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The number of dispensing doctors has increased in the last decade, but the implication of this trend on the quality of health care and drug use is unknown. We present a comparative drug utilization study of 29 dispensing doctors and 28 non-dispensing doctors in Zimbabwe based on standard indicators developed by the World Health Organization. Dispensing(More)
BACKGROUND Dispensing doctors (DDs) have been found to prescribe significantly more drugs, more injections and more antibiotics per patient than non-dispensing doctors (NDDs). However, the rationality of prescription in relation to diagnoses and symptoms has not been studied. OBJECTIVES To identify and assess differences in the rationality of(More)
Skin hypersensitivity was investigated in guinea-pig maximization tests with extracts from pellets of conventional polymethyl-methacrylate (PMMA) bone cements (Palacos R, Simplex RO) and a new methylmethacrylate/n-decylmethacrylate/isobornylmethacrylate (MMA/DMA/IBMA) mixture (Boneloc), but none of the three cements produced evidence of delayed contact(More)
The genotoxicity of conventional polymethylmethacrylate (PMMA) and a new formulation of bone cement: methylmethacrylate/n-decylmethacrylate/isobornylmethacrylate (MMA/DMA/IBMA) were tested by micronucleus test and reverse mutation assays of Salmonella typhimurium (Ames test). In extracts from cement pellets (37 degrees, 72 hr) with water and water/ethanol(More)
Ensuring the availability of essential drugs and using them appropriately are crucial if limited resources for health care are to be used optimally. While training of health workers throughout Zimbabwe in drug management (including stock management and rational drug use) resulted in significant improvements in a variety of drug use indicators, these(More)
BACKGROUND Uganda introduced a multipronged intervention, the supervision, performance assessment, and recognition strategy (SPARS), to improve medicines management (MM) in public and not-for-profit health facilities. This paper, the first in a series, describes the SPARS intervention and reports on the MM situation in Uganda before SPARS (baseline). (More)
BACKGROUND The reported results are part of an overall evaluation of drug management by dispensing (DDs) and non-dispensing doctors (NDDs). This study focuses on appropriate prescription. Other studies assess good pharmacy practice. Whereas rationality of prescription has been studied based on simple indicators, appropriate prescription in relation to(More)
Objective: To develop an indicator-based tool for systematic assessment and reporting of good pharmacy practice (GPP). Method: The tool comprises of a) a set of indicators, b) an indicator and survey manual, c) a data collection sheet, and d) Microsoft Excel based data collection and analysis tool. We developed a set of 34 pharmacy practice (PP) indicators(More)
BACKGROUND Since its inception, the Uganda National Drug Authority (NDA) has regularly inspected private sector pharmacies to monitor adherence to Good Pharmacy Practices (GPP). This study reports findings from the first public facility inspections following an intervention (SPARS: Supervision, Performance Assessment, and Recognition Strategy) to build GPP(More)
Very limited funds are available for expenditure on drugs in the public health sector in most African countries. For example, in Zimbabwe during the 1994–95 fiscal year, about US$5 was spent in the public sector on drugs and supplies per person. Ensuring the optimal use of these limited funds is one of the major challenges facing health managers. The study(More)