Assessment of knowledge and practice on the identification and reporting of substandard and falsified medical products among Healthcare providers in Tanzania

Assessment of knowledge and practice on the identification and reporting of substandard and falsified medical products among Healthcare providers in Tanzania | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of knowledge and practice on the identification and reporting of substandard and falsified medical products among Healthcare providers in Tanzania Vicky Peter Manyanga, Sayuni Ndele, Innocent Daniel, Yusuph Maswaswa, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4270746/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract The circulation of substandard and falsified medical products in the pharmaceutical markets is a global health problem. The existence of these products undermines the efficiency of the healthcare delivery system and economic development. This research aimed at assessing the level of knowledge and practice among Tanzanian healthcare providers on the identification and reporting of substandard and falsified medical products. Participants included pharmacists, medical doctors, nurses, dentists, and medical laboratory scientists holding bachelor’s degrees and providing health services in Tanzania. Google forms were used for data collection and the Statistical Package for Social Sciences (SPSS) 23 was used for data analysis. About 81.9% and 71.2% of respondents were found to have a good level of knowledge and practice on substandard and falsified medical products identification and reporting respectively. However, 92.5% and 84% of the pharmacists were having higher knowledge and practice than other cadres. The age, experience, facility type, and professional cadres were significantly associated with both the respondent’s knowledge and practice. Furthermore, only 13.2% of the respondents reported having learned about substandard and falsified medical products from universities and 53.8% reported having no idea of reporting tools for these products. The level of knowledge and practice of Tanzanian healthcare providers on identifying and reporting substandard and falsified medical products was good. However, regular training and improvement of the medical school's curriculum are necessary to equip Tanzanian healthcare providers with the necessary knowledge and good practice in identifying and reporting Substandard and falsified medical products. Substandard Falsified Medical products Health care providers Knowledge Practice Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction The manufacture and sale of substandard and falsified (SF) medical products is a global problem that affects both developed and developing countries. The high demand for medical products and the high processing cost of genuine medications increase the risk of this falsification [ 1 ]. This problem is widespread in regions with less stringent regulatory authorities such as Africa and Asia compared to those with stringent regulatory authorities such as Europe and North America [ 2 ]. The production, distribution, and sale of substandard and falsified medical products constitute a substantial market valued at several billion dollars, comprising over 50% of the total products available in the market [ 3 ]. The business has also affected the development of genuine pharmaceutical industries due to unjustified competition in the markets since the quality products manufactured according to Good Manufacturing Practices (GMP) are much more expensive [ 4 , 5 ]. The existence of substandard and falsified medical products threatens both patients' health and the government due to economic loss, increased disease burden, frequent hospitalizations, disabilities, and deaths [ 6 – 8 ]. In Africa, about 169,000 and 158,000 children die each year due to pneumonia and malaria following the administration of substandard and falsified antibiotics and antimalarial respectively [ 8 ]. Literature has shown that these problems happen when the Healthcare providers lack the appropriate knowledge for timely identification of substandard and falsified medical products before providing them to the end users[ 9 , 10 ]. The problem of substandard and falsified medical products has also been observed in Tanzania [ 11 – 16 ]. In this case, the most important incident was the closure of the Tanzania Pharmaceutical industry (TPI) in 2012 due to a fake antiretroviral drugs (ARV) scandal [ 15 – 17 ]. Moreover, in 2018 the Tanzania Medicines and Medical Devices Authority (TMDA) reported that in the year 2005 to 2015 there had been removed from the market substandard and falsified medical products worth $ 13.7 million [ 17 ]. Due to the existence of these products in the market, there is a need for healthcare providers (HCPs) in Tanzania to be equipped with the appropriate knowledge necessary to handle any suspect of substandard and falsified medical products [ 18 – 20 ]. Therefore, this study was conducted to assess the level of knowledge and practice of Tanzanian healthcare providers on the identification and reporting of substandard and falsified medical products. So far, there is no such report in the literature. The study, therefore, presents an alert to the medical products surveillance of Tanzanian authorities in addition to the need for a review of curricula for respective higher learning institutions. Materials and methods Study design This is a descriptive cross-sectional study designed to assess the knowledge and practice of the Tanzania healthcare providers on identifying and reporting substandard and falsified medical products during the provision of healthcare services. Included are participants holding a minimum qualification of a bachelor's degree and must be licensed to practice in various medicine outlets in all administrative regions of Tanzania. Moreover, the study included only actively practising healthcare providers. Study area and population This study involved Medical doctors, Pharmacists, Nurse Officers, Dentists, and Medical laboratory scientists holding bachelor’s degrees. Involved participants were only those who are licensed to prescribe, dispense, administer medical products to patients and perform laboratory investigations for diagnosis, in private and public health facilities located in Tanzania. HCPs such as Radiologists were excluded from this study as they are mostly using medical equipment with few chemicals which are not directly consumed by patients for disease treatment. Sampling techniques and sample size A stratified sampling technique was used to get the study participants. Five strata groups were obtained with the classification based on the cadres to which the healthcare providers belong i.e., Medical doctors, Pharmacists, Nurses, Dentists, and Medical laboratory scientists. The registered personnel in each cadre were, 9538 Medical doctors, 4200 Nurse Officers, 2329 Pharmacists, 1242 