Assessment of the Quality of Pharmaceutical Services in the Primary Health Care Facilities of Ethiopia

Abstract

A study was conducted between August 1997 and January 1998 to assess the quality of pharmaceutical services in primary health care facilities of Ethiopia. A total of 42 health centers and 88 health stations were selected, proportionate to size, using a stratified multi-stage random sampling method. Morbidity data indicated that respiratory tract infections, helminthiasis, gastritis, malaria, diarrhea, and skin diseases were the most frequent cases in these facilities' during 1995/96. The majority of the primary health care facilities used morbidity as the major criterion for drug selection and quantification. Although 80.9% of the health centers and 88% of the health stations used stock cards, 83.3% and 70.5% of the health centers and health stations respectively, reported the presence of expired drugs in their stores. This is despite the reported short supply of basic drugs. Findings of this survey show that 58.4% of primary health care facilities take drug inventory once a year, 16.3% twice a year, 9.6% four times a year and 7.8% do not take any inventory at all. Refrigeration and proper ventilation were observed in less than 60% of the facilities studied. Printed prescription papers were used in 81% of the health centers and only in 18.2% of the health stations. The rest of the health centers and stations either used ordinary or no paper at all. With regard to practice of polypharmacy, it was found out that the average number of drugs per prescription in health centers and health stations were 2.05 and 2.17, respectively. Retrospective analysis of prescriptions indicated that prescribing by generic names are overwhelmingly practiced over brand prescriptions. Further assessment of prescriptions revealed the presence of antibiotics in 50 % and 62 %, and injections in 30 % and 38 % of the prescriptions in health centers and health stations respectively.