| dc.description.abstract | The World Health Organization recommends a focus on
the six building blocks of a health system in order to strength
health systems. The focus of this study was medicines, vaccines
and technologies, with rational use of medicines of the
psychotropic variety being the area of interest. An equity, quality,
affordability and efficiency of the health care system hinders due
to inappropriate use of medicines. It is evaluated that, in lowincome and middle-income countries, 80% people with genuine
mental issues do not get the treatment that they require. Lack of
access to psychotropic medicine may be attributed to irrational use
of these medicines and is seen to lead to inflated treatment costs,
mortality, and morbidity and may be reason for undesirable drug
reactions or discouraging psychosocial impact. According to the
Ministry of Health, Kenya Mathari national teaching & referral
hospital is faced with non-availability of psychotropic medications
already on the essential drugs list. The main aim of the study was
to assess the health care provider’s perspective on factors
influencing rational use of psychotropic medicines in Mathari
National Teaching & Referral hospital in Nairobi, Kenya. This
was an institutional based cross sectional descriptive study. A
target population for this study was 125 prescribers and dispensers
who worked at Mathari Teaching and Referral hospital at the time
of study. For the study simple random sampling was used to draw
a sample size of 96 respondents. A structured five-point Likert
scale questionnaire was used to collect the data; the data was
analysed using SPSS version 23. Results showed that, 58 (62%)
were female, 45(49%) were 31-40 years, 60(65%) were doctors
and 47(51%) held a Bachelor's Degree, The coefficient of
correlation of prescribing practices (r=0.397, p<0.001),
patientcare factors (r=0.289, p=0.005), health facility factors
(r=0.446, p<0.001) and complementary factors (r=0.313,
p=0.002) showed a positive and significant relationship with
rational use of psychotropic medicines. In a combined relationship
Prescribing factors (p=0.006), Health Facility factors (p=0.011)
and Complementary factors (p=0.009), all had a significant
influence on the appropriate use of psychotropic medicines.
Efforts to improve the rational drug use would call for prioritized
improvement of health facility factors focusing on the supply
chain, followed by prescribing factors, complementary factors and
finally the patient care factors. This study recommends that:
Prescribers and dispensers ought to be provided with policy
guidelines for rational drug use, these are the guidelines for
standard treatment and a list of essential medicines, in addition to
the available medicines list. Training on the rational use of
psychotropic medicines for staff needs to be undertaken
frequently. In addition, new staff should undergo induction
training on the rational drug use as part of the orientation process.
Continuous education on use of Essential medicines should be
incorporated in health training institutions /hospital. NHIF the
Kenyan social health insurer ought to consider covering mental
health as part of the benefit package to enhance affordability of
psychiatric services. | en_US |
