Exploring the knowledge, attitude, and practices of over-the-counter medical sellers in Ghana

Background and objectives: Rural areas in sub-Saharan Africa face a high prevalence and morbidity of skin disease while also lacking access to dermatologists. In Ghana, where approximately twenty-five licensed dermatologists are available for twenty-five million people, community pharmacies, called...

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Main Authors: Sam Simister, Nicholas Flint, Joshua Webb, Obed Nyarko, Aaron Secrest, Bethany Lewis, Ty Dickerson
Format: Article
Language:English
Published: PAGEPress Publications 2023-04-01
Series:Journal of Public Health in Africa
Subjects:
Online Access:https://jphia.btvb.org/jphia/article/view/2122
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author Sam Simister
Nicholas Flint
Joshua Webb
Obed Nyarko
Aaron Secrest
Bethany Lewis
Ty Dickerson
author_facet Sam Simister
Nicholas Flint
Joshua Webb
Obed Nyarko
Aaron Secrest
Bethany Lewis
Ty Dickerson
author_sort Sam Simister
collection DOAJ
description Background and objectives: Rural areas in sub-Saharan Africa face a high prevalence and morbidity of skin disease while also lacking access to dermatologists. In Ghana, where approximately twenty-five licensed dermatologists are available for twenty-five million people, community pharmacies, called over-the-counter medical sellers (OTCMS), were established to respond to accessibility inequities, albeit without equitable training. Our study evaluates the dermatologic knowledge, attitudes, and practices (KAP) of OTCMS in Ghana’s Ashanti Region. Methods: To assess dermatologic KAP, we created a standardized questionnaire and recorded thirteen interviews with OTCMS in seven communities. Interviews were completed with help from Ghanaian translators and transcripts were transcribed verbatim, then analyzed qualitatively to determine common themes for analysis. Results: Our analysis identified six major themes: 1) prescriber qualifications; 2) diagnostics; 3) therapeutics; 4) economics; 5); health systems integration; and 6) care-seeking behavior. Analysis of these themes outlined many cultural roles and challenges of OTCMS, including serving as the primary contact for the dermatologic conditions for rural communities. While possibly necessary due to the lack of accessible dermatologists, this raises concerns for potential harm in diagnostic error and misuse of therapeutics due to the lack of formal dermatology training. Conclusion: In rural parts of Ghana, the KAP of OTCMS play a pivotal role in assessing and treating skin disease for those who might otherwise lack access to adequate dermatologic management. Furthermore, although our study identifies potential issues related to the roles played by OTCMS, it also suggests strategies to improve dermatologic health of many Ghanaians by enhancing education and healthcare delivery in rural areas.
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spelling doaj.art-5b96866dd7324d8281827f3c59879abd2023-04-20T10:22:21ZengPAGEPress PublicationsJournal of Public Health in Africa2038-99222038-99302023-04-0110.4081/jphia.2023.2122Exploring the knowledge, attitude, and practices of over-the-counter medical sellers in GhanaSam Simister0Nicholas Flint1Joshua Webb2Obed Nyarko3Aaron Secrest4Bethany Lewis5Ty Dickerson6University of Utah, Salt Lake City, UtahUniversity of Utah, Salt Lake City, UtahUniversity of Utah, Salt Lake City, UtahMedical doctor, Department of Child Health; Komfo Anokye Teaching Hospital, KumasiVice Chair of Business Strategy for Dermatology, Assistant Professor of Dermatology and Population Health Sciences, The University of Utah, Salt Lake City, UtahAssistant Professor of Dermatology, The University of Utah, Salt Lake City, UtahProfessor (Clinical) of Pediatrics, Assistant Dean of Global Health Education, The University of Utah, Salt Lake City, Utah Background and objectives: Rural areas in sub-Saharan Africa face a high prevalence and morbidity of skin disease while also lacking access to dermatologists. In Ghana, where approximately twenty-five licensed dermatologists are available for twenty-five million people, community pharmacies, called over-the-counter medical sellers (OTCMS), were established to respond to accessibility inequities, albeit without equitable training. Our study evaluates the dermatologic knowledge, attitudes, and practices (KAP) of OTCMS in Ghana’s Ashanti Region. Methods: To assess dermatologic KAP, we created a standardized questionnaire and recorded thirteen interviews with OTCMS in seven communities. Interviews were completed with help from Ghanaian translators and transcripts were transcribed verbatim, then analyzed qualitatively to determine common themes for analysis. Results: Our analysis identified six major themes: 1) prescriber qualifications; 2) diagnostics; 3) therapeutics; 4) economics; 5); health systems integration; and 6) care-seeking behavior. Analysis of these themes outlined many cultural roles and challenges of OTCMS, including serving as the primary contact for the dermatologic conditions for rural communities. While possibly necessary due to the lack of accessible dermatologists, this raises concerns for potential harm in diagnostic error and misuse of therapeutics due to the lack of formal dermatology training. Conclusion: In rural parts of Ghana, the KAP of OTCMS play a pivotal role in assessing and treating skin disease for those who might otherwise lack access to adequate dermatologic management. Furthermore, although our study identifies potential issues related to the roles played by OTCMS, it also suggests strategies to improve dermatologic health of many Ghanaians by enhancing education and healthcare delivery in rural areas. https://jphia.btvb.org/jphia/article/view/2122Ghanadermatologypublic healthpharmacology
spellingShingle Sam Simister
Nicholas Flint
Joshua Webb
Obed Nyarko
Aaron Secrest
Bethany Lewis
Ty Dickerson
Exploring the knowledge, attitude, and practices of over-the-counter medical sellers in Ghana
Journal of Public Health in Africa
Ghana
dermatology
public health
pharmacology
title Exploring the knowledge, attitude, and practices of over-the-counter medical sellers in Ghana
title_full Exploring the knowledge, attitude, and practices of over-the-counter medical sellers in Ghana
title_fullStr Exploring the knowledge, attitude, and practices of over-the-counter medical sellers in Ghana
title_full_unstemmed Exploring the knowledge, attitude, and practices of over-the-counter medical sellers in Ghana
title_short Exploring the knowledge, attitude, and practices of over-the-counter medical sellers in Ghana
title_sort exploring the knowledge attitude and practices of over the counter medical sellers in ghana
topic Ghana
dermatology
public health
pharmacology
url https://jphia.btvb.org/jphia/article/view/2122
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