Chemical Sellers Research Articles

Factors Influencing the Purchasing and Consumption of Unprescribed Pharmaceutical Products in Africa

The proliferation of pharmaceutical shops, licensed chemical sellers with it attendant over-the-counter-drugs, the limited availability of health facilities and the vast difference between the cost of attending a hospital and the cost of buying known-drugs for use has necessitated the readily preference for majority of people in Africa particularly the middle and the low income groups to buy unprescribed medicines from pharmaceutical shops for use whenever they detect a family member or a relative is not in a good state of health. The researchers sought to find out factors influencing majority in Africa buying medicines from medical shops for use without prescription, an issue destroying the youth as a result of abuse and in some cases putting the health of many in danger due to the little know how of the sales attendants in the medical shops. A sample size of 200 was used with a non-probability sampling method used to gather data obtained and a descriptive analysis used. The researchers identified the need for cost reduction for treatment to encourage hospital attendance and about a 200 bed capacity hospital per thousand of every household should be a policy in Africa. That a prescription should be inspected by both the pharmaceutical shops and other retailers prior to sale of pharmaceutical products or medicines. Keywords: pharmaceutical shops, medicines, self-medication, consumption, unprescribed

LB746 Exploring the knowledge, attitude, and practices of chemical shop owners in rural Ghana

Many rural areas in sub-Saharan Africa face a high prevalence and morbidity of skin disease and are challenged by a lack of accessible dermatologists. In Ghana, community pharmacies, called chemical shops, were established to respond to these inequities. Our study evaluates the dermatologic knowledge, attitudes, and practices (KAP) of Licensed Chemical Sellers (LCS) within several districts of Ghana’s Ashanti Region. To assess the dermatologic KAP of LCS, we created a questionnaire and recorded direct interviews over a three-week period with Ghanaian research assistants' help.

Monitoring of residual solvent contamination in herbal medicinal products in Ghana: A pilot study

The use of herbal medicinal products for complementary and alternative medicine is well established in Ghana. The potential public health risks associated with the use of these products due to the presence of residual solvents have not yet been investigated and/or reported. In this pilot study, 7 liquid dosage forms of herbal medicinal products obtained from pharmacies and licensed chemical seller shops within the Accra metropolis in Ghana were investigated for the presence of 28 residual solvents using a combination of two orthogonal headspace gas chromatography with flame ionization detector methods from a compendial approach in the general chapter <467> Residual Solvents in the United States Pharmacopeia without modification. One herbal medicinal product was contaminated with 498.33 ppm of chloroform, resulting in daily exposure of 41.82 mg/day, which is above the permissible daily exposure level of 0.6 mg/day. The detection of chloroform in herbal medicinal products suggests further investigation into the profile of residual solvent contaminants in herbal medicinal products as a matter of public health concern and the potential need for more stringent regulation of herbal medicinal products marketed in Ghana.

Status of chemicals and aqua-drugs used for freshwater fish health management at Rangpur district of Bangladesh

In order to know the existing situation of different chemicals and aqua-drugs used for fish health management an investigation was conducted following a time frame of May, 2019 to October, 2019 at Rangpur district of Bangladesh. Data were collected from the randomly selected fish farmers, company representatives and chemical sellers through questionnaire interview, personal contact and Focus Group Discussion (FGD). Farmers were facing several water quality problems associated with different fish diseases. To overcome those obstacles they use variety of chemicals inclulding lime, salt, potassium permanganate, urea, TSP, phitkiri and copper sulphate. Farmers used different chemicals for various purposes like Aquapure, Biopond, Zeofresh, JV-zeolite, Zeorich, Megazeo plus, Geo-ren etc. for pond preparation and water quality management; Sumithion, Engreb, I-mec, Sanmarine etc. for eradication of unwanted species; Oxymax, Oxymore, Oxylife, Aci-ox, Oxyrich, Oxy-aqua, Oxyren etc. to increase oxygen concentration and Gasonil, Gastrap, Bioaqua-50, Gasonex, Metrix, Pondkleen etc. for reducing harmful gases in pond water. Used disinfectants like Timsen, Virex, Polgard+, , Micronil etc.; antibiotics include Renamycin, Eskamycin, Bactitab, Cotrim vet bolus, Chemycin, Aquamycin etc.; Aqua photo, Safegut, Biomax, Profs, Pond care etc. were the used probiotics where various growth promoters include Panvit aqua, Nutrigel, Aquazyme, Spa gelly, Charger gel etc. Some problems were reported regarding the use of chemicals such as their indiscriminate use, method of application, time of application and inappropriate doses.&#x0D; Asian J. Med. Biol. Res. June 2020, 6(2): 283-293

Barriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIP

BackgroundGlobally, hypertension is a leading cause of cardiovascular disease and mortality, with the majority of deaths occurring in low- and middle-income countries. Because the burden of hypertension is increasing in low resource settings with restricted infrastructure, it is imperative that new models for hypertension care are realised. One such model is the Community-based Hypertension Improvement Project (ComHIP) which employs a community-based method of task-shifting for managing hypertension. This study is a qualitative analysis of the barriers and facilitators of the main components of ComHIP.MethodsWe purposively selected 55 informants for semi-structured interviews or focus group discussions, which were carried out bythree trained local researchers in Krobo, Twi or English. Informants included patients enrolled in ComHIP, health care providers and Licensed Chemical Sellers trained by ComHIP, and Ghana Health Service employees. Data were analysed using a multi-step thematic analysis.ResultsWhile results of the effectiveness of the intervention are pending, overall, patients and nurses reported positive experiences within ComHIP, and found that it helped enable them to manage their hypertension. Healthcare providers appreciated the additional training, but had some gaps in their knowledge. Ghana Health Service employees were cautiously optimistic about the programme, but expressed some worries about the sustainability of the programme. Many informants expressed concerns over the inability of community nurses and workers to dispense anti-hypertensives, due to legal restrictions.ConclusionsThe WHO recommends task-sharing as a technique for managing chronic conditions such as hypertension in resource constrained settings. ComHIP presents an example of a task-sharing programme with a high level of acceptability to all participants. Going forward, we recommend greater levels of communication and dialogue to allow community-based health workers to be allowed to dispense anti-hypertensives.

Usefulness of combined screening methods for rapid detection of falsified and/or substandard medicines in the absence of a confirmatory method

BackgroundThe influx of substandard and falsified medicines is a global public health challenge and its rapid detection is a key solution to the menace. This study used three screening methods and one confirmatory method for the quality assessment of 25 batches of artemether/lumefantrine dosage forms from the Ghanaian market to test that combined screening methods only can rapidly detect substandard and/or falsified medicines in areas where confirmatory methods may not be available.MethodsThe quality of artemether/lumefantrine tablet products obtained from pharmacies and licensed chemical seller shops within the Accra metropolis in Ghana were analysed using three screening methods (GPHF Minilab, Colorimetry and Counterfeit Drug Indicator) and one confirmatory method (high-performance liquid chromatography).ResultsThe results showed that 18/25 batches of the artemether/lumefantrine samples passed using the combined screening and confirmatory methods and 5/25 batches of the artemether/lumefantrine samples failed using the combined screening and confirmatory methods. However, 1/25 batch of the artemether/lumefantrine samples failed using the combined screening methods but passed using the confirmatory method. Also, 1/25 batch of the artemether/lumefantrine samples passed using the combined screening methods but failed using the confirmatory method. This notwithstanding, the combined screening methods and the confirmatory method provided equivalent quality assessment profiles for 23/25 (92%) batches of the artemether/lumefantrine tablet products. Out of the 6 samples that failed the confirmatory test, 1/6, 2/6, and 3/6 failed on the high (> 110%), low (< 90%), and no active ingredient (0%), respectively. The sensitivity of Minilab, colorimetric, CoDI, and the combined screening methods at 95% confidence level were 0.5 ± 0.57, 0.83 ± 0.33, 0.75 ± 0.49, and 0.83 ± 0.33, respectively. Also, the specificity of Minilab, colorimetric, CoDI, and the combined screening methods at 95% confidence level were 1.00, 0.95 ± 0.10, 1.00, and 0.95 ± 0.10, respectively.ConclusionThe combined screening methods may be used for rapid detection of falsified and/or substandard medicines without using a confirmatory method. However, additional research on the best combinations of screening devices/methods to rapidly detect the quality of medicines is recommended.

