Peer supervision experiences of drug sellers in a rural district in East-Central Uganda: a qualitative study

Bagonza, A., Wamani, H., Peterson, S., Mårtensson, A., Mutto, M., Musoke, D., Kitutu, F.E., Mukanga, D., Gibson, L. ORCID: 0000-0002-1220-8680 and Awor, P., 2020. Peer supervision experiences of drug sellers in a rural district in East-Central Uganda: a qualitative study. Malaria Journal, 19 (1): 270. ISSN 1475-2875

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Background: Support supervision improves performance outcomes among health workers. However, the national professional guidelines for new licenses and renewal for Class C drug shops in Uganda prescribe self-supervision of licensed private drug sellers. Without support supervision, inappropriate treatment of malaria, pneumonia and diarrhoea among children under 5 years of age continues unabated. This study assessed experiences of drug sellers and peer supervisors at the end of a peer supervision intervention in Luuka District in East Central Uganda.

Methods: Eight in-depth interviews (IDIs) were held with peer supervisors while five focus group discussions (FGDs) were conducted among registered drug sellers at the end of the peer supervision intervention. The study assessed experiences and challenges of peer supervisors and drug sellers regarding peer supervision. Transcripts were imported into Atlas.ti 7 qualitative data management software where they were analysed using thematic content analysis.

Results: Initially, peer supervisors were disliked and regarded by drug sellers as another extension of drug inspectors. However, with time a good relationship was established between drug sellers and peer supervisors leading to regular, predictable and supportive peer supervision. This increased confidence of drug sellers in using respiratory timers and rapid diagnostic tests in diagnosing pneumonia symptoms and uncomplicated malaria, respectively, among children under 5 years. There was also an improvement in completing the sick child register which was used for self-assessment by drug sellers. The drug shop association was mentioned as a place where peer supervision should be anchored since it was a one-stop centre for sharing experiences and continuous professional development. Drug sellers proposed including community health workers in monthly drug shop association meetings so that they may also gain from the associated benefits. Untimely completion of the sick child registers by drug sellers and inadequate financial resources were the main peer supervision challenges mentioned.

Conclusion: Drug sellers benefitted from peer supervision by developing a good relationship with peer supervisors. This relationship guaranteed reliable and predictable supervision ultimately leading to improved treatment practices. There is need to explore the minimum resources needed for peer supervision of drug sellers to further inform practice and policy.

Item Type: Journal article
Publication Title: Malaria Journal
Creators: Bagonza, A., Wamani, H., Peterson, S., Mårtensson, A., Mutto, M., Musoke, D., Kitutu, F.E., Mukanga, D., Gibson, L. and Awor, P.
Publisher: BioMed Central Ltd.
Date: December 2020
Volume: 19
Number: 1
ISSN: 1475-2875
Rights: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Divisions: Schools > School of Social Sciences
Record created by: Linda Sullivan
Date Added: 09 Sep 2020 09:44
Last Modified: 31 May 2021 15:13

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