title: Establishment of drug chests in commune health stations in Vietnam, Bamako Initiative.
abstract: In remote areas in Vietnam essential drugs are often not available. Some of the reasons are inadequate resources and failure of distribution. All activities at the health stations are very weak, partly because of inappropriate usage of drugs and lack of fund for buying drugs. The object of the project was to establish sustainable provision of essential drugs for commune health stations in rural areas, to teach the health personnel the importance of essential drugs and to create incentives for the staff and a certain surplus for other health activities. Four District Health Centers (DHC) and 10 Health Stations (HS), 2-4 in each DHC were selected. A pharmacist was made monitor of the project. The health personnel were trained in proper use of drugs, drug prescription, price setting, book keeping and management of pharmacy. Written guidelines were produced. One person was responsible for the drug chest at each HS. After recognizing the aim of the project and signing the contract by which the responsible person was bound, the initial capital was given free. The DHC was responsible for the supervision and advice to the HS. Reporting on prescribed drugs, buying and selling price, profit and fund left took place monthly. Monitoring of recovery of capital, turnover rate, rate of essential drugs and incentives for staff were monitored on forms and quarterly collected by the monitor on his visits. The HS were visited half-yearly by a steering group. All ten HS had been able to establish and maintain the pharmacy and to fully recover or even increase the capital and to create a surplus. Seven out of ten HSs had a turnover rate of more than one. The rate of essential drugs sold was more than 60% in seven pharmacies. The interest rate of 18% on average was used for incentives for staff, to provide drugs for those who cannot pay and for equipment for the HS. The cooperation between the DHC and the HS became closer. Establishment of drug chests seems to be a reasonable strategy of reinforcing primary health. Much attention should be paid on training of staff, monitoring, supervision and integration of health services.
authors.affiliation: Pediatric Hospital No.1, Ho Chi Minh City, Vietnam.
authors.forename: T T
authors.initials: TT
authors.lastname: Tran
authors.forename: T N
authors.initials: TN
authors.lastname: Nguyen
authors.forename: T
authors.initials: T
authors.lastname: Le
authors.forename: C H
authors.initials: CH
authors.lastname: Truong
authors.forename: K
authors.initials: K
authors.lastname: Mogensen
authors.forename: E
authors.initials: E
authors.lastname: Andersen
mesh_terms: D000488:Allied Health Personnel / Q000193:education; D003153:Community Health Services / Q000458:organization & administration*; D003157:Community Pharmacy Services / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D007182:Income; D011320:Primary Health Care / Q000458:organization & administration; D012424:Rural Population; D014744:Vietnam