Abstract
BackgroundIn many developing countries, private pharmacies play an important role in providing health information and services to local communities for common health issues. The aim of this study was to ascertain medium-term impact of educational interventions on knowledge and practice of pharmacy staff regarding management of childhood diarrhea in Vietnam.MethodsThis was a pre- and post-intervention study with 32 and 44 months difference from the time of the baseline survey to the conclusion of trainings and the time of the end-line survey, respectively. Interventions included in-class training for pharmacy staff, printed materials at the pharmacy, and supportive supervision. Knowledge/reported practice and actual practice of pharmacy staff were measured before and after interventions.ResultsAfter interventions, significant improvements (p<0.01) were observed for all indexes related to pharmacy staff's knowledge about childhood diarrhea; for instance, 31% and 60% of surveyed staff asked about weight of the child and accompanying symptoms of childhood diarrhea, respectively, an increase from 11% and 45% at the baseline. Oral rehydration solution (ORS) was the most frequently reported product recommended (97% to 99%), but probiotics and antidiarrheals were the products most frequently prescribed at pharmacies. Public health facilities remained the preferred choice for referrals from pharmacies, but the use of private clinics was increasing. Consultations and advice provided to caregivers also improved, but considerable gaps between knowledge and actual practice of staff in real pharmacy settings remained.ConclusionsEducational interventions were effective in improving pharmacy staff knowledge and practice regarding management of childhood diarrhea. Knowledge and actual practice of staff in real pharmacy settings did not always correlate; there is need for a stronger regulatory and law enforcement system. Interventions to improve pharmacy practice in developing countries should be focused, comprehensive, and evidence-based.
Highlights
Despite worldwide progress made over the past decades in reducing mortality from diarrhea, the disease remains the second-leading killer of children aged 1 to 59 months [1]
The objective of this paper is to report the impact of a 44-month educational intervention package on knowledge and practice of staff in pharmacy settings regarding management of childhood diarrhea from June 2008 to March 2012
In the baseline simulated client survey, 3 observational visits were deemed invalid due to missing and inconsistent data, leaving 217 visits for analysis; no such problems were found for the pharmacy staff survey and the two end-line surveys
Summary
Despite worldwide progress made over the past decades in reducing mortality from diarrhea, the disease (which in 2010 killed about 0.8 million children–more than the child deaths from AIDS, malaria, and measles combined) remains the second-leading killer of children aged 1 to 59 months [1]. While morbidity and mortality from childhood diarrhea have decreased, 10% of child deaths under 5 were attributed to diarrhea in 2010 [3]. Private pharmacies are often a patient’s first point of contact with the health care system; they are a preferred source of health information, advice, and services for common health problems in local communities [4,5,6]. Private pharmacies play an important role in providing health information and services to local communities for common health issues.
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