African Journal of Public Health and Health Systems | 25 July 2009
The Impact of Mandatory Continuing Professional Development on Antibiotic Dispensing Practices: A 2009 Case Study of Private Pharmacies in Dar es Salaam
J, u, m, a, R, a, s, h, i, d, i, ,, F, a, t, m, a, M, w, i, n, y, i
Abstract
Inappropriate antibiotic dispensing by private pharmacies is a major driver of antimicrobial resistance in Tanzania. A mandatory continuing professional development (CPD) policy was introduced for pharmacists to improve knowledge and adherence to dispensing guidelines. This case study assessed the initial impact of the mandatory CPD policy on antibiotic dispensing practices among private pharmacists in Dar es Salaam. It sought to understand changes in knowledge, attitudes, and reported behaviours following the policy’s implementation. A qualitative case study design was employed. Data were collected via in-depth, semi-structured interviews with a purposive sample of private pharmacy owners and practising pharmacists. Interview transcripts were analysed thematically to identify key patterns and perceptions. The impact was mixed. Pharmacists reported improved theoretical knowledge of antibiotic stewardship, but this did not consistently translate into practice. A prominent theme was the persistent pressure to dispense antibiotics without prescription due to commercial imperatives and patient demand. Many participants admitted to frequently deviating from guidelines to maintain customer relations. The mandatory CPD policy enhanced pharmacists’ knowledge but was insufficient alone to change entrenched dispensing practices. Structural and economic drivers within the private pharmacy sector significantly undermined the policy’s intended effect on antibiotic stewardship. Recommendations include integrating more practical, scenario-based training into CPD programmes. Educational interventions should be coupled with stronger regulatory enforcement and public awareness campaigns to reduce patient demand for inappropriate antibiotics. Antimicrobial resistance, continuing professional development, pharmacy practice, private sector, Tanzania, antibiotic stewardship This case study provides insights for policymakers on the limitations of standalone educational mandates in changing complex health behaviours, highlighting the need for multi-faceted strategies to combat antimicrobial resistance.