Medical laboratory scientists, and 264 Dentists, this makes a total population of 17,573. The proportion sample from each cadre was 232 Medical doctors, 102 Nurse Officers, 57 Pharmacists, 30 Medical laboratory scientists, and 7 dentists. This makes a total sample size of 428 healthcare providers. The participants from each cadre were obtained through snowball sampling techniques and participated in the study conveniently. Questionnaire and data collection methods The questionnaire was adopted from previous similar studies [ 4 , 18 , 21 , 22 ] and the data were collected through Google forms as an online survey. The participants recruited other targeted healthcare providers providing health services elsewhere (Fig. 1 ) by forwarding the tool through WhatsApp groups and email (Snowballing). A total of 773 Healthcare providers were therefore approached to fill out the questionnaire for the study as compared to the predetermined sample size of 428 Healthcare providers. Description of variables The main dependent variables were knowledge and practice among the healthcare providers on identifying and reporting substandard and falsified medical products. Independent variables such as age, sex, type of health facility, administrative zones, bachelor's degree studied, level of education attained, and experience were assessed to determine their association with knowledge and practice. Chi-square and Fisher’s exact test at P ≤ 0.05 were used as a measure of association. In the context of this study, Knowledge means a familiarity, awareness, or understanding of substandard and falsified medical products, their impacts on the patients, and the ways they are identified and reported. Whereas, Practice refers to any professional role played by a healthcare provider that is related to the handling of substandard and falsified medical products during the delivery of health services to clients. Data processing and analysis Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 23. The number of questions was twelve for both knowledge and practice assessments. Each positive response (Yes) was assigned a score of 1, and negative responses (No or I do not know) were assigned a score of 0. The knowledge and practice were considered good for those who scored 7–12 questions and poor knowledge or bad practice for those who scored 0–6 questions as was done in the previous studies [ 21 – 22 ]. Ethical approval The ethical clearance for conducting this study was obtained from the Institutional Review Board (IRB) of the Muhimbili University of Health and Allied Sciences (MUHAS). An informed consent form was provided to the study respondents to fill out. The privacy and confidentiality of the research participants' data were observed throughout the conduct of the study. Results A total of 773 healthcare providers participated in this study. Responses from 0.8% (6) of the participants were excluded due to an incomplete filled questionnaire, therefore the results of this study were recorded from 767 (99.2%) healthcare providers. Amongst 767, there were 405 (52.8%) Medical doctors, 185 (24.2%) Nurse officers, 106 (13.8%) Pharmacists, 53 (6.9%) Medical laboratory scientists, and 18 (2.3%) Dentists. About 85.3% of the participants had a bachelor's degree, 62.1% were males and 72.6% of the participants were working in hospitals, the remaining percent were from other health facilities (Table 1). The remaining 14.7% of participants had both Bachelor's and Master's degrees qualifications. Table 1. Demographic and professional characteristics of the study participants Variables Category Frequency Percentage Age group (years) 20 – 29 138 18.0 30 – 39 364 47.5 40 – 49 184 24.0 50 – 59 66 8.6 ≥ 60 15 2.0 Sex Males 476 62.1 Females 291 37.9 Professional cadre Pharmacist 106 13.8 Medical Doctor 405 52.8 Dentist 18 2.3 Nurse officer 185 24.1 Medical lab scientist 53 6.9 Education level Bachelor degree 654 85.3 Master degree 113 14.7 Working experience (in years) ≤ 5 298 38.9 6 – 10 222 28.9 11 – 15 116 15.1 16 – 20 50 6.5 21 – 25 42 5.5 ≥26 39 5.1 Health facilities Hospitals 557 72.6 Health centers 77 10.0 Community pharmacies 37 4.8 Community laboratories 3 0.4 Dental clinics 4 0.5 Other clinics 89 11.6 Zones Northern zone 80 10.4 Lake zone 84 11.0 Southern highlands zone 153 19.9 Eastern zone 297 38.7 Western zone 39 5.1 Southern zone 48 6.3 Central zone 66 8.6 The healthcare providers who responded to all twelve (12) knowledge questions were 767. The proportions of the responses to the questions are shown in Table 2. The scores were adopted from other studies [21-22] in which respondents who scored 7-12 questions (81.9%) were considered to have good knowledge and those who scored 0 to 6 questions (18.1%) as having poor or bad knowledge (Figure 2). Table 2. The proportion of responses on the knowledge of health care providers regarding substandard and falsified medical products Questions Responses Frequency Percentage What are substandard/falsified medicine, medical devices, and diagnostics products? Are products from an unknown source 206 26.9 Are placebo products 54 7.0 Are orphan products 21 2.7 Are fake medical products 486 63.4 In which areas do these substandard/falsified medical products are available? Urban areas 112 14.6 Rural areas 58 7.6 Both urban and rural 531 69.2 Don't know 66 8.6 The following are some of the medical products that may be falsified or produced as substandard, which ones are most common? lifestyle medicines 264 34.4 Antimalarial and antibiotic medicines 204 26.6 Diagnostics like blood glucose test strip 100 13.0 Protective devices like Face Masks 199 25.9 What factor contribute to the product of your choice above being at high risk of being falsified or being out of standard? Unavailable & unaffordable 132 17.2 Highly demanded 466 60.8 Highly promoted on the internet 116 15.1 Don't Know 53 6.9 The following are the health impact of using substandard and falsified medical products, which one is correct? Increase in mortality and morbidity 95 12.4 Promote drug resistance 146 19.0 Prevalence of diseases increases 15 2.0 All of the above 511 66.6 The following are the economic outcome of SF medical products, select the appropriate answer Increase in productivity 116 15.1 Reduced poverty 16 2.1 Limited resources are wasted 407 53.1 All of the above 228 29.7 From which source did you become aware/learned about substandard and falsified medical products During practice 532 69.4 From university 101 13.2 From conferences 38 5.0 Not aware of it 96 12.5 What factors contribute to the circulation of SF medical products Highly-priced medical products Yes 588 76.7 No 179 23.3 Inadequate control of medical products by the regulatory authority Yes 655 85.4 No 112 14.6 Poor reporting culture of identified SF medical products by HCPs Yes 702 91.5 No 65 8.5 Allowing patients to buy medical products anywhere due to stock out. Yes 582 75.9 No 185 24.1 Lack of knowledge of SF medical