Abstract
BackgroundIn India, private pharmacies are ubiquitous yet critical establishments that facilitate community access to medicines. These are often the first points of treatment seeking in parts of India and other low income settings around the world. The characteristics of these pharmacies including their location, drug availability, human resources and infrastructure have not been studied before. Given the ubiquity and popularity of private pharmacies in India, such information would be useful to harness the potential of these pharmacies to deliver desirable public health outcomes, to facilitate regulation and to involve in initiatives pertaining to rational drug use. This study was a cross sectional survey that mapped private pharmacies in one district on a geographic information system and described relevant characteristics of these units.MethodsThis study of pharmacies was a part of larger cross sectional survey carried out to map all the health care providers in Ujjain district (population 1.9 million), Central India, on a geographic information system. Their location vis-à-vis formal providers of health services were studied. Other characteristics like human resources, infrastructure, clients and availability of tracer drugs were also surveyed.ResultsA total 475 private pharmacies were identified in the district. Three-quarter were in urban areas, where they were concentrated around physician practices. In rural areas, pharmacies were located along the main roads. A majority of pharmacies simultaneously retailed medicines from multiple systems of medicine. Tracer parenteral antibiotics and injectable steroids were available in 83.7% and 88.7% pharmacies respectively. The proportion of clients without prescription was 39.04%. Only 11.58% of staff had formal pharmacist qualifications. Power outages were a significant challenge.ConclusionThis is the first mapping of pharmacies & their characteristics in India. It provides evidence of the urban dominance and close relationship between healthcare provider location and pharmacy location. The implications of this relationship are discussed. The study reports a lack of qualified staff in the presence of a high proportion of clients attending without a prescription. The study highlights the need for the better implementation of regulation. Besides facilitating regulation & partnerships, the data also provides a sampling frame for future interventional studies on these pharmacies.
Highlights
In India, private pharmacies are ubiquitous yet critical establishments that facilitate community access to medicines
This study aims to survey all private pharmacies in one district of Central India, and map them on a geographical information system (GIS) to study their location including their rural-urban distribution, as well as their relationship to major roadways and the location of other healthcare providers
Setting This study was conducted in Ujjain district, Madhya Pradesh, Central India
Summary
In India, private pharmacies are ubiquitous yet critical establishments that facilitate community access to medicines These are often the first points of treatment seeking in parts of India and other low income settings around the world. Numerous studies have established the important role of pharmacists in providing medications and advice for diarrhea [3], respiratory tract infections [4,5], tuberculosis [6,7], asthma [8], and sexually transmitted diseases [9,10] in populations around the world. A recent study of a province of central India indicated that three quarters of all qualified paramedical staff (including pharmacists) were in the private sector [13]
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