| dc.description.abstract | The World Health Organization recommends a focus on the six building blocks of a
health system in order to strengthen 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. If the drugs are not used rationally it
will adversely affect equity, quality, affordability and efficiency of the health care
system. It is evaluated that, in low-income and middle-income countries, 80% of
people with genuine psychiatric issues do not get the treatment that they require.
Accessibility of the psychotropic medicine may be one of the elements that is
attributed to inappropriate use of these medicines and is seen to lead to inflated
treatment costs, mortality, and morbidity and may be a 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 focus 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 National 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 old, 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), patient care 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
/hospitals. NHIF ought to consider covering mental health as part of the benefit
package to enhance affordability of psychiatric services. | en_US |
