Peer supervision experiences of drug sellers in a rural district in East-Central Uganda: a qualitative study

Abstract Background Support supervision improves performance outcomes among health workers. However, the national professional guidelines for new licenses and renewal for class C drug shops in Uganda prescribe self-supervision of licensed private drug sellers. As such, inappropriate treatment of malaria, pneumonia and diarrhoea among children under five years of age continues unabated. This study assessed experiences of drug sellers and peer supervisors at the end of a peer supervision intervention in Luuka district in East Central Uganda. Methods Eight in-depth interviews (IDIs) were held with peer supervisors while five focus group discussions (FGDs) were conducted among registered drug sellers at the end of the peer supervision intervention. The study assessed experiences and challenges of peer supervisors and drug sellers regarding peer supervision. Transcripts were imported into Atlas ti 7 qualitative data management software (ATLAS.ti GmbH, Berlin) where they were analysed using qualitative thematic content analysis. Results Initially, peer supervisors were disliked and regarded as another extension of drug inspectors by drug sellers. However, with time a good relationship was established between drug sellers and peer supervisors leading to regular, predictable and supportive peer supervision. This increased confidence of drug sellers in using respiratory timers and rapid diagnostic tests in diagnosing pneumonia symptoms and uncomplicated malaria respectively among children under five years. There was also an improvement in completing the sick child register which was used for self-assessment by drug sellers. The drug shop association was mentioned as a place where peer supervision should be anchored since it was a one-stop center for sharing experiences and continuous professional development. Drug sellers proposed including community health workers in monthly drug shop association meetings so that they may also gain from the associated benefits. Untimely completion of the sick child registers by drug sellers and lack of adequate resources were the main peer supervision challenges mentioned. Conclusion Drug sellers benefitted from peer supervision by developing a good relationship with peer supervisors. This relationship guaranteed reliable and predictable supervision ultimately leading to improved treatment practices. There is need to explore the bare minimum resources needed for peer supervision.