Private Retail Research Articles

Evaluating the Financial Performance of Retail Oil Distribution Companies in India: A Comparative Study of Public and Private Sectors

This study examines the financial performance of public and private sector retail oil distribution companies in India from 2013 to 2023. The research focuses on two hypotheses: first, that private sector companies (RIL and Nayara Energy) demonstrate superior profitability metrics (ROCE, ROA, ROE) compared to public sector counterparts (BPCL, HPCL, IOCL) due to operational flexibility and market-driven strategies; and second, public sector companies exhibit lower financial leverage (Debt-Equity Ratio) reflecting conservative financial management and government oversight. Statistical tools such as ANOVA were employed to analyse ten years of financial data, revealing significant differences in profitability metrics favouring private-sector companies, and lower financial leverage among public-sector entities. These findings provide investors, policymakers, and stakeholders valuable insights in understanding sectoral dynamics and making informed decisions. The study contributes to the existing literature by illustrating distinct financial strategies and performance trends within India's retail oil distribution sector, crucial for strategic planning and regulatory frameworks in the energy industry.

Identifying and Analysing Constraints in the Branded Rice Market: A Comprehensive Study of Stakeholders in Kerala, India

The study assessed the various constraints faced by the stakeholders in branded rice market in Kerala. These stakeholders include farmers, exporters, non-exporting private rice manufacturers, co-operative society, wholesalers, retailers and consumers. By examining the constraints across the branded rice market from production to consumption, the study aimed to identify the critical issues like, production constraints, procurement constraints, marketing constraints, institutional constraints export constraint and financial constraints. A sample of 30 farmers and one agent, five exporters and 10 non-exporters 20 wholesalers and 30 retailers and 120 consumers from Ernakulam and Palakkad districts were selected for the study. The study identified the major problems faced by the stakeholders of branded rice market by using Garret’s ranking method. Farmers were facing difficulties in rice production due to high input costs, high labour costs and untimely availability of water. Delay in procurement from SUPPLYCO and adequate facilities for drying and cleaning compel them to sell their produce in the open market. There was a communication gap between institutions and farmers. Lack of transportation facilities, high maintenance cost of machinery and financial difficulties were the major constraints faced by PADDICO. High transportation cost, high international trade barriers and price volatility were the major constraints faced by private manufacturers of branded rice. Heavy documentation & procedures was the major constraint faced by exporters. Lack of demand of branded rice was the major constraint faced by resellers. High price was the major constraint faced by the consumers. The high cost of production faced by farmers can be reduced by improved mechanisation in the rice cultivation. The study also recommended the suggestions for the constraints of other market stakeholders of branded rice market.

Job Satisfaction and Associated Factors Among Public and Private Pharmacy Professionals in Gondar Town, Northwest Ethiopia.

The quality of the healthcare system and the achievement of specific patient outcomes rely on the contentment of pharmacy experts working in both public and private pharmacies. This study aims to evaluate and compare the levels of job satisfaction among pharmacy professionals employed in public and private medication retail outlets in Gondar town, northwest Ethiopia. A cross-sectional survey was conducted to assess job satisfaction and associated factors among pharmacy professionals in public and private pharmacies in Gondar town from July 20 to August 1, 2022. All pharmacy professionals were included in the study and no sample size was calculated. Bivariable and multivariable binary logistic regression analysis was used to identify the factors associated with job satisfaction and a p < 0.05 was considered significant with 95% CI. A total of 217 private and public pharmacy professionals were included in the study, and 183 volunteered to participate with a response rate of 84%. Among the study participants, 52.5% were dissatisfied with their job. The majority of the respondents (92.3%) believed that the job has a good future, 72% of them received good recognition from the community for their job and more than half (57.3%) received a good salary. Private pharmacy workers were found to be more satisfied than public pharmacy workers (AOR: 2.770), pharmacy professionals who had good salaries and benefits, (AOR: 0.302), and individuals who were closeness of their workplace to home (AOR: 0.298) were significantly associated with job satisfaction levels. In this study, more than half of participants were disatisfied with their job. Pharmacy professionals working in private medication retail outlets, who had good salaries and benefits, and lived close to their homes were significantly associated with job satisfaction levels.