products Yes 682 88.9 No 85 11.1 The findings show that 92.5% of Pharmacists, 88.9% of Dentists, 84.9% of Medical laboratory scientists, 81.7% of Medical doctors, and 74.6% of Nurse Officers had good knowledge regarding substandard and falsified medical products. The difference in knowledge within the cadres was statistically significant with P = 0.003 (Figure 3). The Pharmacist's knowledge regarding substandard and falsified medical products was significantly higher (92.5%) than other cadres (80.2%) with P = 0.003. However, the knowledge of Nurse Officers was significantly lower (74.6%) than other cadres (84.2%) with P = 0.004 (Table 3). The age, experience, professional cadres, and facilities show a positive correlation to the respondents' knowledge of substandard and falsified medical products with P< 0.05 (Table 4). Table 3. The knowledge between health professional cadres on substandard and falsified medical products Variable Category Knowledge frequency(n) P value Poor knowledge Good knowledge Pharmacists Pharmacists 8 (7.5 %) 98 (92.5%) 0.003 Other cadres 131 (19.8%) 530(80.2%) Medical doctors Medical doctors 74 (18.3%) 331(81.7%) 0.925 Other cadres 65 (18.0%) 297 (82.0%) Dentists Dentists 2 (11.1%) 16 (88.9%) 0.755 Other cadres 137 (18.3%) 612 (81.7%) Nurse officers Nurse officers 47 (25.4%) 138 (74.6%) 0.004 Other cadres 92 (15.8%) 490 (84.2%) Medical laboratory scientists Medical laboratory scientists 8 (15.1%) 45 (84.9%) 0.589 Other cadres 131 (18.3%) 583 (81.7%) Notes: P is significant at <0.05, n is the number of participants Table 4. Factors associated with the knowledge of the respondents on substandard and falsified medical products Variables Category Knowledge of SF medical products P-Value Poor n (%) Good n (%) Age groups (years) 20-29 14 (10.1) 124 (89.0) <0.001 30-39 55 (15.1) 309 (84.9) 40-49 52(28.3) 132(71.7) 50-59 14 (21.2) 52 (78.8) ≥ 60 4(26.7) 11(73.3) Sex Males 86 (18.1) 390 (81.9) 1.000 Females 53 (18.2) 238 (81.8) Professionals Pharmacists 8 (7.5) 98 (92.5) 0.003 Medical Doctors 74 (18.3) 331 (81.7) Dentists 2 (11.1) 16 (88.9) Nurse officers 47 (25.4) 138 (74.6) Medical laboratory scientists 8 (15.1) 45 (84.9) Education level Bachelor degree 124 (19.0) 530 (81.0) 0.185 Master degree 15 (13.3) 98 (86.7) Experience (years) ≤5 32 (10.7) 266 (89.3) 0.001 6-10 42 (18.9) 180 (81.1) 11-15 32 (27.6) 84 (72.4) 16-20 13 (26.0) 37 (74.0) 21-25 10 (23.8) 32 (76.2) ≥ 26 10 (25.6) 29 (74.4) Zones Northern zone 15 (18.8) 65 (81.3) 0.053 Lake zone 21 (25.0) 63 (75.0) Southern highland zone 25 (16.3) 128 (83.7) Eastern zone 40 (13.5) 257 (86.5) Western zone 10 (25.6) 29 (74.4) Southern zone 13 (27.1) 35 (72.9) Central zone 15 (22.7) 51 (77.3) Health facilities Hospitals 101 (18.1) 456 (81.9) 0.029 Health centers 21 (27.3) 56 (72.7) Community pharmacies 1 (2.7) 36 (97.3) Community laboratories 0 3 (100) Dental clinics 0 4(100) Other clinics 16(18) 73 (82) Notes: P is significant at <0.05 On the other hand, the healthcare providers who responded to all twelve (12) practice questions regarding substandard and falsified medical product identification and reporting were 767. The proportions of the responses to the questions are shown in Table 5. Participants who scored 7-12 questions (71.2%) were considered to have good practice and 0 to 6 (28. 8%) as having bad practice (Figure 4). Table 5. The proportion of responses on identifying and reporting practice of substandard and falsified medical products Questions Responses Frequency Percent What is the source of information you heard about the presence of substandard and falsified medicines, medical devices, and diagnostic tools? Media and advertising materials 313 40.8 Patients and Colleagues 171 22.3 Encountered in routine work 221 28.8 Never heard 62 8.1 How do you identify substandard/falsified medicine/medical devices/diagnostics from the original? Through label Yes 621 81.0 No 146 19.0 Through packaging materials Yes 578 75.4 No 189 24.6 Through expire date Yes 565 73.7 No 202 26.3 Through cost/price of medical products Yes 462 60.2 No 305 39.8 Through package insert( leaflet) Yes 455 59.3 No 312 40.7 Through unexpected adverse reactions to a few patients after using the same medical product of the same batch. Yes 610 79.5 No 157 20.5 Wrong diagnosis through laboratory results Yes 524 68.3 No 243 31.7 Through reporting treatment outcomes to regulatory authorities Yes 610 79.5 No 157 20.5 (When/if) you encounter SF medical products (do you/will you) report them? Yes 665 86.7 No 102 13.3 Which form (do you use/will you use) to report them to the regulatory authority? Yellow form 273 35.6 Green form 36 4.7 Blue form 45 5.9 Don't know 413 53.8 In your opinion, what is the current situation regarding the circulation of substandard and falsified medicine, medical devices, and diagnostics in Tanzania? It is a big problem 203 26.5 Substandard and falsified medical products are not existing 13 1.7 The products are existing but not identified and reported 344 44.8 Detection of SF medical products is increasing but reporting is a problem. 207 27.0 In which action do you suggest can help to reduce the penetration of substandard and falsified medical products in our country? Through public sensitization to raise their awareness against SF medical products. 146 19.0 Adherence to ethics and reporting the identified SF medical products 72 9.4 The strictness of entry points(Borders) 46 6.0 All of the above 503 65.6 Moreover, the findings show that 84% of Pharmacists, 75.5% of Medical laboratory scientists, 73% of Nurse Officers, 66.7% of Dentists, and 66.7% of Medical doctors had good practice in substandard and falsified medical product identification and reporting. The difference in practice within the cadres was statistically significant with P = 0.009 (Figure 5). In between the cadres, the practice of Pharmacists was significantly higher (84%) compared to other cadres (69.1%) with P = 0.002. However, the practice among Medical doctors was significantly lower (66.7%) than for other cadres (76.2%) with P = 0.004 (Table 6). The age, experience, and professional cadres revealed a positive association in identifying and reporting substandard and falsified medical products among the respondents with P < 0.05 (Table 7). The knowledge of the respondents regarding substandard and falsified medical products was found to affect the respondents’ practice of identifying and reporting substandard and falsified medical products with P< 0.001 (Figure 6). Table 6. Practice in identifying and reporting substandard and falsified medical products between the cadres. Variable Category Practice frequency (n) P value Bad practice Good practice Pharmacists Pharmacists 17 (16.0%) 89 (84.0%) 0.002 Other cadres 204 (30.9%) 457(69.1%) Medical doctors Medical doctors 135 (33.3%) 270 (66.7%) 0.004 Other cadres 86 (23.8%) 276 (76.2%) Dentists Dentists 6 (33.3%) 12 (66.7%) 0.792 Other cadres 215 (28.7%) 534 (71.3%) Nurse officers