Authors ' conclusions Training probably improves quality of care ( i.e. adherence to recommended practice ) , regulation may improve quality of care , and we are uncertain about the effects of co‐ordination on quality of private for‐profit healthcare services in LMICs .
Background Governments use different approaches to ensure that private for‐profit healthcare services meet certain quality st and ards .
Such government guidance , referred to as public stewardship , encompasses government policies , regulatory mechanisms , and implementation strategies for ensuring accountability in the delivery of services .
However , the effectiveness of these strategies in low‐ and middle‐income countries ( LMICs ) have not been the subject of a systematic review .
Objectives To assess the effects of public sector regulation , training , or co‐ordination of the private for‐profit health sector in low‐ and middle‐income countries .
Post-training quality of syndromic management of sexually transmitted infections by chemists and druggists in Pokhara, Nepal: is it satisfactory?
OBJECTIVE Using simulated client and provider interview methods , this study assessed chemists and druggists ' post-training management quality of syndromic sexually transmitted infections focusing on the areas of privacy maintaining , encouraging , history taking , counseling , referral practice , partner notification , and drug prescribing and then compared the findings of two methods . DESIGN Forty-five pharmacies from a list of 75 in Pokhara , who collected sexually transmitted infections data during 1999 , were selected r and omly . First simulated client successfully presented either urethral or vaginal discharge syndrome at 37 pharmacies and recorded the events of whole encounter into an observation form within 20 minutes . Later 39 chemists and druggists were interviewed by a pre-tested semi-structured question naire . MAIN MEASURE Results were reported mainly by numbers and corresponding percentages . For comparative purpose , P values were also shown . RESULTS Overall , interview method revealed satisfactory knowledge of chemists and druggists for management of sexually transmitted infections except drug prescribing but their actual behaviors , revealed by simulated client method , indicated lower quality and differed significantly in the areas of encouraging , history taking , counseling , referral practice , and partner notification . Both methods indicated very poor qualities of drug prescribing . CONCLUSION Retained knowledge of chemists and druggists for syndromic management of sexually transmitted infections were not applied to simulated client in actual practice . They should not prescribe drugs for patients of sexually transmitted infections , except referring to the doctors/hospitals . Continuous monitoring and further motivations for them may improve syndromic management quality of sexually transmitted infections . Moreover , depending on the purpose of study , various methods should be applied simultaneously to reach a better conclusion
Authors ' conclusions Training probably improves quality of care ( i.e. adherence to recommended practice ) , regulation may improve quality of care , and we are uncertain about the effects of co‐ordination on quality of private for‐profit healthcare services in LMICs .
Background Governments use different approaches to ensure that private for‐profit healthcare services meet certain quality st and ards .
Such government guidance , referred to as public stewardship , encompasses government policies , regulatory mechanisms , and implementation strategies for ensuring accountability in the delivery of services .
However , the effectiveness of these strategies in low‐ and middle‐income countries ( LMICs ) have not been the subject of a systematic review .
Objectives To assess the effects of public sector regulation , training , or co‐ordination of the private for‐profit health sector in low‐ and middle‐income countries .