Promoting Appropriate Drug Use in Missionary Health Facilities in Cameroon - EDM Research Series No. 028
(1998; 80 pages) Ver el documento en el formato PDF
Índice de contenido
Ver el documentoAcknowledgements
Ver el documentoAbbreviations
Abrir esta carpeta y ver su contenidoExecutive summary
Ver el documento1. Introduction
Ver el documento2. Background
Ver el documento3. Literature review
Abrir esta carpeta y ver su contenido4. Objectives and significance
Abrir esta carpeta y ver su contenido5. Overall approach and design
Cerrar esta carpeta6. Results
Ver el documento6.1 Drug indicators
Ver el documento6.2 Patient care indicators
Ver el documento6.3 Health facility indicator
Ver el documento6.4 Prescriber characteristics
Ver el documento6.5 Dispenser characteristics
Abrir esta carpeta y ver su contenido7. Analysis
Abrir esta carpeta y ver su contenido8. Discussion
Abrir esta carpeta y ver su contenido9. Recommendations
Ver el documento10. Conclusion
Abrir esta carpeta y ver su contenido11. Appendices
Ver el documentoReferences
 

6.4 Prescriber characteristics

In general, CBC prescribing personnel, "screening nurses" and doctors were young and relatively well educated. The average age of CBC prescribing personnel was 38.5 years. Nearly 70% had at least a secondary school education. However, there was a marked difference between the mean age of staff in hospitals and busy clinics, and in less busy clinics. At the hospitals and busy clinics the average age of prescribing staff was 41.2 years, while in less busy rural clinics the average age of prescribers was 33.2 years. In those clinics with a younger staff there was a higher level of formal education; the majority of prescribers at the less busy rural clinics had at least a secondary school education.

Prescribers had worked with the CBC in various capacities on average for 15 years. Those prescribers who had worked with the CBC for a longer time were located in hospitals and busier clinics. For example, prescribers at one busy clinic had 25.2 years on average with the CBC, while in two less busy clinics personnel had only 7.0 average years. Regarding job-specific experience, prescribers had at least 9.0 years experience "screening" patients. Again, the most experienced prescribers were located in the hospitals and busier clinics (13.4 years), and the less experienced prescribers located in less busy clinics (0.4 years).

Fifty-six percent (56.8%) of CBC prescribing personnel had participated in a "screening course". The screening courses offered by the CBC were a three-month, six-week, one-week or four-day course on history taking, physical examination, diagnosis and prescription for common illnesses. CBC personnel had an average of 6.1 weeks of training on diagnosis and prescription (excluding doctors) and had received that training 66.7 months (more than five years) ago. Excluding the hospitals, busy clinics on average had more personnel with training in diagnosis and prescription. In the three busiest clinics (seeing more than 100 patients per day) all prescribing staff had taken a screening course with the CBC. In contrast, in less busy clinics (seeing less than 30 patients per day) only half of the prescribing staff had taken the screening course. In general, personnel who participated in training reported being very satisfied with the amount and relevancy of knowledge gained from the training (average 6.6 on a scale of 1-7). Findings are summarized in Table 5 and given in detail in Appendix 10.

Table 5. Prescriber characteristics

n = 44

Average age

% with secondary schooling

Average years screening experience

% of personnel with screening course*

% of personnel with standard treatment guidelines course

Average weeks training**

Average months since training

CBC health facilities overall average

38.5

68.2

9.0

56.8

52.3

6.1

66.7

Range of data collected

             

highest

47.7

100

13.4

100

100

13.0

131.0

lowest

27.0

0

0.4

0

0

0.0

24.0

* Includes doctors.
** Excludes doctors.

Most prescribers reported receiving at least some supervision (54.5%), but stated that they received on-site or off-site supervision only as needed (as determined by the prescriber), and not regularly (yearly, monthly, weekly, etc.). Supervision was considered less helpful than training, receiving 5.8 on a scale of 1-7. A more useful source of supervision mentioned was doctor's clinics. Depending on the facility, doctor's visits were daily (in hospitals), monthly, bimonthly or twice annually. In general, hospitals and busy clinics had more frequent doctor's visits while isolated rural clinics, both moderately busy and less busy, received less frequent visits.

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