Barriers and facilitators for integration of guidelines on operating health shops: a case of family planning services

Abstract Background The Zambia Medicines Regulatory Authority (ZAMRA) piloted the implementation of Guidelines on Operating Health Shops in Zambia in 2016, with a view to making basic medicines more accessible to communities. The guidelines aim to transform ordinary drug shops into health shops, whi...

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Autores principales:	Joseph M. Zulu, Doreen Sitali, Zubin Cyrus Shroff, Geetanjali Lamba, George Sichone, Charles Michelo, Chileshe H. Mpandamabula, Wesely Mwambazi, Cecilia Mwenda, Malizgani P. Chavula
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Health shops Guidelines Integration Health system Zambia Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/442b96c10b804bb7be85555a5b9fce27
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spelling	oai:doaj.org-article:442b96c10b804bb7be85555a5b9fce272021-11-21T12:03:06ZBarriers and facilitators for integration of guidelines on operating health shops: a case of family planning services10.1186/s40545-021-00337-42052-3211https://doaj.org/article/442b96c10b804bb7be85555a5b9fce272021-11-01T00:00:00Zhttps://doi.org/10.1186/s40545-021-00337-4https://doaj.org/toc/2052-3211Abstract Background The Zambia Medicines Regulatory Authority (ZAMRA) piloted the implementation of Guidelines on Operating Health Shops in Zambia in 2016, with a view to making basic medicines more accessible to communities. The guidelines aim to transform ordinary drug shops into health shops, which are dispensing facilities permitted to sell a ZAMRA-prescribed list of medicines over the counter. However, studies that explore the integration and uptake of guidelines into the health system are lacking. This study aims to inform future improved implementation of these guidelines by examining the current acceptability of guidelines within the Zambian health system, especially in relation to family planning services. Methodology Data collected through documentary review, key informant interviews with district pharmacists, staff from ZAMRA and in-depth interviews with 24 health shop owners and dispensers were analyzed using thematic analysis. A conceptual framework on the integration of health innovations into health systems guided the analysis. Results The Guidelines on Operating Health Shops were implemented to address the problem of inadequate access to quality medicines especially in rural areas. Factors that facilitated the acceptability of the guidelines included their perceived relevance and simplicity, comprehensive training and improved knowledge among health shop operators on the guidelines, development of a governance and reporting structure or steering committee at the national level as well as perceived improved health outcomes at the community level. Factors that hindered acceptability of the guidelines included the high cost of implementing them, a restricted list of drugs which affected consumer choice, limited communication between the local council and the operators of health shops, health shop owners not owning the health shop premises restricting their ability to adapt the building, and cultural norms which constrained uptake of family planning services. Conclusion In addition to training, facilitating the acceptability of the guidelines among health shop owners requires paying attention to operational issues such as location, ownership of the shop, size of infrastructure as well as financial costs of implementing guidelines through decentralizing the registration process and thus reducing the cost of registration. It is also important to have effective communication strategies between operators and the regulators of health shops.Joseph M. ZuluDoreen SitaliZubin Cyrus ShroffGeetanjali LambaGeorge SichoneCharles MicheloChileshe H. MpandamabulaWesely MwambaziCecilia MwendaMalizgani P. ChavulaBMCarticleHealth shopsGuidelinesIntegrationHealth systemZambiaTherapeutics. PharmacologyRM1-950Pharmacy and materia medicaRS1-441ENJournal of Pharmaceutical Policy and Practice, Vol 14, Iss S1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Health shops Guidelines Integration Health system Zambia Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441
spellingShingle	Health shops Guidelines Integration Health system Zambia Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441 Joseph M. Zulu Doreen Sitali Zubin Cyrus Shroff Geetanjali Lamba George Sichone Charles Michelo Chileshe H. Mpandamabula Wesely Mwambazi Cecilia Mwenda Malizgani P. Chavula Barriers and facilitators for integration of guidelines on operating health shops: a case of family planning services
description	Abstract Background The Zambia Medicines Regulatory Authority (ZAMRA) piloted the implementation of Guidelines on Operating Health Shops in Zambia in 2016, with a view to making basic medicines more accessible to communities. The guidelines aim to transform ordinary drug shops into health shops, which are dispensing facilities permitted to sell a ZAMRA-prescribed list of medicines over the counter. However, studies that explore the integration and uptake of guidelines into the health system are lacking. This study aims to inform future improved implementation of these guidelines by examining the current acceptability of guidelines within the Zambian health system, especially in relation to family planning services. Methodology Data collected through documentary review, key informant interviews with district pharmacists, staff from ZAMRA and in-depth interviews with 24 health shop owners and dispensers were analyzed using thematic analysis. A conceptual framework on the integration of health innovations into health systems guided the analysis. Results The Guidelines on Operating Health Shops were implemented to address the problem of inadequate access to quality medicines especially in rural areas. Factors that facilitated the acceptability of the guidelines included their perceived relevance and simplicity, comprehensive training and improved knowledge among health shop operators on the guidelines, development of a governance and reporting structure or steering committee at the national level as well as perceived improved health outcomes at the community level. Factors that hindered acceptability of the guidelines included the high cost of implementing them, a restricted list of drugs which affected consumer choice, limited communication between the local council and the operators of health shops, health shop owners not owning the health shop premises restricting their ability to adapt the building, and cultural norms which constrained uptake of family planning services. Conclusion In addition to training, facilitating the acceptability of the guidelines among health shop owners requires paying attention to operational issues such as location, ownership of the shop, size of infrastructure as well as financial costs of implementing guidelines through decentralizing the registration process and thus reducing the cost of registration. It is also important to have effective communication strategies between operators and the regulators of health shops.
format	article
author	Joseph M. Zulu Doreen Sitali Zubin Cyrus Shroff Geetanjali Lamba George Sichone Charles Michelo Chileshe H. Mpandamabula Wesely Mwambazi Cecilia Mwenda Malizgani P. Chavula
author_facet	Joseph M. Zulu Doreen Sitali Zubin Cyrus Shroff Geetanjali Lamba George Sichone Charles Michelo Chileshe H. Mpandamabula Wesely Mwambazi Cecilia Mwenda Malizgani P. Chavula
author_sort	Joseph M. Zulu
title	Barriers and facilitators for integration of guidelines on operating health shops: a case of family planning services
title_short	Barriers and facilitators for integration of guidelines on operating health shops: a case of family planning services
title_full	Barriers and facilitators for integration of guidelines on operating health shops: a case of family planning services
title_fullStr	Barriers and facilitators for integration of guidelines on operating health shops: a case of family planning services
title_full_unstemmed	Barriers and facilitators for integration of guidelines on operating health shops: a case of family planning services
title_sort	barriers and facilitators for integration of guidelines on operating health shops: a case of family planning services
publisher	BMC
publishDate	2021
url	https://doaj.org/article/442b96c10b804bb7be85555a5b9fce27
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Barriers and facilitators for integration of guidelines on operating health shops: a case of family planning services

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