Health system actors’ perspectives of prescribing practices in public health facilities in Eswatini: A Qualitative Study

Rational medicines use (RMU) is the prescribing/dispensing of good quality medicines to meet individual patient's clinical needs. Policy-makers, managers and frontline providers play critical roles in safeguarding medicine usage thus ensuring their rational use. This study investigated perspect...

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Bibliographic Details
Published in:PloS one 2020-07, Vol.15 (7), p.e0235513-e0235513
Main Authors: Ncube, Nondumiso B. Q, Knight, Lucia, Bradley, Hazel Anne, Schneider, Helen, Laing, Richard, Thet Wai, Khin
Format: Article
Language:English
Subjects:
Behavior
Data collection
Drug stores
Evaluation
Guidelines
Health care
Health care facilities
Health facilities
Health sciences
Hospitals
Medical personnel
Medicine
Medicine and Health Sciences
Nurses
Patients
People and Places
Pharmaceuticals
Pharmacists
Physicians
Practice guidelines (Medicine)
Public health
Public sector
Qualitative reasoning
Qualitative research
Schneider, Richard
Technicians
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Summary:Rational medicines use (RMU) is the prescribing/dispensing of good quality medicines to meet individual patient's clinical needs. Policy-makers, managers and frontline providers play critical roles in safeguarding medicine usage thus ensuring their rational use. This study investigated perspectives of key health system actors on prescribing practices and factors influencing these in Eswatini. Public sector healthcare service delivery is through health facilities (public sector, not-for-profit faith-based, industrial) and community-based care. A qualitative, exploratory study using semi-structured in-depth interviews with seven policymakers and managers, and 32 facility-based actors was conducted. Drawing on Social Practice Theory, material (health system context), competence (provider) and cultural (patient and provider) factors influencing prescribing practices were explored. In Eswatini, prescribing practices are influenced by the interaction of factors (health system, provider and patient) that span levels (facility, region, and policy-making) of the health system. Promoting RMU thus goes beyond the availability of guidelines and provider training and requires concerted efforts of multiple stakeholders.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0235513