Penerapan Sistem Informasi Website Absensi dengan RFID Berbasis IoT di PT. Eksgon Brother

The expansive number of laborers spread over different offices in a private retail traderequires an proficient time following framework for its workers. This causes teach andinfluences the work execution of each worker. Manual recording and participationframeworks for representatives who are still in utilize result in misplaced time and otherinfringement. Computers are information handling apparatuses that can turn this timeadministration framework into an programmed and valuable framework. In this manner,uncommon information collection is required to record participation and nonattendanceso that work exercises can be recorded precisely and in genuine time. There are numerousways to induce a great time following data framework. One way is to utilize a computerwith a web-based time following application. At PT Eksgon Brother, the framework utilizedwithin the time recording handle is continuously manual and employments a every dayparticipation book, so that it has an affect on the effectiveness and adequacy in collectingand collecting information and its calculation takes a moderately long time. With thechance of blunders and misfortune of participation information is expanding. Based on theover issues, an representative timekeeping data framework was made at PT. EksgonBrother.

Truth is relative; Client report versus provider report, a post-modern analysis of data from a trial in the private retail medicine sector.

In malaria-endemic countries, private retail outlets are a major source of antimalarials for individuals experiencing an acute febrile illness. However, there remains a challenge in how the decision to dispense the drugs is made. The lack of malaria diagnostic tools in the retail sector leads to a presumptive approach to diagnosis and overuse of ACTs. The TESTsmART study trained retail outlet attendants to perform malaria rapid diagnostic tests (mRDTs) in conjunction with a mobile application to capture testing and drug dispensing data. Concurrently, febrile clients were randomly selected for exit interviews outside the outlet, and analogous information about testing and drug purchasing was recorded based on self-report. A small subset of clients enrolled in exit interviews were also asked to participate in exit Plasmodium falciparum mRDT testing to confirm the accuracy of mRDTs in the outlet and to estimate malaria positivity amongst untested clients. In this sub-study, comparison of these two concurrent data sources showed the testing rate for eligible participants was slightly lower in the exit interview (42.8%, 2436/5695) than in the app (51.1%, 24,446/49,804). We noted important differences in the experiences of testing and adherence reported by outlets compared to clients; 11.0% of clients had positive mRDT reported in the app (and validated by photo review) compared to 35.3% from exit interviews. Outlets reported that 97% of test-positive clients received a first-line Artemether Combination Therapy (ACT), but only 77% of clients who reported a positive test also reported receiving the first-line ACT in the exit interview. For test-negative clients, 35% received an ACT based on outlet reports compared to 25% by exit interviews. Among 109 clients randomly selected for re-test at exit interview, nearly two-thirds of those who reported a positive test from the outlet had a negative mRDT (64.3%, 9/14) when retested. Contrasting outcomes reported by the provider and the client highlight barriers to improving testing and adherence for malaria as well as challenges for monitoring case management in the retail sector. These include accurate communication of results to the client, poor confidence in a negative result, and reluctance to withhold antimalarials from test-negative clients.

Examining consumers' perceptions of relationship value with retailers: a multi-method approach

