Examining characteristics, knowledge and regulatory practices of specialized drug shops in Sub-Saharan Africa: a systematic review of the literature.

BACKGROUND: Specialized drug shops such as pharmacies and drug shops are increasingly becoming important sources of treatment. However, knowledge on their regulatory performance is scarce. We set out to systematically review literature on the characteristics, knowledge and practices of specialized drug shops in Sub-Saharan Africa. METHODS: We searched PubMed, EMBASE, WEB of Science, CAB Abstracts, PsycINFO and websites for organizations that support medicine policies and usage. We also conducted open searches using Google Scholar, and searched manually through references of retrieved articles. Our search included studies of all designs that described characteristics, knowledge and practices of specialized drug shops. Information was abstracted on authors, publication year, country and location, study design, sample size, outcomes investigated, and primary findings using a uniform checklist. Finally, we conducted a structured narrative synthesis of the main findings. RESULTS: We obtained 61 studies, mostly from Eastern Africa, majority of which were conducted between 2006 and 2011. Outcome measures were heterogeneous and included knowledge, characteristics, and dispensing and regulatory practices. Shop location and client demand were found to strongly influence dispensing practices. Whereas shops located in urban and affluent areas were more likely to provide correct treatments, those in rural areas provided credit facilities more readily. However, the latter also charged higher prices for medicines. A vast majority of shops simply sold whatever medicines clients requested, with little history taking and counseling. Most shops also stocked popular medicines at the expense of policy recommended treatments. Treatment policies were poorly communicated overall, which partly explained why staff had poor knowledge on key aspects of treatment such as medicine dosage and side effects. Overall, very little is known on the link between regulatory enforcement and practices of specialized drug shops. CONCLUSIONS: Evidence suggests that characteristics and practices of specialized drug shops differ across rural and urban locations, and that these providers are highly responsive to client demand. However, there is a dearth in knowledge on how regulatory enforcement influences their characteristics and practices, and what strategies can be employed to strengthen the governance of the retail pharmaceutical sector

Children (but not women) first: New Labour, child welfare and gender

This article has been published in the journal, Critical Social Policy [© Sage]. The definitive version is available at: DOI: 10.1177/0261018306062588The paper’s starting point is an analysis of New Labour’s agenda for children in an emergent 'social investment state'. It provides an overview of policies for children, which simultaneously are investing in children and regulating children and their parents/mothers. Although children have moved to the heart of social policy, there is some disquiet about the way they are being positioned in this brave new world of social investment. This disquiet focuses in particular on: the construction of children as ‘becomings’ rather than ‘beings’; the paid work-focused and future-oriented model of citizenship; the relative neglect of groups of children who are not seen to represent such a good investment; and the eclipse of parents’, and in particular, mothers’ welfare. The final section sketches out how the social investment approach might be modified in the interests of children’s well-being and flourishing and with reference to principles of (gendered) social justice