Irrational drug use in Tanzania

The Essential Drugs (ED) Concept was initiated by the World Health Organization (WHO) in 1975 in a paper presented by WHO Director-General to the 28th World Health Assembly.1,4,10 The rationale for the ED concept was the acute shortage of essential drugs in the rural areas of many developing countries. 11,12 As part of an Essential Drugs Programme (EDP) evaluation project, we investigated the factors affecting rational use of essential drugs in rural Mbeya region, Tanzania in June 1989. The study involved interviewing primary health care workers and observing the activities carried out by the health workers. Health workers with long service were more prone to over-diagnose malaria and ‘ill-defined conditions’ and prescribe drugs not indicated, than those who had recently qualified. Over 60% of the health workers in the study areas prescribed drugs requested by patients. Traditional local beliefs on drug-use played a role in irrational drug usage. The results of this study suggest that control of irrational use of drugs in Tanzania requires the improvement of drug information at all levels of health care. Recommendations to improve the situation are made.