Tanzania is located in the Eastern part of Africa. It is among the poorest countries in the world whereby the majority of the rural population is living on less than a dollar per day. It has a population of 35 million with about 80% living in rural area depending on subsistence farming. Majority of the urban population are engaged in micro and small business to earn their living. Tanzania has 21 regions, 119 districts and 2,766 wards which form 8 zones as per Ministry of Health and Social Welfare description. Among the indicators of abject poverty is failure of being able to access quality primary health care for a majority of the people, particularly those in rural and peri-urban areas. This has lead to reduced economic growth due to disease burden, reduced life expectancy, maternal, child and adult mortalities; and high medical services costs at both individual citizen and the government levels.
Among the components of quality primary health care is access to essential medicines and other health commodities. In view of the fact that there are a limited number of health facilities and pharmacies countrywide, particularly in rural and peri-urban areas, a provision was made under the repealed Pharmaceuticals and Poisons Act, 1978, for establishment of Part II Poisons shops. Such shops were allowed to sell non-prescription medicines to supplement services provided by health facilities, including pharmacies. It is estimated that, there are 10,000 Part II Poisons shops which deliver approximately 80% of the medicines and health commodities provided by private drug outlets by June 2009.
A countrywide inspections conducted by the then Pharmacy Board and an assessment conducted by Management Science for Health (MSH) and Tanzania Food and Drugs Authority (TFDA) in 2001 revealed a number of anomalies regarding operations of the Part II Poisons shops which call for redress. Anomalies found including selling of unauthorized medicines, dispensing of medicines by unqualified personnel, and inadequate record keeping. Other anomalies are weak regulatory system, poor and inadequate storage and dispensing space with no cooling facilities and uneven distribution of shops geographically resulting in limited access to essential affordable, quality, safe and effective medicines in rural, peri-urban and underserved urban communities.
In view of this state of affair TFDA, in the year 2002 derived a comprehensive and holistic approach to the problem by devising an Accredited Drug Dispensing Outlet (ADDO) program as an initiative to address such identified anomalies. The program establishes a network of Accredited Drug Dispensing Outlets (ADDOs), popularly known as Duka la Dawa Muhimu (DLDM), to provide essential medicines and other health supplies to ensure that Tanzanians living in rural, peri-urban, and underserved urban communities have the opportunity to purchase quality, affordable non-prescription and a limited number of prescription medicines from regulated and properly operated drug outlets staffed by trained and supervised drug dispensers.
Under the program, training is being provided to dispensers on management and dispensing medicines, hygiene, record keeping whereby owners are trained in business management and ADDO regulations. Also premises standards are improved by owners before can be accredited, the general community is sensitized to use services from approved premises and enforcement of the standards has been delegated to Local Authorities. The program was first launched in Ruvuma region in August 2003 and has been extended to other 12 regions by December 2009.
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