Assessment of community pharmacies readiness to dispense antiretroviral medicines in Rwanda

Abstract

Since the introduction of the ‘’Test and Treat’’ approach in HIV management, different strategies have been developed and implemented by countries to decongest public health facilities from big numbers of people visiting the sites for medicine refill and clinical follow up. The decentralized delivery of antiretroviral drugs, including dispensing through Community Pharmacies, is one of the strategies. In Rwanda, Community Pharmacies are not yet involved in ARVs dispensing, and no study has assessed their readiness to provide this service

This cross-sectional study has assessed the readiness of Community Pharmacy staff and infrastructure to implement a decentralized model of antiretroviral medicines dispensing in Rwanda. A sample of 262 Pharmacies was evaluated out of the 761 authorized Pharmacies.

The research has shown a high proportion of Community Pharmacy staff trained in HIV Prevention (82.4% trained on HIV testing), but a low level of training in treatment (30.5%) and psychosocial support of people living with HIV (29.8%). Infrastructure and storage conditions were also found to be adequate, with 99.6% of surveyed Pharmacies having sufficient storage space. Majority (93.9%) expressed their willingness to dispense ARVs in the Pharmacy premises. Staff willingness to dispense antiretroviral medicines was found to be associated with the training in HIV treatment and psychosocial care and support to people living with HIV. Community Pharmacies anticipate several potential benefits from their participation in ARVs distribution, essentially the likely increase in medicine sales (92.4%) and the development of HIV knowledge and skills (89.3%).

The Ministry of Health and the National HIV Control Program may adopt the model of antiretroviral medicine distribution through Community Pharmacies by leveraging the identified enabling factors, which include staff willingness to participate in the model and the Pharmacy readiness in terms of infrastructure and equipment. Mitigation of anticipated barriers should accompany effective implementation.