Health workers require re-orientation on handling of medicines

The need to provide re-orientation for health workers in the handling of medicines, particularly those used for women during childbirth is being emphasised by experts in medicine quality and public health.

This need was reinforced when BusinessDay correspondent interviewed Chioma Ejekam, a public health physician, who works in the department of community health, Lagos University Teaching Hospital (LUTH). Ejekam, led a study on the quality of Oxytocins in the Nigerian market, assessing the clinical experiences of healthcare providers.

Ejekam told BusinessDay that some of the key findings indicated, “Respondents (comprising Doctors and Nurses) have experienced use of ineffective brands of Oxytocin and nothing is being done about it. They just particularly tilt towards a particular brand while there are several others available in the Nigerian market.

Ejekam explained that one major problem with Oxytocin is degradation, especially cold storage practices in the supply chain and even the health facilities. According to her, a lot healthcare providers did not know the proper storage should be at cold chain temperature (which is +2°C to +8°C). It is possible that this poor management had translated to poor storage practices.

An important finding according to Ejekam is that, even when some medical workers have experienced ineffectiveness of Oxytocin, “it is never discussed, and it is not documented”.

“It was evident that our respondents were using like three to four times the WHO recommended dose for use of Oxytocin for prevention of postpartum haemorrhage. It just means that they do not get their desired contraction at the recommended dose so they had to increase until they get the desired effect, and of course we know that has its consequent effects,” she said.

The solution to this as she mentioned, starts with creating awareness of the proper storage and handling for Oxytocin. As she explained, “The problem of poor quality, therapeutic ineffectiveness, is widespread across every therapeutic area. Medicines quality issue is everybody’s problem, from the manufacturer to the pharmacists, to the clinicians and to the consumer. So, we should not be left to the care of the pharmacists or maybe the pharmacy vigilance system. Whatever they do, even if they do it right, there could be problems before it gets to the consumer.

“We found out that most times clinicians do not remember that medicines quality is one of those things to consider in the chain of events that could predict disease progression, or poor disease treatment outcome,” said Ejekam

One more thing it appears medical practitioners need to pay attention to, is whether the medicine they have given a patient could be poor, hence, the reason why that patient has not responded. Checking off this box accurately is largely, a function of how properly such a medicine may be stored. The findings from Ejekam’s research, support another study by NAFDAC and the United States Pharmacopeia (USP), which had found almost 70 percent of Oxytocins in Nigeria were degraded, mostly on account of how they were stored.

CALEB OJEWALE