Evidence map›Paper›PMID 28893243›Full record

ArticleBMC health services research2017

Impact of pharmacy worker training and deployment on access to essential medicines for children under five in Malawi: a cluster quasi-experimental evaluation.

Joseph B Babigumira, Solomon J Lubinga, Alisa M Jenny, Erin Larsen-Cooper, Jessica Crawford, Charles Matemba, Andy Stergachis

Open access · goldAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Joseph B BabigumiraGlobal Medicines Program, Departments of Global Health and Pharmacy, University of Washington, Harris Hydraulics Building 1510 San Juan Road, Box 357965, Seattle, WA, 98195, USA. babijo@uw.edu.ORCID http://orcid.org/0000-0003-3834-7141
Solomon J LubingaGlobal Medicines Program, Departments of Global Health and Pharmacy, University of Washington, Harris Hydraulics Building 1510 San Juan Road, Box 357965, Seattle, WA, 98195, USA.
Alisa M JennyGlobal Medicines Program, Departments of Global Health and Pharmacy, University of Washington, Harris Hydraulics Building 1510 San Juan Road, Box 357965, Seattle, WA, 98195, USA.
Erin Larsen-CooperVillageReach, Seattle, WA, USA.
Jessica CrawfordVillageReach, Lilongwe, Malawi.
Charles MatembaVillageReach, Lilongwe, Malawi.
Andy StergachisGlobal Medicines Program, Departments of Global Health and Pharmacy, University of Washington, Harris Hydraulics Building 1510 San Juan Road, Box 357965, Seattle, WA, 98195, USA.
University of Washington · USVillageReach · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPoor access to essential medicines is common in many low- and middle-income countries, partly due to an insufficient and inadequately trained workforce to manage the medicines supply chain. We conducted a prospective impact evaluation of the training and deployment of pharmacy assistants (PAs) to rural health centers in Malawi.

methodsA quasi-experimental design was used to compare access to medicines in two districts where newly trained PAs were deployed to health centers (intervention) and two districts with no trained PAs at health centers (comparison). A baseline household survey and two annual post-intervention household surveys were conducted. We studied children under five years with a history of fever, cough and difficulty in breathing, and diarrhea in the previous two weeks. We collected data on access to antimalarials, antibiotics and oral rehydration salts (ORS) during the childrens' symptomatic periods. We used difference-in-differences regression models to estimate the impact of PA training and deployment on access to medicines.

resultsWe included 3974 children across the three rounds of annual surveys: 1840 (46%) in the districts with PAs deployed at health centers and 2096 (53%) in districts with no PAs deployed at health centers. Approximately 80% of children had a fever, nearly 30% had a cough, and 43% had diarrhea in the previous two weeks. In the first year of the program, the presence of a PA led to a significant 74% increase in the odds of access to any antimalarial, and a significant 49% increase in the odds of access to artemisinin combination therapies. This effect was restricted to the first year post-intervention. There was no effect of presence of a PA on access to antibiotics or ORS.

conclusionThe training and deployment of pharmacy assistants to rural health centers in Malawi increased access to antimalarial medications over the first year, but the effect was attenuated over the second year. Pharmacy assistants training and deployment demonstrated no impact on access to antibiotics for pneumonia or oral rehydration salts for diarrhea.

Indexed as

Health Services AccessibilityPharmaceutical ServicesAdultChild, PreschoolCluster AnalysisDrugs, EssentialFemaleHealth Care SurveysHealth PersonnelHumansInfantMalawiMaleProgram EvaluationProspective StudiesYoung AdultDrugs, EssentialDiarrheaEssential medicinesHealth workforceImpact evaluationMalariaMalawiPneumoniaQuasi-experimentSupply chain

Identifiers

PMID28893243
PMCPMC5594492
OpenAlexW2756339822

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.