International Journal for Quality in Health Care Advance Access originally published online on May 5, 2005
International Journal for Quality in Health Care 2005 17(4):307-313; doi:10.1093/intqhc/mzi049
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Quality of pharmacies in Pakistan: a cross-sectional survey
1 World Health Organization, Campaign and Social Mobilization Cell, Islamabad, Punjab, Pakistan, 2 Aga Khan University, Biological and Biomedical Sciences, Karachi, Pakistan, 3 Pacific Health and Development Sciences, Victoria, British Columbia, Canada, 4 Aga Khan University, Department of Pharmacy, Karachi, Pakistan
Objective. To estimate the proportion of pharmacies meeting licensing requirements and to identify factors associated with these pharmacies in urban Rawalpindi, Pakistan.
Design. Cross-sectional questionnaire survey conducted during July–September 2001, of 311 pharmacies selected from a drug company list of 506.
Setting. Free-standing licensed and unlicensed pharmacies in urban Rawalpindi.
Study participants. A pharmacist or (if unavailable) the most experienced drug seller.
Results. The proportion of pharmacies meeting licensing requirements was 19.3% [95% C.I (confidence interval): 15.1, 24.2], with few qualified persons (22%). Only 10% had a temperature-monitoring device and 4% an alternative power supply for refrigerators (present in 76% of pharmacies). Associated with pharmacies meeting licensing requirements was the knowledge of not giving co-trimoxazole, a prescription drug, without prescription [OR (odds ratio) = 2.0; 95% CI: 1.1, 3.6], knowledge of the temperature range for vaccines (OR = 2.6; 95% CI: 1.4, 4.8), availability of vaccines (OR = 2.8; 95% CI: 2.8, 18.4), and alternative power supply for the refrigerator (OR = 6.0; 95% CI: 1.5, 23.7). The practice of selling drugs without prescription was not found to have a significant association (OR = 1.1; 95% CI: 0.5, 2.3); however, it did show a trend indicating discrepancy between knowledge and practice.
Conclusions. Most drug sellers had fragmentary knowledge regarding drug dispensing and storage, and improper dispensing practices. There is a need to enforce existing legislation with training programmes directed towards drug sellers and to involve the pharmaceutical industry, which plays an important role in influencing pharmacy knowledge and practices.
Keywords: drug sellers, licensing requirements, Pakistan, pharmacies
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Accepted for publication March 22, 2005.