The private retail drug shops market in
Bangladesh is largely unregulated and unaccountable, giving rise to irrational
use of drugs and high Out-of-pocket expenditure on health. These shops are
served by salespersons with meagre or no formal training in dispensing.This facility-based cross-sectional
study was undertaken to investigate how the drug shops currently operate
vis-a-vis the regulatory regime including dispensing practices of the
salespersons, for identifying key action points to develop an accredited model
for Bangladesh. About 90 rural and 21 urban retail drug shops
from seven divisions were included in the survey. The salespersons were
interviewed for relevant information, supplemented by qualitative data on
perceptions of the catchment community as well as structured observation of
client-provider interactions from a sub-sample.
In 76% of the shops, the owner and the salesperson
was the same person, and > 90% of these were located within 30 minutes
walking distance from a public sector health facility. The licensing process was
perceived to be was cumbersome, lengthy, and costly. Shop visits by drug
inspectors were brief, wasn’t structured, and not problem solving. Only 9%
shops maintained a stock register and 10% a drug sales record. Overall, 65% clients
visited drug shops without a prescription. Forty-nine percent of the
salespersons had no formal training in dispensing and learned the trade through
apprenticeship with fellow drug retailers (42%), relatives (18%), and village
doctors (16%) etc. The catchment population of the drug shops mostly did not
bother about dispensing training, drug shop licensing and buying drugs without
prescription. Observed client-dispenser interactions were found to concentrate
mainly on financial transaction, unless, the client pro-actively sought advice regarding the use of the drug.
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