Factors affecting availability of artemisinin-based combination therapy in private drug outlets in Tororo district, Uganda.
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Background: Uganda has a high malaria burden, with reported 30 to 50 percent malaria-related outpatient visits. However, about 60% of patients seek treatment from private drug outlets. In response to this challenge, the Government of Uganda implemented a national Affordable Medicines Facility malaria (AMFm) pilot subsidy to increase availability and access of ACT in public and private sectors. This study sought to assess the impact of AMFm program in private drug outlets in Tororo district. Study Objective: To determine factors associated with availability of subsidised ACT in private drug outlets in Tororo district in order to recommend practical interventions to improve availability of ACT in the private sectors. Methods: A cross-sectional survey was conducted in 98 randomly selected private drug outlets and 3 wholesale pharmacies in Tororo district. Data was collected using interviewer-administered questionnaires for outlet attendants, anti-malarial drug audits and a total of 253 outlet customers were selected to participat in exit interviews, at selected drug outlets. Results: Ninety-three percent of drug outlets were stocking ACT; with 73.6% of drug outlets stocked subsidised ACT and 13.6% were selling Chloroquine. Factors significantly associated with availability of subsidised ACT were; anti-malarial drugs trainings (AOR=3.72; 95% CI 1.77 - 8.93), customer demand (AOR=2.98; 95% CI 3.87 - 7.21), attendants who had heard about subsidised ACT before (AOR=4.41; 95% CI 2.07 - 7.68), local wholesale pharmacies that provided information on subsidised ACT (AOR=2.57; 95% CI 1.07 - 8.63) and if an outlet were a drug shop (AOR=3.83; 95% CI 1.61 – 6.67). There was low (4%) awareness of AMFm subsidy program among drug outlet customers in Tororo district Conclusion: AMFm-subsidised anti-malarial drugs are widely available in private drug outlets. However, there is low awareness of AMFm subsidy program among the drug outlet customers in Tororo district. The Uganda ministry of health should implement immediate public campaigns to raise awareness on the AMFm program in Tororo district.