Providing Access to Medicines and Health: A Conversation with Two Women Accredited Drug Dispensing Outlet (ADDO) Owners - Part 1: Meet Audensia

Providing Access to Medicines and Health: A Conversation with Two Women Accredited Drug Dispensing Outlet (ADDO) Owners - Part 1: Meet Audensia

 {Photo credit: Jafary Liana/MSH}Audensia Batholomew shares her path to accreditation as an drug shop outlet owner and dispenser with Dr. Suleiman Kimatta.Photo credit: Jafary Liana/MSH

In developing countries, a community medicines shop often serves as the first point of contact for health care. Empowering the drug shop owner and dispenser to provide safe, quality medicines, and referrals to a health facility for more complex care, is key to improving maternal and children’s health in rural areas.

MSH’s Jafary H. Liana and Dr. Suleiman Kimatta visited two accredited drug dispensing outlet (ADDO) owners in Mkuranga District, Tanzania. One woman owns two ADDOs, while the other owns one. Both are also trained ADDO dispensers (an estimated 90 percent of ADDO dispensers are women).

Meet Audensia Batholomew

Audensia Batholomew, MBIGI, a 45-year-old single mother, lives in Mkuranga district headquarters with two dependents and an adult son at university. She owns two ADDOs, one located in Chamazi village (20 km from her home) and one in Njopeka village (30 km away). Audensia also holds a one-year nurse assistant certificate.

Why did you become an accredited drug shop owner?

Audensia: I was originally employed by a faith-based health facility in the district, but the salary did not cover my daily living expenses. I decided to seek other opportunities, and focused on establishing my own business. I had always had the idea of managing a drug shop in a rural location where I could provide medicine services and earn a living.

What was it like to open your own shop and get accredited?

Audensia: In 2007, I visited Njopeka village and discovered that the closest health facility was over 5 km away! I discussed my idea of a drug shop with village leadership, and they allowed me to initiate the process of registering one. I borrowed some money from relatives and started the business while going through the licensing process. In 2010, The ADDO Program was introduced in Mkuranga district and I joined the accreditation process.

Through the ADDO owner accreditation and training process, I received training on business skills and ADDO regulations. I also received a dispensing training and was certified by the Tanzanian Food and Drug Authority (TFDA) as an ADDO dispenser. Upon completing the accreditation and training process, my outlet was accredited as an ADDO and given the name: Upendo Duka La Dawa Muhimu.

How has the training and accreditation improved how you can provide health services for your community?

Audensia: The accreditation process significantly improved how I provide health services in the outlets. My medicines dispensing skills have improved and I learned how to communicate with clients better. The accreditation allows me to stock and dispense more medicines than I could before due to the laws. Also, my clients seem to trust my services more: I now have legal documents in the shop which signify recognition by the government; the conditions at the outlet are better; and, now I have a uniform, a white coat from the Tanzanian Food and Drug Authority (TFDA).

Can you share a story with us about a moment when you realized you were helping to save someone’s life or improve their health – perhaps a child or woman that you remember – someone who came to you, and you were able to help them and provide appropriate medications or commodities?

Audensia: Last year, a mother brought her one-and-a-half-year-old child to my outlet. The child had a very high fever and was convulsing; the mother came seeking immediate support before reaching health facility.  I took the child, gave paracetamol, and did some sponging to lower her temperature. After a while, her temperature went down slightly; and then I referred the child to the health facility for further treatment. Two days later, I saw the mother and asked about the condition of her child, and the mother was highly appreciative to me. Her child was better: she had been discharged back home after receiving malaria treatment and recovery. Most of the clients I see are children with malaria and respiratory infections.

What’s a typical day like for you?

Audensia: Well, I start with serving breakfast to the seven-year-old, before she leaves for school. I clean the house and make plans for lunch and supper. Then I travel to Njopeka village to open the shop by around 10:00 in the morning. I’m there through 7:00 pm. Then, I travel back home, or, sometimes, spend the night and travel back the next morning—particularly on days when many clients arrive during the evening hours.  Every three days, I visit the second shop to assess stock status and replenish stocks. (The second shop is usually managed by another dispenser that works for me.)

What are some of the ongoing challenges and opportunities of managing the shop? What are your hopes or dreams for the shop’s role in improving the health of your community?

Audensia: It is hard getting a dispenser to support me in this outlet. Being a typical rural location, I have tried to bring two dispensers at different times. I supported them to attend ADDO training, but as soon as they completed training, they moved to look for a similar job in a better setting. Also, being a rural located shop, the purchasing power of the community is low and sometimes clients come to get medicines in credit or in exchange with other commodities. The initial capital needed to start the business was high, and I did not get enough money to well stock my shop.

On the other hand, my outlet is the only shop in the village. I am in good relation with most people; in my community, I’m regarded as a health care support person. I often get requested to establish a health facility, rather than running a drug shop. I hope to establish a private dispensary in the future to provide more comprehensive health services for the village.

For more information about the ADDO program in Tanzania, visit: SDSI.

Jafary H. Liana is an MSH senior technical advisor with the Sustainable Drug Seller Initiatives (SDSI) in Tanzania. Dr. Suleiman Kimatta is MSH/Tanzania’s country representative and a senior technical advisor.