Drug retailer training: experiences from Nepal.

Area of Science:

• Public Health
• Pharmaceutical Policy
• Health Systems Research

Background:

• Informal drug sellers are a primary healthcare source in developing countries, offering convenience and accessibility.
• Self-medication via these channels can lead to ineffective, wasteful, or harmful outcomes.
• Limited regulatory capacity often hinders effective control of informal drug sales.

Purpose of the Study:

• To evaluate the feasibility and impact of a training program for informal drug retailers in Nepal.
• To address challenges of manpower shortages and unqualified drug dispensing in the informal sector.

Main Methods:

• Nepal's Department of Drug Administration established a 45-hour training course for drug retailers starting in 1981.
• The curriculum included pharmacology, ethics, drug storage, and legal aspects, with practical training.
• The program's administrative feasibility, cost-effectiveness, and acceptance were assessed.

Main Results:

• By 1989, 4096 drug retailers graduated; the course proved administratively feasible and popular.
• Geographic coverage was extensive despite logistical constraints, with an average cost of $18 per trainee.
• Professional groups, initially hesitant, came to accept the training program.

Conclusions:

• Focused training for drug retailers is a viable strategy to improve healthcare delivery in resource-limited settings.
• The Nepalese model demonstrates administrative feasibility and cost-effectiveness for similar initiatives in other developing countries.
• Future plans include refresher training on safe dispensing and appropriate patient referral.