Mapping access to drug outlets in Vietnam: distribution of drug outlets and the sociodemographic characteristics of the communities they serve.

Autor:	Beardsley J; University of Sydney Infectious Disease Institute, Sydney, NSW, Australia., Chambers JM; Faculty of Medicine and Health, University of Sydney, Australia., Lam TT; Woolcock Institute of Medical Research, Hanoi, Vietnam., Zawahir S; Woolcock Institute of Medical Research, Hanoi, Vietnam.; Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia., Le H; Woolcock Institute of Medical Research, Hanoi, Vietnam., Nguyen TA; Woolcock Institute of Medical Research, Hanoi, Vietnam., Walsh M; Sydney School of Public Health and Sydney Institute of Infectious Diseases, University of Sydney, Australia.; Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India., Thuy Van PT; Hanoi University of Pharmacy, Hanoi, Vietnam., Cam Van NT; Woolcock Institute of Medical Research, Hanoi, Vietnam., Hoang TH; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam., Mai Hung TT; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam., Thai CH; Medical Service Administration, Ministry of Health, Vietnam., Anh DD; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam., Fox GJ; Woolcock Institute of Medical Research, Hanoi, Vietnam.; Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Western Pacific [Lancet Reg Health West Pac] 2022 Dec 30; Vol. 30, pp. 100668. Date of Electronic Publication: 2022 Dec 30 (Print Publication: 2023).
DOI:	10.1016/j.lanwpc.2022.100668
Abstrakt:	Background: Drug outlets are a vital first point of healthcare contact in low- and middle-income countries (LMICs), but they are often poorly regulated and counter staff may be unqualified to provide advice. This introduces the risk of easy access to potentially harmful products, including unnecessary antimicrobials. Over-the-counter antimicrobial sales are a major driver of antimicrobial resistance (AMR) in LMICs. We aimed to investigate the distribution of different types of drug outlets and their association with socio-economic factors. Methods: We mapped the location of drug outlets in 40 randomly selected geographic clusters, covering a population of 1.96 million people. Data including type of drug outlet, context, operating hours, chief pharmacist name and qualification, and business registration identification were collected from mandatory public signage. We describe the density of drug outlets and levels of staff qualifications in relation to population density, urban vs rural areas, and poverty indices. Findings: We characterised 1972 drug outlets. In the study area, there was an average of 102 outlets/per 100,000 population, compared to the global average of 25. Predictably, population density was correlated with the density of drug outlets. We found that drug outlets were less accessible in rural vs urban areas, and for the poor. Furthermore, for these populations, degree-qualified pharmacists were less accessible and public signage frequently lacked mandatory registration information. Interpretation: Drug outlets appear over-supplied in Vietnam compared to other countries. Unregistered outlets and outlets without degree-qualified pharmacists are prevalent, especially in poor and rural areas, posing a risk for inappropriate supply of antimicrobials, which may contribute to AMR, and raises questions of equitable healthcare access. Funding: This study was funded by a grant from the Australian Department of Foreign Affairs and Trade. Competing Interests: The authors declare that they have no conflict interests. (© 2022 The Author(s).)
Databáze:	MEDLINE
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