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The overall conclusions
of this study were:
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1)
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The
drug-supply to the public sector in Satara District was a mere Rs.
5.6 million, as compared to the most minimum, reliable estimate of
a drug sale of Rs. 212.8 million in the private sector during 1991-92.
The drug supply especially to PHC and RHs suffers from chronic gross
shortages and haphazardousness. |
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2)
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The
overall quality of prescriptions of doctors both in public and private
sector is low. There is very high proportion of use of unnecessary,
irrational, hazardous drugs and unnecessary injections especially
in the private sector. Public sector prescriptions are more rational
than private sector prescriptions. Proportion of rational prescriptions
increases with educational qualifications.
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3) |
There
is very little of proper Continuing Medical Education (CME) of doctors.
This along with the influence of the Medical Representatives, increasing
prices drugs and competition amongst doctors, influence the prescriptions
of doctors in the private sector, whereas in the public sector,
the chronic shortage of drugs affects prescriptions, apart from
lack of proper CME.
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4)
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Knowledge
of PHC-nurses about the drugs they use is satisfactory as regards
indications and dosage but quite unsatisfactory as regards precautions
and side-effects. |
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5) |
Due to irrational
prescribing, 69 per cent and 55 per cent of the money spent on prescriptions
in the private and public sector respectively, is a waste, with
an average of 63 per cent. Projected to the Satara district level,
this wastage amounts to Rs.17.7 crores out of the total drug supply
of Rs.22 crores.
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6) |
Patients visiting government clinics in Satara district have to buy
15 per cent of the drugs prescribed to them, instead of getting all
drugs free. |
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7) |
If all the patients coming to the six PHC under study, were to be
adequately and rationally treated, there would be a drug-shortfall
of Rs. 30525.92 per PHC. This shortfall can be met by a mere 8.42
per cent increase in the annual recurring expenditure of Rs. 0.363
million per PHC. |
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8) |
If all the patients in Satara district were to be adequately and rationally
treated and if all children and women were to be fully covered in
the Mother and Child Health Programme in 1991-92, the drug-expenditure
would have been Rs. 20.61 crores, compared to the total drug expenditure
of Rs. 21.84 crores in Satara district. It is thus, not lack of resources,
but its irrational, wasteful use, which is responsible for the unmet
drug needs of the Satara district. |
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The
overall drug situation in Satara district is that of 'Poverty
Amidst Plenty'
- poor drug supply to the public sector, poor quality of prescriptions,
a lot of wastage of the adequate drug-expenditure incurred by the
people in Satara district.
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| Source:
Phadke et al. (1995) |
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