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 .
Private pharmacies in Hanoi, Vietnam: a randomized trial of a 2-year multi-component intervention on knowledge and stated practice regarding ARI, STD and antibiotic/steroid requests.
OBJECTIVES To assess the effectiveness of a multi-component intervention on knowledge and reported practice amongst staff working in private pharmacies in Hanoi regarding four conditions : urethral discharge [ sexually transmitted diseases ( STD ) ] , acute respiratory infection ( ARI ) , and non-prescription requests for antibiotics and steroids . METHOD R and omized controlled trial with staff working in 22 matched pair intervention and control private pharmacies who were administered a semistructured question naire on the four conditions before and 4 months after the interventions . The interventions focused on the four conditions and were in sequence ( i ) regulations enforcement ; ( ii ) face-to-face education and ( iii ) peer influence . Outcome measures were knowledge and reported change in practice for correct management of tracer conditions . RESULTS The intervention/control-pairs ( 22 after drop-outs ) were analysed pre- and post-intervention using the Wilcoxon signed rank test . STD : More drug sellers stated they would ask about the health of the partner ( P = 0.03 ) and more said they would advise condom use ( P = 0.01 ) and partner notification ( P = 0.04 ) . ARI : More drug sellers stated they would ask questions regarding fever ( P = 0.01 ) , fewer would give antibiotics ( P = 0.02 ) and more would give traditional medicines ( P = 0.03 ) . Antibiotics request : Fewer said they would sell a few capsules of cefalexin  without a prescription ( P = 0.02 ) . Steroid requests : No statistical difference was seen in the numbers who said they would sell steroids without a prescription as numbers declined in both intervention and control groups ( P = 0.12 ) . CONCLUSION The three interventions in series over 17 months were effective in changing the knowledge and reported practice of drug sellers in Hanoi
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 .