Resource shortage in public health facilities and private pharmacy practices in Odisha, India.

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Bijetri Bose, Terence C Cheng, Anuska Kalita, Annie Haakenstaad, Winnie Yip
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Abstract

In low- and-middle-income countries (LMICs), private pharmacies play a crucial role in the supply of medicines and the provision of healthcare. However, they also engage in poor practices including the improper sale of medicines and caregiving beyond their legal scope. Addressing the deficiencies of private pharmacies can increase their potential contribution towards enhancing universal health coverage. Therefore, it is important to identify the determinants of their performance. The existing literature has mostly focused on pharmacy-level factors and their regulatory environment, ignoring the market in which they operate, particularly their relationship to existing public sector provision. In this study, we fill the gap in the literature by examining the relationship between the practices of private pharmacies and resource shortages in nearby public health facilities in Odisha, India. This is possible due to three novel primary datasets with detailed information on private pharmacies and different levels of public healthcare facilities, including their geospatial coordinates. We find that when public healthcare facilities experience shortages of healthcare workers and essential medicines, private pharmacies step in to fill the gaps created by adjusting the type and amount of care provision and medicine dispensing services. Moreover, the relationship depends on their location, with public facilities and private pharmacies in rural areas performing substitutive caregiving roles, while they are complementary in urban areas. This study demonstrates how policies aimed at addressing resource shortages in public health facilities can generate dynamic responses from private pharmacies, highlighting the need for thorough scrutiny of the interaction between public healthcare facilities and private pharmacies in LMICs.

印度奥迪沙邦公共卫生设施和私营药房的资源短缺问题。
在中低收入国家(LMICs),私营药店在药品供应和医疗保健服务方面发挥着至关重要的作用。然而,它们也存在一些不良行为,包括不当销售药品和超出法定范围提供护理服务。解决私营药店的不足之处可以提高其对加强全民医保的潜在贡献。因此,确定其绩效的决定因素非常重要。现有文献大多关注药房层面的因素及其监管环境,而忽视了它们所处的市场,尤其是它们与现有公共部门提供的服务之间的关系。在本研究中,我们通过考察印度奥迪沙邦私营药店的经营行为与附近公共医疗机构资源短缺之间的关系,填补了这一文献空白。这得益于三个新颖的原始数据集,其中包含私营药店和不同级别公共医疗机构的详细信息,包括它们的地理空间坐标。我们发现,当公共医疗机构出现医护人员和基本药物短缺时,私营药店会通过调整其提供的护理和配药服务的类型和数量来填补空缺。此外,这种关系还取决于它们所处的地理位置,在农村地区,公共医疗机构和私营药店发挥着替代性的护理作用,而在城市地区,它们则是互补的。这项研究强调了旨在解决公共医疗机构资源短缺问题的政策如何能够引起私营药店的动态反应,突出了对低收入和中等收入国家公共医疗机构与私营药店之间互动关系进行深入研究的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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