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The impact of training on malaria treatment practices: a study of patent medicine vendors in Birnin-kebbi.
Abstract
Background: Patent medicine vendors are major providers antimalaria treatment in Nigeria. The management of malaria by this informal sector of healthcare delivery is however dominated by negative practices. This study determines the influence of training on antimalaria treatment practices of patent medicine vendors. Methods: Fifty-five patent medicine vendors selected through a multistage sampling technique in
Birnin-Kebbi were recruited into the study. Their baseline treatment practices were determined and the negative ones identified. Intervention training was instituted and its impact assessed using a
interviewer-administered questionnaire. Simulated visit mystery client survey which involved direct observation of patent medicine vendors practice was conducted after the intervention and the results
compared with self reported post intervention practices. Results: The negative practices identified included inappropriate dosage regimen, frequent unnecessary use of injectables and alteration of physicians’ prescriptions. Following the intervention training of the patent medicine vendors, the overall appropriate treatment practice score rose from baseline value of 3.6% to 45.5% (p<001). However, direct observation of treatment through mystery client survey showed no improvement, the appropriate treatment practice score being comparable to pre-intervention value (5.5% versus 3.6%; p>0.05) and significantly lower than the post training values (p<0.001). The results of the mystery client survey were comparable only to pre-intervention values, (5.5%) versus 2 (3.6%); p>0.05) and was significantly lower than the post intervention values (p<0.0001). Profit was the core factor underlying the negative practices among the patent medicine
vendors. Conclusion: Though single intervention training improves the knowledge of patent medicine vendors on the treatment of malaria, gaps persisted between knowledge and practice. Continuous training of
this group of informal healthcare givers is recommended.
Birnin-Kebbi were recruited into the study. Their baseline treatment practices were determined and the negative ones identified. Intervention training was instituted and its impact assessed using a
interviewer-administered questionnaire. Simulated visit mystery client survey which involved direct observation of patent medicine vendors practice was conducted after the intervention and the results
compared with self reported post intervention practices. Results: The negative practices identified included inappropriate dosage regimen, frequent unnecessary use of injectables and alteration of physicians’ prescriptions. Following the intervention training of the patent medicine vendors, the overall appropriate treatment practice score rose from baseline value of 3.6% to 45.5% (p<001). However, direct observation of treatment through mystery client survey showed no improvement, the appropriate treatment practice score being comparable to pre-intervention value (5.5% versus 3.6%; p>0.05) and significantly lower than the post training values (p<0.001). The results of the mystery client survey were comparable only to pre-intervention values, (5.5%) versus 2 (3.6%); p>0.05) and was significantly lower than the post intervention values (p<0.0001). Profit was the core factor underlying the negative practices among the patent medicine
vendors. Conclusion: Though single intervention training improves the knowledge of patent medicine vendors on the treatment of malaria, gaps persisted between knowledge and practice. Continuous training of
this group of informal healthcare givers is recommended.