Agrochemicals used in freshwater aquaculture in Jhenaidah district, Bangladesh

The present experiment was conducted in order to investigate the use of agrochemicals in freshwater aquaculture with emphasis on fish health management. The selected area was Mahespur upazila under Jhenaidah district and the study duration was six months. The main group was fifty fish farmers and the data were collected through interview with fish farmers and key informants (chemical seller). Ten categories of chemicals were identified that are used by fish farmers for various purposes such as pond preparation, water quality management, controlling diseases, supplying oxygen, killing fish predators, Ten pharmaceutical companies were found to provide the agrochemicals to fulfill the farmers need. These companies are Novartis Anmal Health Ltd, Fishtech (BD) Ltd, SK+F BD Ltd, Renata Ltd, ACI Animal Health, Opsonin Pharma Ltd, Eon Animal Health Products Ltd, Square Pharmaceuticals Ltd, Sciencetech Agro Industries Ltd, Rals. In the study area some kinds of diseases were founded such as Epizotic Ulcerative Syndrome (EUS) in Rohu (Labeo rohita), Catla (Catla catla), Mozambique tilapia (Oreochromis niloticus), Black spot in Stinging cat fish, skin diseases, gill damage, tail and fin rot in Yellow tail catfish (Pangasius pangasius). For highest stocking density tilapia and pangus were mostly affected by diseases in winter. Farmers use various chemicals such as for water quality management agriculture lime, Geotox, JV Zeolite, Mega Zeo Bio, Aquakleen and Biomin, as antibiotic they use Novamix 101, Erocot, Captor, Oxysentin 20%, Renamycin, Aquamycin and Oxysentin 20% are antibiotics with different trade names were seen in the market as well as used by the fish farmers in the study area. The fish farmers use a wide variety of disinfectants in freshwater aquaculture. Timsen, Polgard plus, Formalin, Bleaching powder, EDTA are found available in all the shops of Mahespur. Formalin is used to control protozoan diseases. Virex is used to destroy virus and bacteria. Fish farmers use oxygen suppliers to increase the oxygen level in the water body. Oxidizing agent, hydrogen peroxide are major active ingredients of such chemical. The recovery of fish diseases was found 80-90% in the study area. During field observation many problems were identified in case of using agrochemicals which included lack of skill and knowledge of farmers about the application, withdrawal period of agrochemicals and drugs and some adverse effects on fish and human health.&#x0D; Asian Australas. J. Food Saf. Secur. 2019, 3(2), 63-76

Health system challenges to hypertension and related non-communicable diseases prevention and treatment: perspectives from Ghanaian stakeholders

BackgroundHypertension, itself a cardiovascular condition, is a significant risk factor for other cardiovascular diseases. Hypertension is recognized as a major public health challenge in Ghana. Beginning in 2014, a collaborative team launched the community-based hypertension improvement program (ComHIP) in one health district in Ghana. The ComHIP project, a public-private partnership, tests a community-based model that engages the private sector and utilizes information and communication technology (ICT) to control hypertension. This paper, focuses on the various challenges associated with managing hypertension in Ghana, as reported by ComHIP stakeholders.MethodsA total of 55 informants – comprising patients, health care professionals, licensed chemical sellers (LCS), national and sub-national policymakers – were purposively selected for interview and focus group discussions (FGDs). Interviews were audio-recorded and transcribed verbatim. Where applicable, transcriptions were translated directly from local language to English. The data were then analysed using two-step thematic analysis. The protocol was approved by the two ethics review committees based in Ghana and the third, based in the United Kingdom. All participants were interviewed after giving informed consent.ResultsOur data have implications for the on-going implementation of ComHIP, especially the importance of policy maker buy-in, and the benefits, as well as drawbacks, of the program to different stakeholders. While our data show that the ComHIP initiative is acceptable to patients and healthcare providers – increasing providers’ knowledge on hypertension and patients’ awareness of same- there were implementation challenges identified by both patients and providers. Policy level challenges relate to task-sharing bottlenecks, which precluded nurses from prescribing or dispensing antihypertensives, and LCS from stocking same. Medication adherence and the phenomenon of medical pluralism in Ghana were identified challenges. The perspectives from the national level stakeholders enable elucidation of whole of health system challenges to ComHIP and similarly designed programmes.ConclusionsThis paper sheds important light on the patient/individual, and system level challenges to hypertension and related non-communicable disease prevention and treatment in Ghana. The data show that although the ComHIP initiative is acceptable to patients and healthcare providers, policy level task-sharing bottlenecks preclude optimal implementation of ComHIP.

