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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
4270.0: Tuesday, December 13, 2005 - Board 4

Abstract #111013

Assessing the quality of health services provided by informal drug sellers in rural Cambodia

Sivan Oun1, Anbarasi Edward-Raj, PhD, MPH2, Olubukola Ojuola, MBBS, MPH1, Geof Bowman1, and W. Meredith Long, DrPH1. (1) World Relief, PO Box 126, Phnom Penh, Cambodia, (2) International Health, Johns Hopkins School of Public Health, 615 N Wolfe, Baltimore, MD 21205, 410-955-3928, aedward@jhsph.edu

In many developing countries limited access to formal health services necessitates the utilization of drug sellers for relieving common symptoms. In Cambodia although drug sellers are legally prohibited to prescribe drugs, they continue to be the popular choice for health services. The study was designed to determine the knowledge and prescribing practices of drug sellers. All 37 drug sellers providing services in 16 villages, Ponhea Krek district were interviewed using structured questionnaires. Although 51% of the drug sellers had high school education, 95% had no formal training for drug prescription. Reference materials were used by 25% of the providers for prescriptions. Knowledge assessments indicated that only 10% of the providers knew the danger signs for referring children, except for difficult/fast breathing (27%) and chest indrawing (60%). Antibiotics such as ampicillin, amoxicillin, tetracycline, and cotrimoxazole were prescribed by more than 40% of the providers, with ampicillin more frequently prescribed (67.6%). Less than 30% of the providers sold ORS or condoms and 32% reported selling iron tablets although 67% did not know the dosage for pregnant women. More than 50% of the drug sellers gave incorrect responses for treatment of acute diarrhea and common cold in children . Forty six percent expressed the need for training in drug prescription. The findings illustrate the need for developing appropriate strategies to improve the quality of care by the non formal sector in compliance with national regulations. The use of job aids to determine signs for referral and drug doses for common illnesses is being tested.

Learning Objectives:

Keywords: Child Health, Quality of Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Health Systems: Addressing Quality, Affordability, and Access

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA