Factors Influencing Prescribing Practices of Medical Practitioners in Public and Private Health Facilities in Dar es Salaam, Tanzania

Purpose: To determine the factors that influence prescribing practices of medical practitioners in public and private health facilities in Dar es Salaam, Tanzania
Methods: One hundred and ninety two (192) medical practitioners from 11 public and 3 private health facilities of Dar es Salaam, Tanzania were interviewed for the criteria they consider when making prescribing decisions. Systematic sampling was used to obtain the required number of medical practitioners working in the hospitals, while for those working in the health centers convenience sampling was used.
Results: Medical information from textbooks (64 %) and internet (63 %) were the main sources of prescribing information among medical practitioners. In comparison, medical practitioners in private health facilities (97 %) were more concerned with proven effectiveness of drugs than those working in public health facilities (74.2 %, p = 0.001). Cost of drug to patients was considered much more by practitioners in public health facilities (48.4 %) than their counterparts in private health facilities (24.3 %, p = 0.010). Availability of drugs in the health facility influenced prescribing decisions by a majority of prescribers from public health facilities (53.5 %) than those working in private health facilities (18.9 %, p = 0.000).
Conclusion: There are substantial differences between prescribers working in public and private health facilities with regard to the factors which influence their prescribing decisions. In order to promote rational use of medicines, these factors should be considered by health planners when formulating policies and allocating resources in health facilities.

Keywords
Prescribing practice; Medical practitioners; Health facilities; Prescribing information; Drug costs; Rational use; Drug effectiveness