Self-medication practice in Akuse, a rural setting in Ghana

In most resource-poor settings, there is a paucity of data on self-medication and possible factors that influence this practice. The current study assesses self-medication among the people of Akuse, a rural setting in the Eastern Region of Ghana. A quantitative cross-sectional study was carried out in Akuse from 4th January 2016 to 27th February 2016. Using a questionnaire, interviews were conducted to assess self-medication: class of drugs taken, sources of drugs, knowledge of potential adverse effects, among others. Of the 363 participants enrolled, 361 completed questionnaires administered. Of the 361 respondents, 58.4% were female. A majority of the respondents were within the ages of 30 and 45 years. Respondents were mainly farmers (40.2%), and a majority (44.6%) had primary level as the highest education. One major reason for self-medication was influence from family and friends (32.7%). Antibiotics (32.1%) and analgesics (21.0%) were the most common self-medicated drugs, and these drugs were mostly obtained from licenced chemical sellers (32.5%). A little more than a third (39.9%) of the respondents said that their condition did not change after self-medication. A greater number of the respondents (81.7%) did not have knowledge of potential adverse reactions associated with self-medicated drugs. However, respondents with high educational level had the most knowledge of adverse drug reactions. The study found self-medication as a common practice among a number of residents of Akuse. Findings from this study provide data that could be used for targeted education and sensitisation of self-medication and its demerits in similar resource-poor rural settings.

To sell or not to sell; the differences between regulatory and community demands regarding access to antibiotics in rural Ghana

BackgroundIn Ghana, there is extensive over-the-counter dispensing of antibiotics, resulting in high levels of inappropriate use, and an increase in antibiotic resistance. Regulations prevent Licenced Chemical Sellers (LCS, Over-the-Counter Medicine Sellers) from selling antibiotics other than Cotrimoxazole. In practice, however, these sellers sell a variety of antibiotics. This paper aims to provide insight into the differences between regulatory and community demands on the sale of antibiotics, and to explore how these differences in demand could be resolved to facilitate safe and appropriate use of antibiotics in rural Ghana.MethodsA total of 32 in-depth interviews were conducted in the Kintampo North and South Districts in Ghana; 16 among antibiotic suppliers, predominantly LCS, and 16 among community members. Six focus group discussions were also conducted among 40 community members. Data were coded using Nvivo 10 and thematically analyzed in line with study objectives. The results are presented as narratives with quotes to illustrate the findings.ResultsGenerally, antibiotic suppliers were aware that regulations prevent LCS from selling antibiotics except Cotrimoxazole. However, LCS sell all types of antibiotics because of community demand, economic motivations of LCS, and the poor implementation of regulations that are intended to prevent them from selling these medications. Factors that influence community demand for antibiotics include previous knowledge of effectiveness of some antibiotics, delays in seeking care at health facilities, financial constraints, and distance to health facilities. LCS suggested that they should be trained and allowed to sell some types of antibiotics instead of being prevented completely from selling. Community members also suggested that Community-based Health Planning and Services (CHPS) compounds should be equipped to dispense antibiotics.ConclusionThe sale of antibiotics by LCS at the community level is influenced by both structural and individual contextual factors. There is a need to educate community members on the appropriate access and use of antibiotics in rural Ghana. In addition, rather than enforcing rules that go against practice, it may be more effective to regulate the sale of antibiotics by LCS and train them to make their dispensing more appropriate. CHPS compound could also be equipped to dispense some antibiotics to improve appropriate antibiotic access at the community level.

