A baseline survey on use of drugs at the primary health care level in Bangladesh

The drug use pattern and the quality of care were assessed in 80 public sector facilities throughout rural Bangladesh. A total of 40 thana health complexes and 40 union subcentres, the lowest level in primary health care facilities, were selected at random. A total of 2880 prescriptions, consultations, and drug-dispensing practices were studied, and the availability and use of essential drugs and of the essential drugs list were recorded. The average consulting time (54 seconds), the proportion of adequate examinations (37%), and prescription of drugs according to standard treatment guidelines (41%) were unsatisfactory. The mean number of drugs prescribed per patient was 1.44; 25% were treated with antibiotics, and 17% with metronidazole, irrespective of the diagnoses. The availability of drugs (54%) and the presence of an essential drugs list (16%) in the health facilities were low. However, 78% of the drugs were prescribed by their generic names, 85% complied with the essential drugs list, and 81% were dispensed according to prescription. The average dispensing time (23 seconds) and the proportion of patients who correctly understood the dosage (55%) were poor.