Nurse officers 50 (27.0%) 135 (73.0%) 0.577 Other cadres 171 (29.4%) 411 (70.6%) Medical laboratory scientists Medical laboratory scientists 13 (24.5%) 40 (75.5%) 0.533 Other cadres 208 (29.1%) 506 (70.9%) Notes: P is significant at <0.05 Table 7 Factors associated with identifying and reporting practice of substandard and falsified medical products Variable Category Practice handling SF products P-value Bad n (%) Good n (%) Age (years) 20 – 29 31 (22.5) 107 (77.5) < 0.001 30 – 39 83 (22.8) 281 (77.2) 40 – 49 70 (38.0) 114 (62.0) 50 – 59 29 (43.9) 37 (56.1) ≥ 60 8 (53.3) 7 (46.7) Sex Males 126 (26.5) 350 (73.5) 0.071 Females 95 (32.6) 196 (67.4) Health facilities Hospitals 175( 31.4) 382 (68.6) 0.099 Health centres 20 (26.0) 57 (74.0) Community Pharmacies 6 (16.2) 31 (83.8) Community laboratories 1 (33.3) 2 (66.7) Dental clinics 0 4 (100) Other clinics 17 (21.3) 70 (78.7) Zone Northern zone 31 (38.8) 49 (61.3) 0.237 Lake zone 28 (33.3) 56 (66.7) Southern Highland zone 37 (24.2) 116 (75.8) Eastern zone 79 (26.6) 218 (73.4) Western zone 14 (35.9) 25 (64.1) Southern zone 13 (27.1) 35 (72.9) Central zone 19 (28.8) 47 (71.2) Professional cadre Pharmacists 17 (16.0) 89(84.0) 0.009 Medical doctors 135 (33.3) 270 (66.7) Dentists 6 (33.3) 12 (66.7) Nurse officers 50 (27.0) 135(73.0) Medical laboratory scientists 13 (24.5) 40 (75.5) Experience(years) ≤ 5 67 (22.5) 231(77.5) < 0.001 6-10 56 (25.2) 166 (74.8) 11-15 46 (39.7) 70 (60.3) 16-20 16 (32.0) 34 (68.0) 21-25 17 (40.5) 25 (59.5) ≥ 26 19 (48.7) 20 (51.3) Education level Bachelor degree 190 (29.1) 464 (70.9) 0.738 Master degree 31 (27.4) 82 (72.6) Variable Category Practice on handling SF products P value Bad n (%) Good n (%) Age (years) 20 – 29 31 (22.5) 107 (77.5) < 0.001 30 – 39 83 (22.8) 281 (77.2) 40 – 49 70 (38.0) 114 (62.0) 50 – 59 29 (43.9) 37 (56.1) ≥ 60 8 (53.3) 7 (46.7) Sex Males 126 (26.5) 350 (73.5) 0.071 Females 95 (32.6) 196 (67.4) Health facilities Hospitals 175( 31.4) 382 (68.6) 0.099 Health centers 20 (26.0) 57 (74.0) Community Pharmacies 6 (16.2) 31 (83.8) Community laboratories 1 (33.3) 2 (66.7) Dental clinics 0 4 (100) Other clinics 17 (21.3) 70 (78.7) Zone Northern zone 31 (38.8) 49 (61.3) 0.237 Lake zone 28 (33.3) 56 (66.7) Southern Highland zone 37 (24.2) 116 (75.8) Eastern zone 79 (26.6) 218 (73.4) Western zone 14 (35.9) 25 (64.1) Southern zone 13 (27.1) 35 (72.9) Central zone 19 (28.8) 47 (71.2) Professional cadre Pharmacists 17 (16.0) 89(84.0) 0.009 Medical doctors 135 (33.3) 270 (66.7) Dentists 6 (33.3) 12 (66.7) Nurse officers 50 (27.0) 135(73.0) Medical laboratory scientists 13 (24.5) 40 (75.5) Experience(years) ≤ 5 67 (22.5) 231(77.5) < 0.001 6-10 56 (25.2) 166 (74.8) 11-15 46 (39.7) 70 (60.3) 16-20 16 (32.0) 34 (68.0) 21-25 17 (40.5) 25 (59.5) ≥ 26 19 (48.7) 20 (51.3) Education level Bachelor degree 190 (29.1) 464 (70.9) 0.738 Master degree 31 (27.4) 82 (72.6) Notes: p is significant at <0.05 Discussion The World Health organization (WHO) recommends the need for healthcare providers to have high knowledge and appropriate practice on substandard and falsified medical product identification and reporting [4]. This study has explored Tanzanian healthcare providers' knowledge and practice in identifying and reporting those products. The findings have indicated that the majority of Tanzanian healthcare providers have good knowledge and practice regarding substandard and falsified medical products. Both the knowledge and practice of the healthcare providers appear to be influenced by factors such as age, working experience, the type of facility where a respondent is stationed, and the type of professional cadres. The overall level of knowledge among healthcare providers on substandard and falsified medical products was high with 81.9% of the respondents having good knowledge (Figure 2). This is contrary to other studies that have reported the knowledge of substandard and falsified medical products to be low among healthcare providers in various countries [23-29]. However, about 69.4% of the respondents reported learning it during practice. Similar findings were also reported from Sudan where 76% of healthcare providers reported having learned about the products during practice [21]. The result shows the knowledge of the respondents to be significantly influenced by age (P < 0.001), experience (P = 0.001), professional cadres (P = 0.003 ), and health facilities type with P = 0.029 (Table 4). The relationship between knowledge and factors such as age and experience is known to be due to changes in the cognitive process. This has been stated by theories of mind [28-31] and the WHO report [32]. Similar findings were also reported in studies conducted in Lebanon [17], Iran [23], and Italy [34]. The healthcare providers from health centers were revealed to have significantly lower knowledge than those from other facilities ( P = 0.029 ). This could be due to the limited number of medical products in health centers which limits exposure to substandard and falsified medical products among the healthcare providers in those facilities [35]. Concerning practice, the findings show that 71.2% of the respondents had good practice in identifying and reporting substandard and falsified medical products (Figure 4). This is because the respondents' knowledge regarding substandard and falsified medical products was also proportionally high. This is comparable to findings from some other studies, where the practice of healthcare providers in handling such products was reported to be poor [21, 24, 36]. However, 53.8% of the respondents reported having no idea of the tool to use for reporting substandard and falsified medical products when encountered. Findings similar to these were also reported in Sweden where 66.9% of the healthcare providers reported having no idea of the reporting tools [37]. Other studies have reported that healthcare providers are in a hurry with no time for identifying the authentic features of medical products before healthcare service provision [9, 24, 38]. The practice among Health care providers was significantly associated with age (P < 0.001), experience (P < 0.001), and professional cadres with P = 0.009 (Table 7). The influence of practice with age and experience can also be related to cognitive changes in the healthcare provider [27-31]. A similar trend of observation has been reported in Iran in which an increase in working time was also found to affect the practice of healthcare providers in identifying and reporting these products [21]. The knowledge and practice regarding substandard and falsified medical products within professional cadres were found to be good except for only a few respondents (Figures 3 and 5). The findings of this investigation are somewhat contrary to other studies where healthcare providers were reported to have limited knowledge and practice regarding substandard and falsified medical products [21, 24, 36]. However, the knowledge among the