Stakeholders’ Practices and Perspectives on Solid Medical Waste Management: A Community Based Study in Accra, Ghana

Solid medical waste (SMW) is hazardous and requires specific treatment prior to final disposal. Limited information addresses the management of SMW in non-traditional settings such as in households, traditional birth attendants’ (TBAs) homes and chemical seller (CS) shops. A descriptive, exploratory study was conducted to identify major disposal practices and perceived hazards associated with SMW and explore their views regarding segregation as a potential management option. Twenty-nine household members, 10 TBAs and 8 CS who volunteered to participate in the study were involved in 6 focus group discussions (FGDs). Additionally, five key informants in private sector waste management companies were interviewed. FGDs were audio recorded, transcribed and translated, manually coded into themes and sub-themes using an iterative approach, and integrated with data from the interviews. In households, medicines were discarded by dosage forms with solid forms discarded in the household bin, while syrups were mostly emptied into drains. TBAs buried material used for delivery in clients’ compounds and CS tended to burn expired medicines or discard them with general waste. Participants perceived the following as hazards associated with SMW: infection transmission, penetrative injury, poisoning and aesthetic nuisance. Despite this awareness, they reported barriers to source segregation as a potential management option. Barriers included implied consumer costs, lack of supportive logistics and operational knowledge, and possible injury. Reported methods of disposing SMW supported earlier studies and could be potentially hazardous if not addressed. Provision of storage facilities, supportive logistics and public sensitization might encourage source segregation as a potential management option for SMW in the community.

Targeted community based interventions improved malaria management competencies in rural Ghana

BackgroundMalaria is one of the most challenging public health concerns in the developing world. To address its impact in endemic regions, several interventions are implemented by stakeholders. The Affordable Medicine Facility-malaria (AMFm) is an example of such interventions. Its activities include communication interventions to enhance the knowledge of caregivers of children under five years, licensed chemical sellers (LCS) and prescribers on malaria management with artemisinin-based combination therapy (ACT). This study was conducted to evaluate the effectiveness of the AMFm activities on malaria among targeted groups in two rural communities in Ghana.MethodsA communication intervention study was conducted in the Asante-Akim North and South Districts of Ghana. Repeated cross-sectional pre and post surveys were deployed. Relevant malaria messages were designed and used to develop the information, education and communication (IEC) tools for the intervention. With the aid of posters and flipcharts developed by our study, community health workers (CHWs), prescribers, and licenced chemical sellers provided proper counselling to clients on malaria management. Trained CHWs and community based volunteers educated caregivers of children under five years on malaria management at their homes and at public gatherings such as churches, mosques, schools. Chi-square tests and logistic regression were run to determine associations and control for demographic differences respectively.ResultsThere was significantly high exposure to malaria/ACT interventions in the intervention district than in the comparison district (OR = 16.02; 95% CI = 7.88–32.55) and same for malaria/ACT-related knowledge (OR = 3.63; 95% CI = 2.52–5.23). The participants in the intervention district were also more knowledgeable about correct administration of dispersible drug for children <5 years than their counterparts in the unexposed district.ConclusionOur data show that targeted interventions improve malaria based competences in rural community settings. The availability of subsidized ACTs and the intensity of the communication campaigns contributed to the AMFm-related awareness, improved knowledge on malaria/ACTs and management practices.

“My friend who bought it for me, she has had an abortion before.” The influence of Ghanaian women’s social networks in determining the pathway to induced abortion

BackgroundEven given the liberal abortion law in Ghana, abortion complications are a large contributor to maternal morbidity and mortality. This study sought to understand why young women seeking an abortion...

Investigating the Risks in the Pharmaceutical Supply Chain in Ghana

The study was to investigate the risks in the Pharmaceutical Supply Chain in Ghana. Questionnaire was the main instrument used for the data collection and the responses were analysed using SPSS. Sample size of Eighty (80) was used for the analysis. Data analysis was descriptive. The study revealed that Drug Shortages, Pilfering and Expiration of Drugs are the risks associated with the Pharmaceutical Supply Chain. The major reasons given for the occurrence of the risks include difficulty in obtaining raw materials, unethical attitude of pharmacists and chemical sellers, low income of consumers, poor inventory management and reverse logistics not being encouraged in the pharmaceutical industry in Ghana. The paper recommends the integration of Information and Communication Technology (ICT) tools in the management of inventory and also the strengthening of the Pharmaceutical Supply Chain. These measures would go a long way to reduce if not completely eliminated the exposure of the Pharmaceutical Supply Chain to risks.

Insights into the Affordable Medicines Facility-malaria in Ghana: the role of caregivers and licensed chemical sellers in four regions.