PurposeThis study employs a multi-method approach to investigate how perceived relationship marketing investment affects perceived relationship value and consumer gratitude, influencing consumer involvement, word-of-mouth intentions, and long-term relationships across three retail consumer types.Design/methodology/approachThe study analyses a model involving 542 consumers, employing structural equation modeling and fuzzy-set qualitative comparative analysis to identify distinctive factor configurations across public, semi-public, and private retail organizations.FindingsA retailer’s investment in relationship marketing significantly enhances relationship value and consumer gratitude, leading to increased engagement and word-of-mouth intentions. Perceived benevolence moderates the effect of relationship marketing on gratitude. However, gratitude alone does not ensure long-term relationships. Using fsQCA, we identify four distinct consumer configurations, providing nuanced insights.Research limitations/implicationsRetail organizations broaden relationship marketing strategies to boost perceived value and elicit consumer gratitude, influencing consumer performance outcomes.Practical implicationsRetail organizations should broaden relationship marketing strategies to boost perceived value and elicit consumer gratitude, influencing consumer performance outcomes.Social implicationsManagers should develop strategies that lead to consumer gratitude toward the firm, such as journey mapping can help visualize retail delivery. Grateful consumers may contribute to firms’ profitability by influencing current and potential consumers in their social networks and communicating their expertise through review/feedback for improvement. Therefore, various strategies are needed to stimulate positive comments from grateful consumers about the firm’s excellent performance.Originality/valueThis study builds on Lawler’s affect theory, highlighting how relationship value and consumer gratitude profoundly influence exchange process outcomes. It introduces new psychological mechanisms to explain the impact of perceived relationship marketing investment on performance outcomes. Integrating these elements provides a comprehensive understanding of retailer–consumer dynamics, revealing how emotional and psychological factors shape marketing strategies and business performance. This contribution enriches theoretical frameworks and offers practical insights for enhancing relationship marketing practices.

Sickness absence after work accidents and post-traumatic stress among white-collar workers in the retail and wholesale industry; a longitudinal Swedish cohort study

BackgroundMost studies about accidents and about PTSD, respectively, have been conducted either on blue-collar workers, or on the entire working population. There are very few such studies on white-collar workers.AimTo examine diagnosis-specific sickness absence (SA) and disability pension (DP) after a work accident or PTSD, respectively, among white-collar workers in the private retail and wholesale industry.MethodsA prospective population-based cohort study of all 192,077 such workers aged 18–67 (44% women) in Sweden in 2012, using linked microdata from nationwide registers. We identified individuals who had secondary healthcare due to work-related accidents (n = 1114; 31% women) or to PTSD (n = 216; 79% women) in 2012–2016. Their average number of net days of diagnosis-specific SA (in SA spells > 14 days) and DP were calculated for 365 days before and 365 days after the healthcare visit.Results35% of the women and 24% of the men had at least one new SA spell during the 365 days after healthcare due to work accidents. Among women, the average number of SA/DP days increased from 14 in the year before the visit to 31 days the year after; among men from 9 to 21 days. SA days due to fractures and other injuries increased most, while SA days due to mental diagnoses increased somewhat. 73% of women and 64% of men who had healthcare due to PTSD had at least one new SA spell in the next year. Women increased from 121 to 157 SA/DP days and men from 112 to 174. SA due to stress-related disorders and other mental diagnoses increased the most, while DP due to stress-related diagnoses and SA due to musculoskeletal diagnoses increased slightly.ConclusionsAbout a quarter of those who had secondary healthcare due to work accidents, and the majority of those with such healthcare due PTSD, had new SA in the following year. SA due to injury and mental diagnoses, respectively, increased most, however, SA/DP due to other diagnoses also increased slightly. More knowledge is needed on factors associated with having or not having SA/DP in different diagnoses after work accidents and among people with PTSD.

Voluntary turnover of high achievers: A systems psychodynamics analysis with CIBART