five health professional cadres shows that Pharmacists’ knowledge is higher (92.5%) than other cadres (80.2%) with P = 0.003 (Table 3). This is contrary to a study done in Qatar which showed that only 18% of Pharmacists have sufficient knowledge about substandard and falsified medical products [24]. On the other side, the knowledge of Nurse Officers was lower (74.6%) than other cadres (84.2%) with P = 0.004 (Table 3). A comparable gap in the Nurses’ knowledge regarding substandard and falsified medical products was reported to be low in Medina [9] and the International Council of Nurses (ICN) [39]. Again, the practice of substandard and falsified medical products identification and reporting among the cadres revealed that the Pharmacists have better conduct (84%) than other cadres (69.1%) with P = 0.002 (Table 6). This can be related to the fact that in most cases Pharmacists assume the major role in preventing the entry, distribution, and dispensing of medical products [23]. Moreover, another reason for this observation could be because to some extent the University curriculum for Pharmacists in some postgraduate courses incorporated some topics about substandard and falsified medical products [35, 39]. However, the practice among Medical doctors was significantly lower (66.7%) than in other cadres (76.2%) with P = 0.004 (Table 6). Some studies have shown that in most circumstances, Medical doctors overlook the identification of substandard and falsified medical products when in a hurry with a huge patient load [9, 24, 39]. Conclusion The findings revealed that 81.9% and 71.2% of HCPs have good knowledge and practice regarding substandard and falsified medical product identification and reporting. However, only 13.2% of respondents reported learning it at Universities and only 5.9% of the respondents reported using the right form to report the products. Therefore regulatory authorities in the country are recommended to ensure the availability of Standard Operating procedures (SOP) for identifying and reporting the products in all health facilities. Higher learning institutions are recommended to include modules on substandard and falsified medical products in their curricula. This study further presents an alert and a need for medical product surveillance and legal implications from the responsible Tanzanian authority. Declarations Funding statement No funding was received for this study Conflict of Interest Statement The authors declare no conflicts of interest for this work. Data availability The data utilized to draw this conclusion are accessible from the corresponding author upon reasonable request. Code availability Not applicable. Author contributions VPM and SN participated in conceptualization, study design, data collection, data analysis and writing the initial draft of the manuscript . ID participated in study design, data collection and data analysis. YM, EY, GGN, PMM, RS, NEM, NN and JS participated in data collection and data analysis. EK participated in guiding the study design, data analysis, manuscript writing and ensuring integrity of the research. The submission of the final version of the manuscript followed the approval of all authors of this research work. Acknowledgments The authors would like to acknowledge all healthcare providers who participated in this study. We wish to thank registrars of Medical doctors and dentists, Pharmacists, Nurses, Midwifery, and Medical laboratory scientist’s councils for providing statistical data on registered personnel. We also thank all staff from MUHAS for their dedicated cooperation during the study. References Naira G. Substandard and falsified medicines: Global and local efforts to address a growing problem. Pharm. J. 2019;1-11 Yadav S, Rawal G. Falsified drugs : the problem of developing and developed countries. J Pharm Anal. 2015; 2:46-50. Nafiu A, Abubakar S, Abdulhakim A, et al. Unveiling the peril of substandard and falsified medicines to public health and safety in Africa: Need for all-out war to end the menace.Wichtig International. 2017; 1:145-154. World Health Organization.WHO Global Surveillance and Monitoring System for substandard and falsified medical products. 2017. ISBN 978-92-4-151342-5 Ubajaka CF, Obi-okaro AC, Emelumadu OF, et al. 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Antimicrobial resistance pattern : A report of microbiological cultures at a tertiary hospital in Tanzania. BMC Infect. Dis. 2016; 16:1-7. Horumpende PG, Mshana SE, Mouw EF, et al. Point prevalence survey of antimicrobial use in three hospitals in North-Eastern Tanzania. Antimicrob. 2020; 3:1-6. Hamill H, David-Barrett E, Mwanga J, et al. Monitoring, reporting and regulating medicine quality: tensions between theory and practice in Tanzania,” BMJ Glob. Heal. 2020;6:1-8 Mhando L, Jande MB, Liwa A, et al. Public Awareness and Identification of Falsified Drugs in Tanzania: A View on Antimalarial Drugs. Adv. Public Heal. 2016:1-8. Association of Journalists against AIDS in Tanzania (AJAAT). Who’s lying in the fake ARVs scam ? www.ajaat.or.tz. 2012; 195:10-16. Mziray S. Quality of Selected Anti-retroviral Medicines : Tanzania Mainland Market A Case Study Current Status : Under Review. BMC Pharm. Toxicol. 2020; 2: 1-27. Mori AT, Meena E, Kaale EA. The economic cost of substandard and falsified human medicines and cosmetics with banned ingredients in Tanzania from 2005 to 2015 : A retrospective review of data from the regulatory authority. BMJ Open, 2018; 1-7. Blomberg B, Mwakagile DSM, Urassa WK, et al. Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania. BMC Public Health. 2014; 4:1-12. Hamilton WL, Doyle C, Halliwell-Ewen M, et al. Public health interventions to protect against falsified medicines : a systematic review of international, national and local policies. Health Policy and Plan. 2016; 31:1448-1466. Karunamoorthi K. The falsified anti-malarial is a crime against humanity : a systematic review of the scientific evidence. Malar. J. 2014; 13: 1-13. Yadav V, Budania N, Mondal A, et al. A questionnaire-based study on knowledge and attitude towards falsified medication among the doctors in tertiary care hospital. Int. J. Basic Clin. Pharmacol. 2018; 7:802-806. Wala WW, Shaza WS, Imad OA, et al. Community pharmacists Awareness and Attitude toward Falsified medicine in “Khartoum Locality : Cross-Sectional Survey, 2020; 1-14. Chambliss WG, Carroll WA, Kennedy D, et al. Role of the Pharmacist in Preventing Distribution of Falsified Medications. J. Am. Pharm. Assoc. 2012; 52:195-199. Alfadl AA, Ibrahim MIM, Maraghi FA, et al. The general public and community pharmacist’s perception on falsified medicines: A preliminary cross-sectional study in Qatar. J. Clin. Diagnostic Res. 2018; 12: IC01-IC06. Hagan AO, Garlington A. Falsified drugs and the online pharmaceutical trade, a threat to public safety. FRCIJ. 