BackgroundThe Affordable Medicine Facility-malaria (AMFm) was an innovative global financing mechanism for the provision of quality-assured artemisinin-based combination therapy (ACT) across both the private and public health sectors in eight countries in sub-Saharan Africa. This study evaluated the effectiveness of AMFm subsidies in increasing access to ACT in Ghana and documented malaria management practices at the household and community levels during the implementation of the AMFm.MethodsThis study, conducted in four regions in Ghana between January, 2011 to December, 2012, employed cross-sectional mixed-methods design that included qualitative and quantitative elements, specifically household surveys, focus group discussions (FGD) and in-depth interviews.ResultsThe study indicated high ACT availability, adequate provider knowledge and reasonably low quality-assured ACT use in the study areas, all of which are a reflection of a high market share of ACT in these hard-to-reach areas of the country. Adequate recognition of childhood malaria symptoms by licensed chemical seller (LCS) attendants was observed. A preference by caregivers for LCS over health facilities for seeking treatment solutions to childhood malaria was found.ConclusionsArtemisinin-based combination therapy with the AMFm logo was accessible and affordable for most people seeking treatment from health facilities and LCS shops in rural areas. Caregivers and LCS were seen to play key roles in the health of the community especially with children under 5 years of age.

Challenges of medicines management in the public and private sector under Ghana's National Health Insurance Scheme - A qualitative study.

BackgroundGhana established its National Health Insurance Scheme (NHIS) in 2003 with the goal of ensuring more equitable financing of health care to improve access to health services. This qualitative study examines the challenges and consequences of medicines management policies and practices under the NHIS as perceived by public and private service providers.MethodsThis study was conducted in health facilities in the Eastern, Greater Accra and Volta regions of Ghana between July and August 2014. We interviewed 26 Key Informants (KIs) from a purposively selected sample of public and private sector providers (government and mission hospitals, private hospitals and private standalone pharmacies), pharmaceutical suppliers and NHIS district offices. Data was collected using semi-structured interview guides which covered facility accreditation, reimbursement practices, medicines selection, purchasing and pricing of medicines, and utilization of medicines. Codes for data analysis were developed based on the study questions and also in response to themes that emerged from the transcripts and notes.ResultsMost KIs agreed that the introduction of the NHIS has increased access to and utilization of medicines by removing cost barriers for patients; however, some pointed out the increased utilization could also be corollary to moral hazard. Common concerns across all facilities were the delays in receiving NHIS reimbursements, and low reimbursement rates for medicines which result in providers asking patients to pay supplementary fees. KIs reported important differences between private and public sectors including weak separation of prescribing and dispensing and limited use of drugs and therapeutic committees in the private sector, the disproportionate effects of unfavorable reimbursement prices for medicines, and inadequate participation of the private sector providers (especially pharmacies and licensed chemical sellers) in the NHIS.ConclusionsHealth providers generally perceive the NHIS to have had a largely positive impact on access to medicines. However, concerns remain about equity in access to medicines and the differences in quality of pharmaceutical care delivered by private and public providers. Routine monitoring of medicines use during the implementation of health insurance schemes is important to identify and address the potential consequences of medicines policies and practices under the scheme.Electronic supplementary materialThe online version of this article (doi:10.1186/s40545-016-0055-9) contains supplementary material, which is available to authorized users.

Health Care in Ghana: A Study of Health Care Opinion Leadership

AbstractGhana is a developing sub-Saharan country in West Africa and it struggles with delivering health care within the universal health system. The primary barrier to medical care is the lack of access. The government of Ghana subsidizes universal health insurance for all of its citizens, but lacks technology, workforce, and more importantly access to sanitation and clean running water. Access to health care remains a challenge in Ghana, especially in rural areas. In this research, we studied opinion leadership for health care in Ghana using two surveys conducted in May, 2014. Student investigators administered a survey to explore who was identified as the health care opinion leaders by local community members. The respondents were asked to rank seven categories of health care providers by how often they spoke to the health care provider about their health, from most often to least often , including medical doctors, chemical sellers, herbalists, prayer camps, family members, midwives and shrines or voodoo priests. The study surveyed 157 respondents from local community members, including 51 people in cities, 65 people in rural villages and 41 people in Kpanla, a remote isolated island on Lake Volta. Student investigators also gave a self-designating survey to 61 health care providers to measure their health care opinion leadership. The results of these two surveys were consistent. Local community residents preferred to talk to medical doctors about their health care when medical doctors were accessible. Health care providers’ responses to the self-designating opinion leadership survey supported their strong opinion leadership for health care.

