The ACTwatch Outlet Survey, one of the ACTwatch project components, involves quantitative
research at the outlet level in ACTwatch countries (Benin, Cambodia, the Democratic Republic of
Congo [DRC], Madagascar, Nigeria, Uganda and Zambia). Other elements of ACTwatch include
Household Surveys led by Population Services International (PSI) and Supply Chain Research led by
the London School of Hygiene & Tropical Medicine (LSHTM). This report presents the results of a
cross-sectional survey of outlets conducted in Uganda from the 16th of March to the 7th of April
2009.
The objective of the outlet survey is to monitor levels and trends in the availability, price and
volumes of antimalarials, and providers’ perceptions and knowledge of antimalarial medicines at
different outlets. Price and availability data on diagnostic testing services is also collected.
A nationally representative sample of all outlets with the potential to sell or provide antimalarials to
a consumer was taken through a census approach in 38 clusters across Uganda; clusters being
defined as sub-counties. Sampling was conducted using a stratified one-stage probability proportion
to size (PPS) cluster design, with the measure of size being the relative cluster population.
Oversampling of public health facilities and registered pharmacies was conducted to ensure
adequate representation of these outlet types in the survey.
The inclusion criteria for this study were outlets that stocked an antimalarial at the time of survey or
had stocked antimalarials in the previous three months. An outlet is defined as any point of sale or
provision of commodities for individuals. Outlets included in the survey were: 1) public health
facilities (national/regional referral hospitals, district hospitals, health centres [county, sub-county
and parish level]); 2) private-not-for-profit health facilities (mission and Non-Governmental
Organisation [NGO] health facilities); 3) private-for-profit health facilities (private clinics,
domiciliaries and midwives); 4) pharmacies; 5) drug stores; 6) general retailers (groceries, dukas and
general merchandise store and kiosks; and 7) community medicine distributors (analogous to
community health workers in other countries). Refer to the appendices for definitions and numbers
of each type of outlet included in the analysis.
Three questionnaire modules were administered to participating outlets: 1) a screening module, 2)
an audit module, and 3) a provider module. For all outlets, trained interviewers administered the
screening module to collect information on the outlet type andlocation, including the outlet’s
longitude and latitude and information on availability of antimalarials. Among those outlets that
stocked antimalarials at the time of survey, the audit module was administered. For each
antimalarial, information was recorded on the brand and generic names, strength, expiry, amount
sold in the last week and price to the consumer. Among outlets that stocked antimalarials at the
time of interview or in the past three months, the interviewer collected information on provider
demographics, knowledge, perceptions, and medicine storage conditions using the provider module.
Several validation and data checking steps occurred during and after data collection. Double data
entry was conducted using Microsoft Access (Microsoft Cooperation, Seattle, WA, USA). Data were
analysed using Stata 11 (Stata Corp, College Station, TX).