ASSESSMENT OF RATIONAL DRUG-USE AND PRESCRIBING IN PRIMARY HEALTH-CARE FACILITIES IN NORTH-WEST ETHIOPIA

A study on rational drug use was undertaken in nine health centres (HC s) and nine health stations (HSs) in Ethiopia, Prescribing, patient ca re and facility specific factors were measured using drug use indicato rs. Prescribing patterns of drugs were also assessed. With only few ex ceptions, the drug use indicators in HCs and HSs and between retrospec tive and prospective studies were similar despite differences in manpo wer and facilities, The average consultation time tin minutes) in HSs and HCs was 5.1+/-0.8 and 5.8+/-1.06, respectively. The dispensing tim e tin minutes) was 1.5+/-0.7 in HSs and 1.9+/-0.6 in HCs, Both patient care indicators seem to be adequate to influence patient satisfaction to the overall health service and patient knowledge of important dosa ge instructions. Most drugs (more than 89% in HCs and 71% in HSs) were actually dispensed from the health facilities and labelling was satis factory. Prescribing by generic names (average: 75% in HCs and 83% in HSs) was encouraging. While the availability of key drugs was ensured, essential documents were missing in most facilities or they were unpo pular for use, and those available required revision and updating. Pol ypharmacy in which the number of drugs/encounter was <2.5 was minimal, but that a large proportion of the prescriptions contained two or mor e drugs could result in adverse drug-drug interactions. The most frequ ently prescribed drugs were anti-infectives and analgesics accounting for over 76% in HCs and 82% in HSs and in most cases they are probably prescribed with little justification. The exposure of patients to ant ibiotics (average: 60% in HCs and 65% in HSs) was unacceptably high to justify epidemiological trends, The high exposure of patients to inje ctions, especially in the HSs (over 37%), should be seen from the heal th and economic points of view, The results revealed priority areas fo r intervention. They also provide standard references to compare drug use situations and their change over time in different settings, area and time in Ethiopia.