Orientation: Voluntary turnover is a costly and frequently disruptive organisational phenomenon, particularly when it involves high achievers.Research purpose: The study aimed to develop a psychodynamic exposé of voluntary turnover by applying the conflict, identity, boundaries, authority, roles and task (CIBART) model to the lived experiences of high achievers.Motivation for the study: The research primarily focusses on voluntary turnover as an individual, rational decision-making process. It recognises the contribution of unconscious systems psychodynamics to voluntary turnover. Research conducted from this perspective is necessary to gain a more comprehensive and in-depth understanding of the topic.Research approach/design and method: Seven case studies of individual voluntary turnover were conducted in a large private retail company. Data were collected using free association narrative (FANI) interviews. The analysis of the data was guided by hermeneutic phenomenology, and the interpretive frame used was the CIBART model.Main findings: Six themes were constructed to describe the conflict dynamics along each of the six CIBART dimensions. Within each theme, the conflict dynamic is exposed, revealing the subsequent anxiety and defences that accumulate leading to the decision to leave. Ultimately, the six themes synthesise to propose that voluntary turnover is a conscious manifestation, yet an unconscious defence against system-wide conflict.Practical/managerial implications: Facilitating leaders’ understanding and processing of the conflict dynamics that occur across the CIBART dimensions, and which contribute to voluntary turnover, create opportunities for both transformation and prevention.Contribution/value-add: The research offers insights into the psychodynamics of voluntary turnover, which consulting psychologists and organisational leaders can utilise to address this phenomenon within their work groups.

A cluster-randomized trial of client and provider directed financial interventions to align incentives with appropriate case management in private medicine retailers: Results of the TESTsmART trial in Lagos, Nigeria.

Malaria remains a major health priority in Nigeria. Among children with fever who seek care, less than a quarter gets tested for malaria, leading to inappropriate use of the recommended treatment for malaria; Artemisinin-based Combination Therapy (ACT). Here we test an innovative strategy to target ACT subsidies to clients seeking care in Nigeria's private retail health sector who have a confirmed malaria diagnosis. We supported point-of-care malaria testing (mRDTs) in 48 Private Medicine Retailers (PMRs) in the city of Lagos, Nigeria and randomized them to two study arms; a control arm offering subsidized mRDT testing for USD $0.66, and an intervention arm where, in addition to access to subsidized testing as in the control arm, clients who received a positive mRDT at the PMR were eligible for a free (fully subsidized) first-line ACT and PMRs received USD $0.2 for every mRDT performed. Our primary outcome was the proportion of ACTs dispensed to individuals with a positive diagnostic test. Secondary outcomes included proportion of clients who were tested at the PMR and adherence to diagnostic test results. Overall, 23% of clients chose to test at the PMR. Test results seemed to inform treatment decisions and resulted in enhanced targeting of ACTs to confirmed malaria cases with only 26% of test-negative clients purchasing an ACT compared to 58% of untested clients. However, the intervention did not offer further improvements, compared to the control arm, in testing rates or dispensing of ACTs to test-positive clients. We found that ACT subsidies were not passed on to clients testing positive in the intervention arm. We conclude that mRDTs could reduce ACT overconsumption in Nigeria's private retail health sector, but PMR-oriented incentive structures are difficult to implement and may need to be complemented with interventions targeting clients of PMRs to increase test uptake and adherence. Trials registration: Clinical Trials Registration Number: NCT04428307. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816435/ Correction: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476591/.

Geographic clustering of cannabis stores in Canadian cities: A spatial analysis of the legal cannabis market 4 years post-legalisation.

Following the legalisation of non-medical cannabis in 2018, the number of cannabis stores in Canada has rapidly expanded with limited regulation on their geographic placement. This study characterised the clustering of cannabis stores in Canadian cities and evaluated the association of clustering with provincial policy and sociodemographic variables. Cross-sectional spatial analysis of cannabis store density in dissemination areas ('neighbourhoods', n = 39,226) in Canadian cities in September 2022. Cannabis store density was defined as the count of stores within 1000 m of a neighbourhood centre. Clusters of high-density cannabis retail were identified using Local Indicators of Spatial Autocorrelation. Associations between provincial policy (privatised vs. public market), sociodemographic variables and cannabis store density were evaluated using multivariable regression. Clusters of high-density cannabis retail were identified in 86% of Canadian cities, and neighbourhoods in clusters had a median of 5 stores within 1000 m. Toronto, Canada's most populous city, had the most extreme clustering where neighbourhoods in clusters had a median of 10 stores (and a maximum of 25 stores) within 1000 m. Neighbourhoods in private versus public retail markets had a significantly higher neighbourhood-level density of cannabis stores (adjusted rate ratio [aRR] 63.37, 95% confidence interval [CI] 25.66-156.33). Lower neighbourhood income quintile was also associated with a higher neighbourhood-level density of cannabis stores (Q5 vs. Q1, aRR 1.28, 95% CI 1.17-1.40). Since cannabis was legalised, clusters of high-density cannabis retail have emerged in most Canadian cities and were more likely to form lower income neighbourhoods and in private retail markets.

