Access to medicines: Geographic information systems to map the availability of private pharmacies in Ujjain district, Central India Yogesh Sabde1+, Vishal Diwan1,3, V Saraf2, VK Mahadik1, Ayesha De Costa1,3 BACKGROUND In developing countries like India Private pharmacies constitute 75% of all the pharmacies Private pharmacies are one of the 1st points of acces to health care The characteristics of private pharmacies not documented before
STUDY AIMS
To map using GIS, the private pharmacies in Ujjain district
RESULTS
CONCLUSIONS The first mapping of private pharmacies in India revealed ► Urban dominance and concentration around physician practices ► Location on major roads allowed heat, dust and dirt into the premises
Ujjain district
► Tracer drugs available in 80% pharmacies ► Lack of qualified staff and requisite infrastructure ► Drugs dispensed without doctors prescription
To describe the characteristics of
POLICY IMPLICATIONS
mapped pharmacies
Need interventions to improve private pharmacy access for rural population
To study access to tracer drugs in these pharmacies
METHODS Design: Cross-sectional study Duration: July-Nov 2010 Participants: Private pharmacies in Ujjain district Intervention: Survey : With structured questionnaire to record location Infrastructure, human resource, medicines & clients Mapping: • Used geo-referenced digitized maps of Ujjain district & city • Private pharmacies and health providers plotted on the maps • Concentric ring buffers plotted around provider locations Affiliations 1R.D.Gardi
Medical College, Ujjain, India 2National Center for Human Settlement & Environment, Bhopal, India 3Division of Global Health (IHCAR) Karolinska Institutet, Sweden
+Presenting author: e-mail –
[email protected]
Legislation required to curb potential malpractice out of fierce competition in urban areas GIS mapping of private pharmacies in Ujjain city N = 486 private pharmacies; urban - 387 (79.6%) & rural - 99 (20.4%) Density (pharmacies/100,000 population): urban - 58.4, rural - 9.4 Pharmacies located within 0-50m from a health care provider - 78% Allopathic drugs dispensed at 95% of pharmacies and 50% had vaccines Tracer drugs availability - parenteral antibiotics (amoxicilin+clavulonate, cefotaxime) and injectable steroids - available in 83.7% and 88.7% pharmacies respectively Staff with formal pharmacist qualifications - 11.58% Availability of refrigerators, power supply and back up to power were erratic Clients without doctor’s prescription – 40%
Better implementation of the legislations for staffing and dispensing are highly needed
ACKNOWLEDGEMENTS • Management of R.D.Gardi Medical College Ujjain • Dr. D.N.Paliwal, Mr. A. Shrivastav and research team for field and GIS activity • Swedish Research Council, Stockholm for funding project • WHO/SEARO for support in ICIUM 2011 participation
