Original Research

Exploring the knowledge, attitude, and practices of over-the-counter medical sellers in Ghana

Sam Simister, Nicholas Flint, Joshua Webb, Obed Nyarko, Aaron Secrest, Bethany Lewis, Ty Dickerson
Journal of Public Health in Africa | Vol 14, No 4 | a182 | DOI: https://doi.org/10.4081/jphia.2023.2122 | © 2024 Sam Simister, Nicholas Flint, Joshua Webb, Obed Nyarko, Aaron Secrest, Bethany Lewis, Ty Dickerson | This work is licensed under CC Attribution 4.0
Submitted: 06 April 2024 | Published: 30 April 2023

About the author(s)

Sam Simister, University of Utah, Salt Lake City, Utah, United States
Nicholas Flint, University of Utah, Salt Lake City, Utah, United States
Joshua Webb, University of Utah, Salt Lake City, Utah, United States
Obed Nyarko, Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana
Aaron Secrest, University of Utah, Salt Lake City, Utah, United States
Bethany Lewis, University of Utah, Salt Lake City, Utah, Ghana
Ty Dickerson, University of Utah, Salt Lake City, Utah, Ghana

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Abstract

Background: Rural areas in sub-Saharan Africa face a high prevalence and morbidity of skin disease while also lacking access to dermatologists. In Ghana, where approximately 25 licensed dermatologists are available for 25 million people, community pharmacies, called over-the-counter medical sellers (OTCMS), were established to respond to accessibility inequities, albeit without equitable training.

Objective: Our study evaluates the dermatologic knowledge, attitudes, and practices (KAP) of OTCMS in Ghana’s Ashanti Region.

Methods: To assess dermatologic KAP, we created a standardized questionnaire and recorded 13 interviews with OTCMS in seven communities. Interviews were completed with help from Ghanaian translators and transcripts were transcribed verbatim, then analyzed qualitatively to determine common themes for analysis.

Results:
This analysis identified six major themes: i) prescriber qualifications; ii) diagnostics; iii) therapeutics; iv) economics; v) health systems integration; vi) care-seeking behavior. Analysis of these themes outlined many cultural roles and challenges of OTCMS, including serving as the primary contact for dermatologic conditions in rural communities. While possibly necessary due to the lack of accessible dermatologists, this raises concerns for potential harm in diagnostic error and misuse of therapeutics due to the lack of formal dermatology training.

Conclusion
. In rural parts of Ghana, the KAP of OTCMS play a pivotal role in assessing and treating skin disease for those who might otherwise lack access to adequate dermatologic management. Furthermore, although our study identifies potential issues related to the roles played by OTCMS, it also suggests strategies to improve the dermatologic health of many Ghanaians by enhancing education and healthcare delivery in rural areas.


Keywords

Ghana; dermatology; public health; pharmacology

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