Providing Access to Medicines and Health: A Conversation with Two Women Accredited Drug Dispensing Outlet (ADDO) Owners - Part 2: Meet Germana

Providing Access to Medicines and Health: A Conversation with Two Women Accredited Drug Dispensing Outlet (ADDO) Owners - Part 2: Meet Germana

 {Photo credit: Jafary Liana/MSH}Germana (right), ADDO owner and dispenser in Kipara Mpakani Village with full-time accredited dispenser (left).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 Germana Firmini Mroso

Germana Firmini Mroso, 31 years old, owns an ADDO named ROSALA DUKA LA DAWA MUHIMU, which is located at Kipara Mpakani Village, Vikindu ward, in Mkuranga District. Germana is both an owner and dispenser in her outlet. Germana holds a one year nurse assistant certificate. She manages a second small business making medicine-packaging envelopes which she uses in her outlet and sells to other outlets.

Why did you become an accredited drug shop owner?

Germana: I had worked in other drug shops and pharmacies before, but I always had a dream of managing my own business. So, I worked closely with my employers to learn how they manage the business. I finally decided to start my own business: I used personal savings, got assistance from family members, and also borrowed from close relatives.

Now I manage the outlet and another small business: making medicine-packaging envelopes for my outlets and to sell to other outlets. I was able to employ a full-time dispenser, who spends most of the time in the outlet while I attend the other business, as well as managing the purchasing of medicines. Through these businesses, now I can support my family and relatives.

How has receiving ADDO training and accreditation improved your outlet?

Germana: Well, I attended both the ADDO owner and dispenser training. These trainings improved my dispensing and communication skills, which in turn have improved my daily interactions with clients. The trainings also increased my knowledge on how to monitor product sales, types of products to stock to improve business, and how to monitor products’ expiry dates. Accreditation also helped because the list of medicines allowed to be stocked legally grew, which in turn has increased business.

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?

Germana: One of our customers had been visiting the outlet on several occasions, asking for medicines to dress his wound. My dispenser and I realized that his abscess was not improving, so, we referred him to the district hospital for a check-up. He was diagnosed with HIV and TB. He also received counseling and treatment. Later, he visited our outlet to inform us on his progress and he was very thankful. After attending the hospital, he was kept on TB and HIV medicines, and his condition improved significantly. We felt proud when we saw that our advice and referral likely led to saving his life.

What’s a typical day like for you?

Germana: First I have to manage housekeeping activities, such as cleaning and preparing breakfast for my younger sisters. Before going to my ADDO, I make medicine-packaging envelopes. Then I go to work at the ADDO until 8:00 pm.

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

Germana: There is no medicine wholesaler in the district, so there is no reliable supply of medicines.  I travel frequently to Dar es Salaam, about 80 km from Mkuranga district, where wholesalers are available. Tax estimates from revenue authorities are high, and we have to negotiate to bring them down. Also, I’ve been looking for an additional trained dispenser to assist the other dispenser, so that I can also concentrate on the other business; but I have not been able to find one.

In terms of opportunities: many people in the district use this outlet because it has most of the medicines that are allowed to be stocked—and frequently needed—by clients. We offer good customer care, and many clients trust our services. We get more and more clients over time. In the future, I hope to find a registered pharmacist, and transform the ADDO into a full pharmacy.

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.