Assessment of community pharmacies readiness to dispense antiretroviral medicines in Rwanda

Figures & data

Table 1. Sociodemographic characteristics of the respondents.

Respondent designation	Frequency	Percent
Pharmacist	146	55.7
Nurse	116	44.3
Respondent qualification
Masters	6	2.3
Bachelor	154	58.8
A1	82	31.3
A2	20	7.6
Years of experience
<5 years	117	44.7
5–9 years	110	42.0
10+ years	35	13.4

A1: Advanced diploma.

A2: Secondary education certificate.

Table 2. Staff training on HIV prevention and management.

HIV prevention and management related training	Number of staff trained	Percent
HIV testing	216	82.4
Pre/post HIV test counselling	218	83.2
HIV self-testing	212	80.9
HIV post-exposure prophylaxis	140	53.4
HIV pre-exposure prophylaxis	114	43.5
Other HIV prevention methods	76	29.0
HIV treatment	80	30.5
Psychosocial care and support of PLHIV	78	29.8
ART medicine dispensing and adherence counselling	72	27.5
Clinical patient outcomes	33	12.6
No HIV related training	26	9.9
Average score		43.9

Table 3. Infrastructure and storage conditions in community pharmacies.

Infrastructure/storage conditions element	Compliant pharmacies	Percent
Protection of medicines from direct sunlight (painted glass, curtains, …)	262	100
CPs with roof maintained in good condition to avoid water penetration	261	99.6
CPs with sufficient and adequate storage space	261	99.6
Pharmacies with access limited to authorised personnel	258	98.5
CPs with no signs of pests/harmful insects/rodents in their premises	257	98.1
CPs with proven daily temperature monitoring	252	96.2
CPs having fire safety equipment	185	70.6

CPs: Community pharmacies.

Figure 1. Space availability for ARVs dispensing and patient counselling.

Figure 2. Staff willingness and cost implications related to ARVs dispensing.

Table 4. Association between staff willingness to dispense ARVs and their profession, qualification or working experience.

Demographic characteristics	Staff willing to embrace the proposal to dispensing ARVs
	No	Yes	Total	Chi-square test
Total	16	246	262	Pearson chi^2	P-value
Respondent professional belonging
Pharmacist	8	138	146	0.226	0.634
Nurses	8	108	116
Qualification
Masters	1	5	6	3.908	0.272
Bachelor	11	143	154
A1	2	80	82
A2	2	18	20
Years of experience
<5 years	4	113	117	2.671	0.263
5–9 years	9	101	110
10+ years	3	32	35

Table 5. Association between staff training and their willingness to dispense ARVs.

Training on HIV prevention and management	Staff willing to embrace the proposal to dispensing ARVs
	No	Yes	Total	Chi-square test
Total	16	246	262	Pearson chi^2	P-value
Trained on HIV testing
No	4	42	46	0.652	0.419
Yes	12	204	216
Trained on pre/post HIV test counselling
No	3	41	44	0.047	0.829
Yes	13	205	218
Trained on HIV post-exposure prophylaxis
No	3	47	50	0.001	0.972
Yes	13	199	212
Trained on HIV pre-exposure prophylaxis
No	8	140	148	0.292	0.589
Yes	8	106	114
Trained on other HIV prevention methods (VMMC)
No	12	174	186	0.133	0.715
Yes	4	72	76
Trained on HIV treatment
No	6	176	182	8.209	0.004
Yes	10	70	80
Trained on psychosocial care and support of PLHIV
No	7	177	184	5.715	0.017
Yes	9	69	78
Trained on ART medicine dispensing and adherence counselling
No	10	180	190	0.858	0.354
Yes	6	66	72
Trained on clinical patient outcomes
No	12	217	229	2.382	0.123
Yes	4	29	33

Table 6. Potential benefits for CPs to dispense antiretroviral medicines.

Potential benefits for CPs to dispense antiretroviral medicines	Frequency	Percent
Contribution to addressing the burden at health facility through decentralisation	219	83.6
Expanded participation of community pharmacies in public healthcare service provision	226	86.3
Eventual increase in over the counter and other non-HIV medicines uptake	242	92.4
Increased staff knowledge and skills through practice	234	89.3
More opportunities for training and staff capacity development	177	67.6

Table 7. Anticipated challenges to dispensing ARVs through CPs.

Anticipated challenges	Frequency	Percent
Cost of service	198	75.6
Increased workload	184	70.2
Skills gap	189	72.1
Lack of interoperable reporting systems	201	76.7
Defaulting patients	154	58.8
Counselling and confidentiality management	111	42.4