2018; 6:151-158. Health G. Medical Product Quality Report – COVID-19 Issues. Med. Qual. Res. Gr. University OXFORD, 2020; 5:1-72. Moran JM. Lifespan development: The effects of typical aging on the theory of mind. Behav. Brain Res. 2013; 237:32-40. Hess TM, Smith BT. Aging and the impact of irrelevant information on social judgments. Psychol Aging. 2014:29:542-553. Fischer AL, Rourke NO, Thornton WL. Age differences in cognitive and affective theory of mind: Concurrent contributions of neurocognitive performance, sex, and pulse pressure. J Gerontol B Psychol Sci Soc Sci, 2016; 00, 1–11. Grainger SA, Steinvik HR, Henry JD, et al. The role of social attention in older adults’ ability to interpret naturalistic social scenes. Q. J. Exp. Psychol. 2019; 72:1328-1343. World Health Organization. World report on Ageing and Health. 2015; 1-260. Shahverdi S, Hajimiri M, Pourmalek F, et al. Iranian pharmacists’ knowledge, attitude, and practice regarding falsified drugs. Iran. J. Pharm. Res. 2012; 11:963-968. Lombardo S, Marino F, Cosentino M. A nationwide web-based survey of a sample of Italian community pharmacists’ perceptions and opinions about online sales of medicines and falsified drugs. Pharm. Pract. (Granada). 2019; 17:1-8. WHO Member State mechanism on substandard and falsified medical products, Online Handbook on existing training resources, and reference documentation for the prevention, detection, and response to SF medical products. 2019. Yousuf SA, Alshakka M, Badulla WFS, et al. Attitudes and practices of community pharmacists and barriers to their participation in public health activities in Yemen : mind the gap. BMC Health Serv. Res. 2019; 19:1-8. Funestrand H, Liu R, Lundin S, et al. Substandard and falsified medical products are a global public health threat. A pilot survey of awareness among physicians in Sweden. J. Public Health (Oxf). 2018; 41:95-102. Mcmanus D, Naughton BD. A systematic review of substandard, falsified, unlicensed, and unregistered medicine sampling studies : a focus on context, prevalence, and quality. BMJ Global Health, 2020; 5: 1–9. Ferrario A, Orubu ESF, Adeyeye MC, et al. The need for comprehensive and multidisciplinary training in substandard and falsified medicines for pharmacists. BMJ Global Health. 2019; 4:1-3. International Pharmaceutical Federation (FIP). Curriculum for pharmacy students on substandard and falsified medicines. Pharm. Res, 2021; 85:1-80. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editor assigned by journal 02 May, 2024 Submission checks completed at journal 02 May, 2024 First submitted to journal 15 Apr, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4270746","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":297955356,"identity":"1141675f-84dc-48a6-bba4-5d208fd3edaf","order_by":0,"name":"Vicky Peter Manyanga","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Vicky","middleName":"Peter","lastName":"Manyanga","suffix":""},{"id":297955357,"identity":"cfb0fd40-5502-41ad-9d5b-706fed47b485","order_by":1,"name":"Sayuni Ndele","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Sayuni","middleName":"","lastName":"Ndele","suffix":""},{"id":297955358,"identity":"349fd158-c07e-4fc5-9d2f-4650420e9314","order_by":2,"name":"Innocent Daniel","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Innocent","middleName":"","lastName":"Daniel","suffix":""},{"id":297955359,"identity":"db6eb761-baff-47ad-9e9c-41264ae0be96","order_by":3,"name":"Yusuph Maswaswa","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Yusuph","middleName":"","lastName":"Maswaswa","suffix":""},{"id":297955360,"identity":"0e143735-9768-45f7-b768-0e9caf65c9ee","order_by":4,"name":"Emili Yondu","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Emili","middleName":"","lastName":"Yondu","suffix":""},{"id":297955361,"identity":"cd6269a4-c289-4d89-821c-7be1c6ea915d","order_by":5,"name":"Goodluck G. 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15:42:03","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4270746/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4270746/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":56197975,"identity":"a0785c0f-c83a-435d-a011-d4bc78ef6da4","added_by":"auto","created_at":"2024-05-09 18:27:01","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":143113,"visible":true,"origin":"","legend":"\u003cp\u003eThe proportion of participants from twenty-six (26) regions of Tanzania.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4270746/v1/049733390150bacfc3e46870.png"},{"id":56197973,"identity":"c8bbb23b-77b7-46fe-9878-e98fda6b52f4","added_by":"auto","created_at":"2024-05-09 18:27:00","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":12070,"visible":true,"origin":"","legend":"\u003cp\u003eKnowledge of substandard and falsified medical products among Tanzanian healthcare providers\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4270746/v1/6cb93c0fe6324bc52fcba7cd.png"},{"id":56198564,"identity":"fb1bfdae-8c36-430b-a731-f620dcbe1e9c","added_by":"auto","created_at":"2024-05-09 18:35:02","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":20443,"visible":true,"origin":"","legend":"\u003cp\u003eKnowledge within the cadres on substandard and falsified medical products\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4270746/v1/4f46b7877127d6ed997393a7.png"},{"id":56197971,"identity":"7a29e6ae-04bd-4d01-98c1-0b1f7d00618c","added_by":"auto","created_at":"2024-05-09 18:26:57","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":12442,"visible":true,"origin":"","legend":"\u003cp\u003ePractice among healthcare providers on substandard and falsified medical products.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-4270746/v1/8bb238a4a33bca1bbb773c20.png"},{"id":56198052,"identity":"5a4a57fa-f225-4578-b7be-989e6c4cf2d3","added_by":"auto","created_at":"2024-05-09 18:27:19","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":20547,"visible":true,"origin":"","legend":"\u003cp\u003ePractice in handling substandard and falsified medical products within professional cadres.\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-4270746/v1/8d1af7e70fcd4846bc013e51.png"},{"id":56197977,"identity":"fc80fe08-679c-4715-b740-66e5ee54b10d","added_by":"auto","created_at":"2024-05-09 18:27:02","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":13721,"visible":true,"origin":"","legend":"\u003cp\u003eEffect of respondent’s knowledge regarding substandard and falsified medical products on identifying and reporting practice among healthcare providers.