The role of Veterinary Retail Drug Outlets in the Provision of Primary Animal Health Care in Busia District, Kenya
The Government privatised animal health services in 1991 in a bid to improve the efficiency of delivery of veterinary services. Privatisation was however effected before the establishment of alternative suppliers outside the private sector and enactment of policies and standards that could assure the quality of animal health services provided. Since the public sector withdrew from providing animal health service, there has been an explosive development of retail drug outlets in most parts of the country offering drugs, insecticides and other veterinary inputs. Little is known about their numbers and capacities for effective delivery of these services. This study assessed the role of these outlets in the provision of veterinary drugs and advice on their use in Busia District. The main objective was to identify and characterise retail outlets for veterinary drugs in Busia District, Western Province and determine their role in the dissemination of veterinary knowledge and information on drug use following seller/buyer interactions. The study was carried out in three phases. In Phase 1, retail outlets for veterinary drugs were identified and their locations determined using Global Positioning Systems that recorded altitude, latitude and longitude. Their spatial distribution was analysed in Geographical Information Systems. Phase 2 involved shopkeeper interviews using a questionna,ire structured to collect information on the owners' details, manager/salespersons' details, shop and business details and clientele details. In the last Phase, questionnaires were administered to the clients who sought services from the outlets on client details, their livestock inventory, drugs purchased, reasons for purchase and choice of the shop and the common animal health problems encountered in their farms. Statistical analyses were done in Statistical Analysis System (SAS) software. Forty-one retail outlets were identified and classified into agro-veterinary (20) pharmacy (11) and general (10) shops. These outlets were found in towns and market centres. Seventy five percent of these outlets were owned by men, but sex was not associated (p = 0.45) with ownership of any type of outlet. The largest proportions of both agro-veterinary (37.5%, n = 10) and general shops (57%, n = 4) belonged to owners who had secondary education. In the majority of the shops, the owners preferred to employ shopkeepers who had either equivalent or lower levels of education. Therefore, 60% (n = 12), 55.5% (n = 5) and 62.5% (n = 5) of agroveterinary, general and pharmacy shops had salespersons with secondary education. Their main sources of veterinary information came from veterinarians and animal health assistants (AHAs) (35.1%, n = 13) and drug leaflets (32.4%, n = 12). A high proportion (74.4%, n = 61) of clients purchased drugs for their own livestock. Out of 102 drug purchases made, diminzene aceturate was the most frequently purchased individual drug type and it represented 17.6% (n = 18) of the total. The reasons for the drug purchases were classified into preventive versus both preventive curative purposes. The purchase of a preventive drug was significantly associated with ownership of pigs (p = 0.02) or grade cattle (p = 0.03) and living at a distance of > 15 km from a retail outlet (p = 0.05). The odds of buying a curative drug by pig and grade cattle owners were 6.42 (95% CI: 1.42,27.92) and 5.87 (95% CI: 1.13,30.45) times higher than non-pig and non-grade cattle owners, respectively. Living within a distance of 15 km from the shop was also associated with reduced odds of buying a preventive drug. Seventy-four percent (n = 61) of clients sought advice from the shop as they bought drugs. The odds of an AHA advice on drug use were low (OR = 0.15 [0.03.0.78; 95% Cl]) compared to a client who bought drugs for own use. There was a significant interaction between age and cattle keeping experience to predict whether a client sought advice or not. Age was negatively associated with the ability to seek advice from the shop. It was concluded from the study that private animal health providers stationed in the livestock drug stores in the District lacked technical skills needed for the provision of animal health services and consumer protection. Clients of the retail outlets in the District, more often than not, went for curative than preventive services. The Veterinary Department had a big role in advising the private health providers and farmers on the judicious use of veterinary drugs. Their offices could therefore act as drug information centres. Clear policies on delivery of clinical veterinary services were necessary to control the establishment of drug outlets and set standards for animal health providers stationed here.