The objective of this study is to investigate the quality of drug prescript
ions in nine health centres of three districts in rural Burkina Faso. 313 o
utpatient consultations were studied by methods of guided observation. Addi
tionally interviews were held with the health care workers involved in the
study. A total of 793 drugs prescribed by 15 health care workers during the
observation period and 2815 prescribed drugs copied from the patient regis
ter were analyzed. An average of 2.3 drugs were prescribed per visit. 88.0%
of the prescribed drugs were on the essential drug list. 88.4% were indica
ted according to the national treatment guidelines. 79.4% had a correct dos
age. The study revealed serious deficiencies in drug prescribing that could
not be detected by assessing selected quantitative drug-use indicators as
recommended by the WHO. In two-thirds of the cases the patients received no
information on how long the drug had to be taken. Errors in dosage occurre
d significantly more often in children under 5 years. The combined analysis
of choice and dosage of drugs showed that 59.3% of all the patients receiv
ed a correct prescription. Seven out of 21 pregnant women received drugs co
ntraindicated in pregnancy.
We conclude that assessment of quantitative drug-use indicators alone does
not suffice in identifying specific needs for improvement in treatment qual
ity. We recommend that prescribing for children under 5 and for pregnant wo
men should be targeted in future interventions and that the lay-out, conten
t and distribution of treatment guidelines must be improved.