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Pharmacies in informal settlements : a retrospective, cross-sectional household and health facility survey in four countries

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Improving Health in Slums Collaborative (Including:

Bakibinga, Pauline, Kabaria, Caroline, Kasiira, Ziraba, Kibe, Peter, Kyobutungi, Catherine, Mbaya, Nelson, Mberu, Blessing, Mohammed, Shukri, Njeri, Anne, Azam, Iqbal et al.
). (2021) Pharmacies in informal settlements : a retrospective, cross-sectional household and health facility survey in four countries. BMC Health Services Research, 21 (1). 945 . doi:10.1186/s12913-021-06937-9 ISSN 1472-6963.

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Official URL: http://dx.doi.org/10.1186/s12913-021-06937-9

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Abstract

Background
Slums or informal settlements characterize most large cities in LMIC. Previous evidence suggests pharmacies may be the most frequently used source of primary care in LMICs but that pharmacy services are of variable quality. However, evidence on pharmacy use and availability is very limited for slum populations.

Methods
We conducted household, individual, and healthcare provider surveys and qualitative observations on pharmacies and pharmacy use in seven slum sites in four countries (Nigeria, Kenya, Pakistan, and Bangladesh). All pharmacies and up to 1200 households in each site were sampled. Adults and children were surveyed about their use of healthcare services and pharmacies were observed and their services, equipment, and stock documented.

Results
We completed 7692 household and 7451 individual adults, 2633 individual child surveys, and 157 surveys of pharmacies located within the seven sites. Visit rates to pharmacies and drug sellers varied from 0.1 (Nigeria) to 3.0 (Bangladesh) visits per person-year, almost all of which were for new conditions. We found highly variable conditions in what constituted a “pharmacy” across the sites and most pharmacies did not employ a qualified pharmacist. Analgesics and antibiotics were widely available but other categories of medications, particularly those for chronic illness were often not available anywhere. The majority of pharmacies lacked basic equipment such as a thermometer and weighing scales.

Conclusions
Pharmacies are locally and widely available to residents of slums. However, the conditions of the facilities and availability of medicines were poor and prices relatively high. Pharmacies may represent a large untapped resource to improving access to primary care for the urban poor.

Item Type: Journal Article
Subjects: H Social Sciences > HD Industries. Land use. Labor
H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RA Public aspects of medicine
R Medicine > RS Pharmacy and materia medica
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Drugstores, Pharmacy , Pharmaceutical services , Pharmaceutical services -- Developing countries, Pharmacy -- Social aspects -- Developing countries, Pharmacist and patient -- Developing countries, Slums -- Health aspects --Developing countries
Journal or Publication Title: BMC Health Services Research
Publisher: Biomed central
ISSN: 1472-6963
Official Date: 9 September 2021
Dates:
DateEvent
9 September 2021Published
19 August 2021Accepted
Volume: 21
Number: 1
Article Number: 945
DOI: 10.1186/s12913-021-06937-9
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 17 September 2021
Date of first compliant Open Access: 17 September 2021
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
16/136/87[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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