‘I know those people will be approachable and not mistreat us’: a qualitative study of inspectors and private drug sellers’ views on peer supervision in rural Uganda

Globalization and Health

Arthur Bagonza¹  Phyllis Awor¹  Henry Wamani¹  Milton Mutto²  Stefan Peterson³  Freddy Kitutu⁴  Andreas Mårtensson⁵  Linda Gibson⁶ 

[1] Department of Community Health and Behavioural Sciences, Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda;Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda;Department of Health Policy Planning and Management, Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda;Department of Women’s and Children’s Health, International Maternal and Child Health Unit, Uppsala University, Uppsala, Sweden;Department of Pharmacy, School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda;Department of Women’s and Children’s Health, International Maternal and Child Health Unit, Uppsala University, Uppsala, Sweden;School of Social Sciences, Nottingham Trent University, Nottingham, UK;

关键词: Drug sellers;    Inspection;    Pharmaceutical sector, peer supervision;    Grounded theory;    Uganda;   

DOI  :  10.1186/s12992-020-00636-6

来源: Springer

【 摘 要 】

BackgroundPeer supervision improves health care delivery by health workers. However, in rural Uganda, self-supervision is what is prescribed for licensed private drug sellers by statutory guidelines. Evidence shows that self-supervision encourages inappropriate treatment of children less than 5 years of age by private drug sellers. This study constructed a model for an appropriate peer supervisor to augment the self-supervision currently practiced by drug sellers at district level in rural Uganda.MethodsIn this qualitative study, six Key informant interviews were held with inspectors while ten focus group discussions were conducted with 130 drug sellers. Data analysis was informed by the Kathy Charmaz constructive approach to grounded theory. Atlas ti.7 software package was used for data management.ResultsA model with four dimensions defining an appropriate peer supervisor was developed. The dimensions included; incentives, clearly defined roles, mediation and role model peer supervisor. While all dimensions were regarded as being important, all participants interviewed agreed that incentives for peer supervisors were the most crucial. Overall, an appropriate peer supervisor was described as being exemplary to other drug sellers, operated within a defined framework, well facilitated to do their role and a good go-between drug sellers and government inspectors.ConclusionFour central contributions advance literature by the model developed by our study. First, the model fills a supervision gap for rural private drug sellers. Second, it highlights the need for terms of reference for peer supervisors. Third, it describes who an appropriate peer supervisor should be. Lastly, it elucidates the kind of resources needed for peer supervision.

【 授权许可】

CC BY