Practices
6.1.12 Usual Drug Recommendations and the Reasons for Recommendations
6.1.13 Retailers Knowledge on Features of Kala-azar, Advice-giving and Referral
6.1.14 Usual Instructions, Method of Instruction, Testing Understanding Therapy, and Referral Practices
6.1.15 Retailers Reported Patient Demand and Appropriateness of Demand
6.2 Malaria (Kanchanpur)
- 6.2.1 Respondents and Sick Persons Characteristics
6.2.2 Household Actual Treatment Practices
6.2.3 Drugs Received in the First Contact
6.2.4 Treatment Compliance
6.2.5 Sources of Information for the Contact Place
6.2.6 Reasons for Changing the Source of Treatment
6.2.7 Households Usual Practices
6.2.8 Households Knowledge on Features of Malaria
6.2.9 Household Perception on Seriousness for Treatment of Malaria
6.2.10 Retailers Characteristics
6.2.11 History-taking, Drug Recommendation, Advice-giving and Referral Practices
6.2.12 Usual Drug Recommendation and the Reasons for Recommendation
6.2.13 Retailers Knowledge on Features of Malaria, Advice-giving and Referral
6.2.14 Usual Instruction, Methods of Instruction, Testing Understanding Therapy and Referral Practices
6.2.15 Retailers Reported Patient Demand and Appropriateness of Demand
6.3 Findings from FGDs in Sarlahi
6.4 Findings from FGDs in Kanchanpur
7. DISCUSSION AND RECOMMENDATIONS
8. REFERENCES
9. ANNEXES
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