National AMR context
The rising issue of antimicrobial resistance (AMR) in Lao PDR poses a significant public health challenge. The establishment of the Global Antibiotic Resistance Partnership (GARP) committee, the endorsement of a national AMR policy, and the development of a strategic plan help to address and mitigate this growing threat. Laos’s National Strategic Plan for AMR aligns with the Global Action Plan, focusing on specific goals, including reducing infections, increasing prescription-based antibiotic sales, decreasing antimicrobial consumption, and improving public education on AMR. The Food and Drug Department (FDD) oversees enforcement related to pharmaceutical quality and regulation, but faces challenges in achieving targets, particularly in controlling antibiotic sales in private pharmacies. In most LMICs, private pharmacies are the patient’s first point of seeking treatment and the preferred channel to purchase medicine. Similarly, in Lao PDR, the private sector provides an important health service to communities, because of the economic reform policy and to improve the accessibility to medicine. However, the pharmacy services in Lao PDR are not adequately developed to support the healthcare system. Based on FDD consumer interaction and anecdotal information, satisfaction of consumers with the facilities and services received from private pharmacies is considered at a low level.
Problem
The primary issues identified in this project include the lack of specific gender and equity consideration in the management and dispensing of antimicrobials in private pharmacies. There is a recognised need to address disparities in access to antimicrobial treatment and promote health equity, especially in private pharmacies. Additionally, there is a knowledge gap regarding the impact of regulatory interventions on different genders, compounded by the absence of research on gender relations within the pharmacy sector in Lao PDR. Despite socio-economic changes since 1986, gender inequalities in household roles and professional opportunities persist. Thus far, no studies have examined gender and equity specifically in pharmacy practice in Lao PDR.
Project overview
To integrate gender and equity considerations into the existing AMR project, data collection and tools have been simplified to facilitate clearer implementation. KAP questionnaires were adapted to include a gender and equity context. Additionally, equity concepts are implicitly integrated into the training materials. The mystery client methodology will be implemented to assess sales practices, with plans include identifying trainers and interviewers, with an emphasis on promoting appropriate sales behaviors, such as requesting prescriptions and reducing antibiotic sales for viral symptoms. Therefore, this project aims to understand and provide a pathway to improve the role of gender and equity in private pharmacies in Lao PDR, and their incorporation of GPP to improve antibiotic sales and dispensing.
Solutions and outcomes
Findings and outcome will act as fundamental for FDD to further localize and improve gender and equity consideration in the pharmacists’ leadership of GPP implementation in private pharmacies in Lao PDR through:
- Improvement of draft GPP policy and methods
- Improvement of the capacity of GPP inspectors
- Improvement of the awareness and practices of the pharmacists
- Initiate, expand, and sustain a pharmacy model
