TY - JOUR
T1 - Pharmacies in informal settlements
T2 - a retrospective, cross-sectional household and health facility survey in four countries
AU - Improving Health in Slums Collaborative
AU - Bakibinga, Pauline
AU - Kabaria, Caroline
AU - Kasiira, Ziraba
AU - Kibe, Peter
AU - Kyobutungi, Catherine
AU - Mbaya, Nelson
AU - Mberu, Blessing
AU - Mohammed, Shukri
AU - Njeri, Anne
AU - Azam, Iqbal
AU - Iqbal, Romaina
AU - Nazish, Ahsana
AU - Rizvi, Narijis
AU - Shifat Ahmed, Syed A.K.
AU - Choudhury, Nazratun
AU - Alam, Ornob
AU - Khan, Afreen Zaman
AU - Rahman, Omar
AU - Yusuf, Rita
AU - Odubanjo, Doyin
AU - Ayobola, Motunrayo
AU - Fayehun, Olufunke
AU - Omigbodun, Akinyinka
AU - Osuh, Mary
AU - Owoaje, Eme
AU - Taiwo, Olalekan
AU - Lilford, Richard J.
AU - Sartori, Jo
AU - Watson, Samuel I.
AU - Diggle, Peter J.
AU - Aujla, Navneet
AU - Chen, Yen Fu
AU - Gill, Paramjit
AU - Griffiths, Frances
AU - Harris, Bronwyn
AU - Madan, Jason
AU - Muir, Helen
AU - Oyebode, Oyinlola
AU - Pitidis, Vangelis
AU - de Albuquerque, João Porto
AU - Smith, Simon
AU - Taylor, Celia
AU - Ulbrich, Philip
AU - Uthman, Olalekan A.
AU - Wilson, Ria
AU - Yeboah, Godwin
AU - Watson, Sam
N1 - Funding Information:
The project was funded by the National Institutes for Health Research (16/136/87).
Funding Information:
The Improving Health in Slums Collaborative is (in alphabetical order): African Population and Health Research Centre (APHRC), Nairobi, Kenya Pauline Bakibinga, Caroline Kabaria, Ziraba Kasiira, Peter Kibe, Catherine Kyobutungi, Nelson Mbaya, Blessing Mberu, Shukri Mohammed, Anne Njeri, Aga Khan University, Karachi, Pakistan Iqbal Azam, Romaina Iqbal, Ahsana Nazish, Narijis Rizvi, Independent University, Bangladesh, Dhaka, Bangladesh Syed A. K. Shifat Ahmed, Nazratun Choudhury, Ornob Alam, Afreen Zaman Khan, Omar Rahman, Rita Yusuf Nigerian Academy of Sciences, Lagos, Nigeria Doyin Odubanjo University of Ibadan, Ibadan, Nigeria Motunrayo Ayobola, Olufunke Fayehun, Akinyinka Omigbodun, Mary Osuh, Eme Owoaje, Olalekan Taiwo University of Birmingham, Birmingham, UK Richard J Lilford (PI), Jo Sartori, Samuel I Watson University of Lancaster, Lancaster, UK Peter J Diggle University of Warwick, Coventry, UK Navneet Aujla, Yen-Fu Chen, Paramjit Gill, Frances Griffiths, Bronwyn Harris, Jason Madan, Helen Muir, Oyinlola Oyebode, Vangelis Pitidis, Jo?o Porto de Albuquerque, Simon Smith, Celia Taylor, Philip Ulbrich, Olalekan A Uthman, Ria Wilson, Godwin Yeboah
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
KW - Healthcare access
KW - LMICs
KW - Pharmacies
KW - Slums
KW - Welfare
UR - http://www.scopus.com/inward/record.url?scp=85121380993&partnerID=8YFLogxK
U2 - 10.1186/s12913-021-06937-9
DO - 10.1186/s12913-021-06937-9
M3 - Article
AN - SCOPUS:85121380993
SN - 1472-6963
VL - 21
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 945
ER -