Commonly used chemicals in shrimp ghers at Shyamnagar upazila in Satkhira, Bangladesh

The study was carried out to know the purpose of the use of chemicals and current status of chemicals used in various aquaculture activities in Shyamnagar upazila between August 2007 and February 2008. A total of 50 shrimp farmers and chemical sellers were selected for questionnaire interview. Data were collected through PRA tools like questionnaire interview, Focus Group Discussion and key informant interview. All interviewed farmers were male with an average age of 36-45 years and their average family size was 7 members. Commonly used chemicals found in the study area were lime, urea, Triple super phosphate (TSP), Potassium permanganate, Vitamins, Antibiotics, (mainly oxytetracycline and chlorotetreacycline), rotenone, phosphate, phostoxin, sumithion, melathion, timsen, bioaqua, oxymax/oxyflow, aquanarish, aqua clean and théoden. Health management and disease treatment were the major activities where farmers were seen to use a lot of chemicals. Study identified some diseases and conditions like white spot disease, yellow head disease, heavy gill and surface fouling disease, brown spot disease, nutritional disease and environmental disease. This study demonstrated that most of the farmers used chemicals and antibiotics indiscriminately without knowing their mode of action, doses and appropriate procedure of application. Study also shows that farmer used various types of chemicals but did not get benefit only little exception due to shrimp viral disease. The study also highlighted the names and approximate price of aquaculture chemicals available with the chemical sellers in the study areas.Res. Agric., Livest. Fish.2(2): 343-351, August 2015

Public-private Partnership Approaches for Scaling up Zinc with ORS

Objectives: Based on evidence from four previous private sector programs, USAID's SHOPS project, in partnership with the Ghana Health Service, developed a strategy to maximize availability of, demand for, and use of zinc plus oral rehydration solution (ORS) for the treatment of pediatric diarrheas. This abstract describes the private sector-focused strategy for addressing high diarrhea prevalence among children under five in Ghana.&#x0D; Methods: SHOPS established a conducive policy and regulatory environment, engaging stakeholders from both sectors; collaborated with regulatory bodies to train over 10,000 chemical sellers and pharmacy staff and 350 clinicians in diarrhea management; partnered with pharmaceutical manufacturers to increase availability of quality, affordable products; developed an innovative campaign to increase awareness and demand; and partnered with NGOs to promote use through community mobilization. We conducted in-depth interviews and mystery client surveys with providers to assess reported and actual prescribing behavior.&#x0D; Results: Private sector sales of zinc tablets increased ten-fold after training providers and 300% after the media campaign, treating over 2 million children with diarrhea to date. Most (75%) providers mentioned zinc as their preferred diarrhea treatment; 65% actually prescribed zinc with ORS as treatment. Retail audits confirm over 60% of chemist shops and pharmacies carry zinc and ORS. These results are notable in that zinc was completely unknown and unavailable in Ghana prior to the initiation of the program in 2012.&#x0D; Conclusions: In a single year, significant progress in scaling up diarrhea treatment was realized through strategic partnerships with the private sector in Ghana.

Lessons from a geospatial analysis of depot medroxyprogesterone acetate sales by licensed chemical sellers in Ghana

ObjectivesTo map access to depot medroxyprogesterone acetate (DMPA) from licensed chemical sellers (LCS); to estimate the proportion of women of reproductive age in areas with access; and to examine affordability and variability of costs. MethodsA geospatial analysis was conducted using data collected from 298 women who purchased DMPA from 49 geocoded LCS shops in the Amansie West and Ejisu-Juabeng districts of Ghana from June 4 to August 31, 2012. The women reported on cost and average distance traveled to purchase DMPA. ResultsIn Amansie West, 21.1% of all women of reproductive age lived within average walking distance and 80.4% lived within average driving distance of an LCS. In Ejisu-Juabeng, 41.9% and 60.1% of women lived within average walking and driving distance, respectively. Distribution of affordability varied across each district. ConclusionsAccess to LCS shops is high, and training LCS to administer DMPA would increase access to family planning in Ghana, with associated time and cost savings.