Provider characteristics among staff providing care to sexually transmitted infection self-medicating patients in retail pharmacies in Kibera slum, Nairobi, Kenya.
OBJECTIVE
To evaluate the characteristics of providers in management of STI self-medicating patients in retail pharmacies within the largest informal settlement in Kenya.


METHODS
We collected sociodemographic, training, and work history attributes among pharmacy staff from a convenience sample of 50 retail pharmacies in Kibera slum using a self-administered questionnaire. We gathered the required data in 8 weeks, collecting completed self-administered questionnaires within 7 to 14 days after distribution. Two data collectors subsequently presented at these pharmacies as mystery patients seeking care for symptoms of genital ulcer disease and gonorrhea and completed a structured observation form within 10 minutes of leaving the pharmacy.


RESULTS
Approximately half the respondents were men aged less than 28 years. Over 90% had 12 years of formal education and an additional 3 years of medical professional training. Two thirds (66%) had been trained in Government institutions. About 65% reported that patients presented without prescriptions, and 45% noted that patients requested specific medicines but were open to advice. One-third (36%) of the patients used the pharmacy as their first point of care. Using mystery patients to evaluate syndromic management of gonorrhea and genital ulcer disease, only 10% offered appropriate treatment per the Kenya Ministry of Health STI syndromic management guidelines.


CONCLUSIONS
Although the majority of the pharmacy staff in this informal settlement have some medical training and some experience, a very low proportion offered adequate treatment for 2 common STIs.
Kwena
Zachary
Z
Centre for Microbiology Research, Kenya Medical Research Institute, University of Nairobi, Nairobi, Kenya. zkwena@kemri-ucsf.org
Sharma
Anjali
A
Wamae
Njeri
N
Muga
Charles
C
Bukusi
Elizabeth
E
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006069:Gonorrhea / Q000517:prevention & control; D019983:Guideline Adherence; D006801:Humans; D007630:Kenya; D008297:Male; D010593:Pharmaceutical Services / Q000592:standards* / Q000706:statistics & numerical data; D010594:Pharmacies / Q000706:statistics & numerical data; D010595:Pharmacists / Q000706:statistics & numerical data*; D012646:Self Administration; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D000078329:Workforce
D000900:Anti-Bacterial Agents