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-4270746/v1/3f9cbc072237d6c3086077e9.png"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment of knowledge and practice on the identification and reporting of substandard and falsified medical products among Healthcare providers in Tanzania","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe manufacture and sale of substandard and falsified (SF) medical products is a global problem that affects both developed and developing countries. The high demand for medical products and the high processing cost of genuine medications increase the risk of this falsification [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This problem is widespread in regions with less stringent regulatory authorities such as Africa and Asia compared to those with stringent regulatory authorities such as Europe and North America [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The production, distribution, and sale of substandard and falsified medical products constitute a substantial market valued at several billion dollars, comprising over 50% of the total products available in the market [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The business has also affected the development of genuine pharmaceutical industries due to unjustified competition in the markets since the quality products manufactured according to Good Manufacturing Practices (GMP) are much more expensive [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe existence of substandard and falsified medical products threatens both patients' health and the government due to economic loss, increased disease burden, frequent hospitalizations, disabilities, and deaths [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In Africa, about 169,000 and 158,000 children die each year due to pneumonia and malaria following the administration of substandard and falsified antibiotics and antimalarial respectively [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Literature has shown that these problems happen when the Healthcare providers lack the appropriate knowledge for timely identification of substandard and falsified medical products before providing them to the end users[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe problem of substandard and falsified medical products has also been observed in Tanzania [\u003cspan additionalcitationids=\"CR12 CR13 CR14 CR15\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In this case, the most important incident was the closure of the Tanzania Pharmaceutical industry (TPI) in 2012 due to a fake antiretroviral drugs (ARV) scandal [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Moreover, in 2018 the Tanzania Medicines and Medical Devices Authority (TMDA) reported that in the year 2005 to 2015 there had been removed from the market substandard and falsified medical products worth \u003cspan\u003e$\u003c/span\u003e 13.7\u0026nbsp;million [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Due to the existence of these products in the market, there is a need for healthcare providers (HCPs) in Tanzania to be equipped with the appropriate knowledge necessary to handle any suspect of substandard and falsified medical products [\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Therefore, this study was conducted to assess the level of knowledge and practice of Tanzanian healthcare providers on the identification and reporting of substandard and falsified medical products. So far, there is no such report in the literature. The study, therefore, presents an alert to the medical products surveillance of Tanzanian authorities in addition to the need for a review of curricula for respective higher learning institutions.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eThis is a descriptive cross-sectional study designed to assess the knowledge and practice of the Tanzania healthcare providers on identifying and reporting substandard and falsified medical products during the provision of healthcare services. Included are participants holding a minimum qualification of a bachelor's degree and must be licensed to practice in various medicine outlets in all administrative regions of Tanzania. Moreover, the study included only actively practising healthcare providers.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy area and population\u003c/h2\u003e \u003cp\u003eThis study involved Medical doctors, Pharmacists, Nurse Officers, Dentists, and Medical laboratory scientists holding bachelor\u0026rsquo;s degrees. Involved participants were only those who are licensed to prescribe, dispense, administer medical products to patients and perform laboratory investigations for diagnosis, in private and public health facilities located in Tanzania. HCPs such as Radiologists were excluded from this study as they are mostly using medical equipment with few chemicals which are not directly consumed by patients for disease treatment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSampling techniques and sample size\u003c/h2\u003e \u003cp\u003eA stratified sampling technique was used to get the study participants. Five strata groups were obtained with the classification based on the cadres to which the healthcare providers belong i.e., Medical doctors, Pharmacists, Nurses, Dentists, and Medical laboratory scientists. The registered personnel in each cadre were, 9538 Medical doctors, 4200 Nurse Officers, 2329 Pharmacists, 1242 Medical laboratory scientists, and 264 Dentists, this makes a total population of 17,573. The proportion sample from each cadre was 232 Medical doctors, 102 Nurse Officers, 57 Pharmacists, 30 Medical laboratory scientists, and 7 dentists. This makes a total sample size of 428 healthcare providers. The participants from each cadre were obtained through snowball sampling techniques and participated in the study conveniently.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eQuestionnaire and data collection methods\u003c/h2\u003e \u003cp\u003eThe questionnaire was adopted from previous similar studies [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] and the data were collected through Google forms as an online survey. The participants recruited other targeted healthcare providers providing health services elsewhere (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) by forwarding the tool through WhatsApp groups and email (Snowballing). A total of 773 Healthcare providers were therefore approached to fill out the questionnaire for the study as compared to the predetermined sample size of 428 Healthcare providers.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eDescription of variables\u003c/h2\u003e \u003cp\u003eThe main dependent variables were knowledge and practice among the healthcare providers on identifying and reporting substandard and falsified medical products. Independent variables such as age, sex, type of health facility, administrative zones, bachelor's degree studied, level of education attained, and experience were assessed to determine their association with knowledge and practice. Chi-square and Fisher\u0026rsquo;s exact test at \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.05 were used as a measure of association. In the context of this study, Knowledge means a familiarity, awareness, or understanding of substandard and falsified medical products, their impacts on the patients, and the ways they are identified and reported. Whereas, Practice refers to any professional role played by a healthcare provider that is related to the handling of substandard and falsified medical products during the delivery of health services to clients.