Availability, pricing, and affordability of essential medicines for pediatric population in Malawi.

Lack of access to essential medicines negatively impacts on the quality of healthcare delivery and increases morbidity and mortality, especially to the vulnerable pediatric population. We assessed the availability, pricing, and affordability of pediatric formulations in Malawi. The study was conducted in 76 health facilities (public, faith-based and private pharmacies, and clinics) from the northern and southern regions of Malawi from March to May 2023. We adapted the WHO/HAI method for the assessment of both availability and pricing of medicines. Data on availability were collected from stock card records using a WHO/HAI template and medicine prices were provided by the pharmacy personnel who were managing the facilities. Availability of medicines was calculated as the percentage of facilities which had a stock of the respective medicine at the time of data collection while medicine prices was assessed by calculating the median prices of each medicine. To assess the affordability of the medicines, we calculated the number of days it takes for a person who is receiving the government-set minimum wage to work to pay for a treatment course of common indications. The study was approved by the KUHES ethics committee under the numbers U.12/22/3900 and U.12/22/3903. The overall availability of pediatric medicines was 38.1% for public health facilities, 53.7% for private retail pharmacies and drug stores, 49.5% for private clinics and 48.3% for Christian Health Association of Malawi (CHAM) facilities. We found the illegal availability of prescription-only medicines of up to 54% in medicine stores. Medicine median prices were higher in the private clinics followed by retail pharmacies and drugs stores. CHAM had the lowest median prices for medicines of all the sectors. More than 50% of medicines were found to be affordable as less than a day's wage was required to purchase the treatment. We found poor availability of pediatric formulation among public, CHAM, and private sectors in Malawi. This may affect the quality of care among pediatric patients and therefore contribute to morbidity and mortality in Malawi. The supply of medicines and health commodities needs to consider needs of special populations such as children to achieve universal health coverage.

A cluster-randomized trial of client and provider-directed financial interventions to align incentives with appropriate case management in retail medicine outlets: Results of the TESTsmART Trial in western Kenya.

ACTs are responsible for a substantial proportion of the global reduction in malaria mortality over the last ten years, made possible by publicly-funded subsidies making these drugs accessible and affordable in the private sector. However, inexpensive ACTs available in retail outlets have contributed substantially to overconsumption. We test an innovative, scalable strategy to target ACT-subsidies to clients with a confirmatory diagnosis. We supported malaria testing(mRDTs) in 39 medicine outlets in western Kenya, randomized to three study arms; control arm offering subsidized mRDT testing (0.4USD), client-directed intervention where all clients who received a positive RDT at the outlet were eligible for a free (fully-subsidized) ACT, and a combined client and provider directed intervention where clients with a positive RDT were eligible for free ACT and outlets received 0.1USD for every RDT performed. Our primary outcome was the proportion of ACT dispensed to individuals with a positive diagnostic test. Secondary outcomes included proportion of clients tested at the outlet and adherence to diagnostic test results. 43% of clients chose to test at the outlet. Test results informed treatment decisions, resulting in targeting of ACTs to confirmed malaria cases- 25.3% of test-negative clients purchased an ACT compared to 75% of untested clients. Client-directed and client+provider-directed interventions did not offer further improvements, compared to the control arm, in testing rates(RD = 0.09, 95%CI:-0.08,0.26) or dispensing of ACTs to test-positive clients(RD = 0.01,95% CI:-0.14, 0.16). Clients were often unaware of the price they paid for the ACT leading to uncertainty in whether the ACT subsidy was passed on to the client. This uncertainty undermines our ability to definitively conclude that client-directed subsidies are not effective for improving testing and appropriate treatment. We conclude that mRDTs could reduce ACT overconsumption in the private retail sector, but incentive structures are difficult to scale and their value to private providers is uncertain. Trial registration: ClinicalTrials.gov NCT04428307.

Assessing availability, prices, and market share of quality-assured malaria ACT and RDT in the private retail sector in Nigeria and Uganda

BackgroundAn estimated 50% of suspected malaria cases in sub-Saharan Africa first seek care in the private sector, especially in private medicine retail outlets. Quality of care in these outlets is generally unknown but considered poor with many patients not receiving a confirmatory diagnosis or the recommended first-line artemisinin-based combination therapy (ACT). In 2010, a subsidy pilot scheme, the Affordable Medicines Facility malaria, was introduced to crowd out the use of monotherapies in favour of WHO-pre-qualified artemisinin-based combinations (WHO-PQ-ACTs) in the private health sector. The scheme improved the availability, market share, and cost of WHO-PQ-ACTs in countries like Nigeria and Uganda, but in 2018, the subsidies were halted in Nigeria and significantly reduced in Uganda. This paper presents findings from six retail audit surveys conducted from 2014 to 2021 in Nigeria and Uganda to assess whether the impact of subsidies on the price, availability, and market share of artemisinin-based combinations has been sustained after the subsidies were reduced or discontinued.MethodsSix independent retail audits were conducted in private medicine retail outlets, including pharmacies, drug shops, and clinics in Nigeria (2016, 2018, 2021), and Uganda (2014, 2019, 2020) to assess the availability, price, and market share of anti-malarials, including WHO-PQ-ACTs and non-WHO-PQ-ACTs, and malaria rapid diagnostic tests (RDTs).ResultsBetween 2016 and 2021, there was a 57% decrease in WHO-PQ-ACT availability in Nigeria and a 9% decrease in Uganda. During the same period, non-WHO-PQ-ACT availability increased in Nigeria by 41% and by 34% in Uganda. The price of WHO-PQ-ACTs increased by 42% in Nigeria to $0.68 and increased in Uganda by 24% to $0.95. The price of non-WHO-PQ-ACTs decreased in Nigeria by 26% to $1.08 and decreased in Uganda by 64% to $1.23. There was a 76% decrease in the market share of WHO-PQ-ACTs in Nigeria and a 17% decrease in Uganda. Malaria RDT availability remained low throughout.ConclusionWith the reduction or termination of subsidies for WHO-PQ-ACTs in Uganda and Nigeria, retail prices have increased, and retail prices of non-WHO-PQ-ACTs decreased, likely contributing to a shift of higher availability and increased use of non-WHO-PQ-ACTs.

Survey and analysis of accessibility, availability, and affordability of topical glaucoma medicines.

Affordability and availability of medicines is a growing global challenge for health-care systems. Access to medicines is recognized as an important determinant of treatment adherence. The access to glaucoma medicines and how it affects glaucoma management are not known. The purpose of this study was to determine the availability, affordability, and accessibility of topical intraocular pressure (IOP) -lowering eye drops in Haryana state of northern India using the World Health Organization (WHO)/Health Action International (HAI) methods. A cross-sectional study was done to collect data on prices and availability of glaucoma topical medications in public and private sector pharmacies and retail outlets using the WHO/HAI methodology between October 2021 and January 2022. The availability and affordability of topical glaucoma medicines was determined. Comparison of the local price with international prices was done by calculating the median price ratio (MPR). A total of 191 facilities were randomly sampled across 11 ( n = 55) urban, 29 ( n = 92) semi-urban, and 44 ( n = 44) rural places during the study period. The availability of topical medication for glaucoma was low (35.7 ± 22.3) across all sampled sites and all classes of topical glaucoma medications. The median price of topical medication and availability were negatively correlated, Pearson's coefficient r (18) = -0.44, P 0.05, though the relationship was weak. A lowest paid, unskilled Indian government worker must spend between 15% and 203% of their daily wage to acquire a glaucoma medication. The availability and accessibility of topical glaucoma medications was low in this survey.

