Antimalarial stocking decisions among medicine retailers in Ghana: implications for quality management and control of malaria

Osman, Adams; Amoako Johnson, Fiifi; Mariwah, Simon; Amoako-Sakyi, Daniel; Asiedu Owusu, Samuel; Ekor, Martins; Hamill, Heather; Hampshire, Kate

Abstract

Global health efforts such as malarial control require efficient pharmaceutical supply chains to ensure effective delivery of quality-assured medicines to those who need them. However, very little is currently known about decision-making processes within antimalarial supply chains and potential vulnerabilities to substandard and falsified medicines. Addressing this gap, we report on a study that investigated decision-making around the stocking of antimalarial products among private-sector medicine retailers in Ghana. Licensed retail pharmacies and over-the-counter (OTC) medicine retail outlets were sampled across six regions of Ghana using a two-stage stratified sampling procedure, with antimalarial medicines categorised as ‘expensive,’ ‘mid-range,’ and ‘cheaper,’ relative to other products in the shop. Retailers were asked about their motivations for choosing to stock particular products over others. The reasons were grouped into three categories: financial, reputation/experience and professional recommendation. Reputation/experience (76%, 95% CI 72.0% to 80.7%) were the drivers of antimalarial stocking decisions, followed by financial reasons (53.2%, 95% CI 48.1% to 58.3%) and recommendation by certified health professionals (24.7%, 95% CI 20.3% to 29.1%). Financial considerations were particularly influential in stocking decisions of cheaper medicines. Moreover, pharmacies and OTCs without a qualified pharmacist were significantly more likely to indicate financial reasons as a motivation for stocking decisions. No significant differences in stocking decisions were found by geographical location (zone and urban/rural) or outlet (pharmacy/OTC). These findings have implications for the management of antimalarial quality across supply chains in Ghana, with potentially important consequences for malaria control, particularly in lower-income areas where people rely on low-cost medication.

Citation

Osman, A., Amoako Johnson, F., Mariwah, S., Amoako-Sakyi, D., Asiedu Owusu, S., Ekor, M., …Hampshire, K. (2023). Antimalarial stocking decisions among medicine retailers in Ghana: implications for quality management and control of malaria. BMJ Global Health, 6(Suppl 3), e013426. https://doi.org/10.1136/bmjgh-2023-013426

• Journal Article Type: Article
• Acceptance Date: Aug 12, 2023
• Online Publication Date: Sep 21, 2023
• Publication Date: 2023-09
• Deposit Date: Feb 8, 2024
• Publicly Available Date: Feb 8, 2024
• Journal: BMJ Global Health
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: Suppl 3
• Pages: e013426
• DOI: https://doi.org/10.1136/bmjgh-2023-013426
• Public URL: https://durham-repository.worktribe.com/output/2230318