制约因素和信息差距在推动非洲四国风险性药品采购行为方面的作用。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Janelle M Wagnild, Nasima Akhter, Diana Lee, Babatunde Jayeola, Delese Mimi Darko, Moji Christianah Adeyeye, James P Komeh, David Nahamya, Adetayo Kasim, Kate Hampshire
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引用次数: 0

摘要

伪劣医药产品对公众健康和社会经济发展构成重大威胁,尤其是在中低收入国家。为此,各国开展了公众教育活动,提醒消费者注意假冒伪劣药品的风险,并提供 "更安全 "的做法指导,同时还采取了其他供需方面的措施。然而,在获得有质量保证药品的结构性制约因素依然存在的情况下,目前人们对此类活动的潜在效果知之甚少。本文分析了四个非洲国家(加纳、尼日利亚、塞拉利昂和乌干达;每个国家 n>1000 人)有关购药习惯、信息和限制因素的调查数据。通过使用多元回归和结构方程模型,我们首次尝试从统计学角度区分信息差距和结构性限制对公众接触自费药品的潜在影响。分析结果证实,条件较差的群体(包括农村居民、正规教育水平较低、未从事有偿工作、通常为女性、残疾或长期患病的家庭等)可能接触自费药品的比例过高;这些人口群体的认知水平往往较低,受到的限制也较多。尽管存在这些制约因素,但我们的模型表明,公共卫生教育在改变某些(而非所有)高风险做法方面可以发挥重要作用。因此,在打击自费药品的斗争中,目标适当的公共信息传播可以成为工具箱中有用的一部分,但它只有与影响更广泛的改革相结合才能有效发挥作用,以解决非洲药品供应链中更高层次的脆弱性,并扩大获得有质量保证的公共部门医疗服务的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of constraints and information gaps in driving risky medicine purchasing practices in four African countries.

Substandard and falsified (SF) medical products pose a major threat to public health and socioeconomic development, particularly in low- and middle-income countries. In response, public education campaigns have been developed to alert consumers about the risks of SF medicines and provide guidance on 'safer' practices, along with other demand- and supply-side measures. However, little is currently known about the potential effectiveness of such campaigns while structural constraints to accessing quality-assured medicines persist. This paper analyses survey data on medicine purchasing practices, information and constraints from four African countries (Ghana, Nigeria, Sierra Leone and Uganda; n > 1000 per country). Using multivariate regression and structural equation modelling, we present what we believe to be the first attempt to tease apart, statistically, the effects of an information gap vs structural constraints in driving potential public exposure to SF medicines. The analysis confirms that less privileged groups (including, variously, those in rural settlements, with low levels of formal education, not in paid employment, often women and households with a disability or long-term sickness) are disproportionately potentially exposed to SF medicines; these same demographic groups also tend to have lower levels of awareness and experience greater levels of constraint. Despite the constraints, our models suggest that public health education may have an important role to play in modifying some (but not all) risky practices. Appropriately targeted public messaging can thus be a useful part of the toolbox in the fight against SF medicines, but it can only work effectively in combination with wider-reaching reforms to address higher-level vulnerabilities in pharmaceutical supply chains in Africa and expand access to quality-assured public-sector health services.

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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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