Monetary Reform and Central Bank Digital Currencies: The Impact on Retail Banking

This research aims to clarify the impact of monetary reform on retail banking, with the introduction of private crypto-currencies (CCs) and retail central bank digital currencies (CBDCs). Given the exponential increase in private de-centralized CCs, involving stablecoins and non-backed digital assets, total crypto assets have now developed into a USD 1.04 trillion market capitalization. Governments and monetary authorities were initially reticent, but now a number of central banks are developing their own wholesale and retail CBDCs. By conducting library research, document and content analysis involving secondary data, this research confirms, involving central bank admission, that the current centralized monetary system allows commercial banks to lend the vast majority of deposit money into existence. However, the impact of private CCs and introduction of retail CBDCs will eliminate credit creation, thus rendering the commercial banking model obsolete. This will inevitably involve a structural change in the global financial system, with the separation of the public issuance of money and the private issuance of equity finance and investment. Ultimately, retail CBDCs will have to develop into public stablecoins that are pegged to intrinsic value to satisfy the store of value function of money and provide stability as the common denominator for all economic transactions.

Endogenous timing in a mixed duopoly when a public firm supplies its private competitor

ABSTRACT We examine endogenous timing in a quantity setting mixed duopoly where a public firm, in addition to selling a good in the retail market, manufactures an input required to produce this good and supplies it to its private retail competitor. In this setting, the traditional separation between suppliers and retailers fails to hold, a situation commonly observed in many markets. We focus on the case of regulated input prices, which often appear under such circumstances, and consider both an exogenous input price and one optimally chosen by a regulator. The results may be substantially different from those obtained under conventional assumptions about the relationship between suppliers and retailers. In particular, for a wide range of parameter values early simultaneous moves are observed in equilibrium.

Availability of Access, Watch, and Reserve groups of essential antibiotics: a cross-sectional survey.

Lower-middle income countries face drastic challenges in Access to essential medicines. Data regarding Pakistan is scarce with no comprehensive study in this regard. The objectives of the study are to document and compare public and private sector availability of all essential antibiotics as well as to conduct a comparison among the AWaRe groups. The study analyzed 103 essential antibiotics comprising 51 Access, 29 Watch, 6 Reserve, and 17 anti-tuberculosis drugs from 15th August to 10th September 2020 in Lahore, Pakistan. It included on-spot physical availability and availability trend surveys. The survey sites included five public tertiary care hospitals with one as anchor and four randomly selected. Their hospital pharmacies and one randomly selected private retail pharmacy from the vicinity each hospital comprised the ten sampling sites. Percentage availability for each antibiotic was categorized as high (>80%), fairly high (50-80%), low (30-<50%), very low (<30->0%), and not available (0%). The mean percentage on-spot availability was 23.76% ± 5.19 (14-25%) for public facilities and 59.20% ± 4.45 (54-66%) for private sector retail pharmacies. The overall percentage of available essential antibiotics varied significantly (p** < 0.001) in public and private sector sampling sites. Except for the Watch group, all other groups showed the mode of 0% availability. A significant difference (p**** < 0.00001) was seen in percentage availability by Access, Watch, Reserve, and anti-TB-all groups of essential antibiotics. The availability trend survey revealed a list of 18 medicines as 'as never been available', and five medicines were 'not available for 5 years or more than 5 years.' Fourteen medicines as 'never been heard.' Non-availability of essential medicines is a significant public health challenge at public-sector facilities in Pakistan. It was observed that a number of essential antibiotics were not available in both public and private sectors. A number of corrective strategies are required. This includes the engagement of stakeholder and government bodies. This can help to improve supply chain barriers.

