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Interview with Matu, a pharmacist in Kisumu, Kenya

Matu owns his own pharmacy in Kisumu, Kenya that serves the low income community as well as some middle income users. They're open 7am-10pm and all of his staff are qualified. He also occasionally works night shifts at a local hospital's pharmacy, and he's a religious preacher, bringing religion into his approach and style of care.

Matu describing to us how his pharmacy works

Here's some key learnings:

“When you open a pharmacy you need to know 2 things - who your target is and what are the common issues in the region, so that you know what drugs to stock. Here in this region most common diseases are STI’s, typhoid, malaria, URTI’s.”

This approach, to not only know customers personally (Muga knows 7 out of 10) but also to cater for specific diseases locally, was really smart in terms of focusing energies. It will be interesting to see if we can identify some really common ailments that some of the broad spectrum antibiotics are given for, across both markets, as a focal point for our project.

2. Easy testing means more accurate diagnosis

“If I don’t know if someone needs an antibiotic I will send them for a test. You cannot do this by trial and error, this is human life. We don’t do guesswork when it comes to bacterial infections”

We found in Kenya that more pharmacists were equipped with small labs and therefore able to defer to tests for diagnosis than in India - where labs are more associated with doctors. This means they’re (arguably) guessing less around diagnosing and prescribing.

3. Patient understanding is low, and it takes a lot of effort to explain

“Often people take an antimalarial for something that is not malaria (headache and loss of appetite). They come here after they’ve been trying a week of antimalarials but realise it’s Typhoid”
“If a patient a patient asks for a specific antibiotic for no reason or asks for a smaller dose than recommended, I will tell them we don’t have it”
“I sometimes tell patients that they cannot have a drug because it’s controlled”

How might we equip health care providers with better resources to share with patients that help them understand about antibiotics, without eating into the tight consultation time they have? That does more than a ‘no’ which simply sends the customer elsewhere?

4. Likes to keep in touch with patients

In response to Patient Stories -

“This could reduce the abuse of antibiotics and help me do those follow ups”
“I would see this as a feedback mechanism”

He would want this to be a physical giveaway card with his number on, so they could contact him in a few days if they felt worse or better.

Combining prototypes that focus on patient education, with a behaviour that helps the pharmacist feel they’re offering a competitive advantage (like ability to follow up), seems like it could be a great win for someone like Matu