Psychoactive substance consumption after the Fundão dam mine tailing disaster in Minas Gerais State, Brazil.

Disasters cause changes in morbidity, mortality, and medicine use. Brazil is one of the main producers of mineral ores at great environmental cost. Mine tailings are stored in dams and ruptures have led to major disasters. We investigated the consumption of psychoactive medicines in the municipalities affected by the Fundão dam disaster in Minas Gerais State. An ecological study was carried out on drug consumption, estimated using public purchases in Minas Gerais and dispensing data from private retail pharmacies. Consumption (in number of defined daily doses/100,000 inhabitants per day) was analyzed descriptively in eight municipalities, stratified according to consumption level during a 25-month period. Six comparisons of mean consumption values for both data sets were done for pre- and post-disaster periods. The means of medicine consumption before and after the event were plotted and linear trends were added. Public purchase data evinced high consumption levels. Only pharmaceutical retail showed significant differences between the strata in the pre-disaster versus two post-disaster periods. Smaller municipalities showed an increase in consumption 15 months after the disaster. Clonazepam led the way in pharmaceutical retail consumption, followed by fluoxetine. Medicines showed an upward trend after the disaster. The high public provision may have stifled significant consumption patterns of psychoactive drugs; however, peak consumption were observed in private retail, suggesting a modification in use patterns after the disaster. The decrease in consumption immediately after the event was probably related to lower care-seeking behavior on the part of the population, and significant peaks after the disaster may reflect economic consequences of it.

Dynamic Cooperative Promotion in the Presence of Private Brand Introduction and Retailer Myopic Behavior

Dynamic Cooperative Promotion in the Presence of Private Brand Introduction and Retailer Myopic Behavior

Antimicrobial stewardship in private pharmacies in Wakiso district, Uganda: a qualitative study

BackgroundPrivate pharmacies are the first point of contact for the public regarding acquisition of medicines and other pharmaceuticals in many low- and middle-income countries including Uganda. Most antimicrobial stewardship (AMS) programmes in Uganda have targeted pharmacies in public health facilities, with little known about private pharmacies. This study explored knowledge and practices related to AMS in private pharmacies in Wakiso district, central Uganda.MethodsThis was a qualitative study that involved 31 in-depth interviews to explore AMS among retail private pharmacy staff including pharmacists, pharmacy technicians/dispensers, and nurses. Participants were asked about antimicrobial resistance (AMR) and AMS practices at their pharmacy. The audio-recorded interviews were transcribed verbatim and imported to NVivo 2020 (QSR International) for thematic analysis.ResultsFive major themes emerged from the study: commonly sold antimicrobials; knowledge on AMR and AMS; potential contributors to AMR; practices related to AMS; and challenges to AMS. The commonly sold antimicrobials in the pharmacies with or without prescriptions were oral azithromycin, Ampiclox® (ampicillin and cloxacillin), amoxicillin, ciprofloxacin, Septrin® (co-trimoxazole), metronidazole, Flucamox® (amoxicillin and flucloxacillin), Augmentin® (amoxicillin and clavulanic acid), cephalexin, doxycycline, and chloramphenicol. Participants had heard about AMR but not AMS, although only a few correctly defined AMR. Lack of knowledge among health workers and local communities; the overuse, misuse, and abuse of antimicrobials such as non-adherence to dosage; self-medication; and purchase of drugs without prescription were identified as potential accelerators to the emergence of AMR. Current practices related to AMS in private pharmacies were limited to meetings, antimicrobial dispensing, providing client advice, record keeping, and monitoring of drugs. Cost of healthcare, client satisfaction and retention, outdated guidelines, and the business orientation of pharmacies were the main challenges related to AMS.ConclusionThere was poor knowledge of AMR and AMS, and limited AMS practices in private pharmacies. Private pharmacies have the potential to contribute to Uganda’s fight against AMR if motivated and equipped with adequate knowledge to enhance their practices related to AMS.