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData processing and analysis\u003c/h2\u003e \u003cp\u003eData were analyzed using the Statistical Package for Social Sciences (SPSS) version 23. The number of questions was twelve for both knowledge and practice assessments. Each positive response (Yes) was assigned a score of 1, and negative responses (No or I do not know) were assigned a score of 0. The knowledge and practice were considered good for those who scored 7\u0026ndash;12 questions and poor knowledge or bad practice for those who scored 0\u0026ndash;6 questions as was done in the previous studies [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethical clearance for conducting this study was obtained from the Institutional Review Board (IRB) of the Muhimbili University of Health and Allied Sciences (MUHAS). An informed consent form was provided to the study respondents to fill out. The privacy and confidentiality of the research participants\u0026apos; data were observed throughout the conduct of the study.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 773 healthcare providers participated in this study. Responses from 0.8% (6) of the participants were excluded due to an incomplete filled questionnaire, therefore the results of this study were recorded from 767 (99.2%) healthcare providers.\u0026nbsp;Amongst 767, there were 405 (52.8%) Medical doctors, 185 (24.2%) Nurse officers, 106 (13.8%) Pharmacists, 53 (6.9%) Medical laboratory scientists, and 18 (2.3%) Dentists. About\u0026nbsp;85.3% of the participants had a bachelor\u0026apos;s degree, 62.1% were males and 72.6% of the participants were working in hospitals, the remaining percent were from other health facilities (Table 1). The remaining 14.7% of participants had both Bachelor\u0026apos;s and Master\u0026apos;s degrees qualifications.\u003c/p\u003e\n\u003cp\u003eTable 1. Demographic and professional characteristics of the study participants\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.20618556701031%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.20618556701031%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eAge group (years)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\u0026nbsp;\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e20 \u0026ndash; 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e18.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e30 \u0026ndash; 39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e364\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e47.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e40 \u0026ndash; 49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e50 \u0026ndash; 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e\u0026ge; 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.20618556701031%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e476\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e62.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e37.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.20618556701031%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eProfessional cadre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003ePharmacist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eMedical Doctor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e405\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e52.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eDentist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eNurse officer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eMedical lab scientist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.20618556701031%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eBachelor degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e654\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e85.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eMaster degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.20618556701031%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eWorking experience\u003c/p\u003e\n \u003cp\u003e(in years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e\u0026le; 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e298\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e38.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e6 \u0026ndash; 10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e11 \u0026ndash; 15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e15.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e16 \u0026ndash; 20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e21 \u0026ndash; 25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003e\u0026ge;26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.20618556701031%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eHealth facilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eHospitals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e557\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e72.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eHealth centers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eCommunity pharmacies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eCommunity laboratories\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eDental clinics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eOther clinics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.20618556701031%\" rowspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003eZones\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eNorthern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eLake zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e11.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eSouthern highlands zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e19.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eEastern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e38.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eWestern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eSouthern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\" style=\"width: 24.6699%;\"\u003e\n \u003cp\u003eCentral zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.137931034482758%\" valign=\"top\" style=\"width: 16.5195%;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.862068965517242%\" valign=\"top\" style=\"width: 21.2305%;\"\u003e\n \u003cp\u003e8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe healthcare providers who responded to all twelve (12) knowledge questions were 767. The proportions of the responses to the questions are shown in Table 2. The scores were adopted from other studies [21-22] in which respondents who scored 7-12 questions (81.9%) were considered to have good knowledge and those who scored 0 to 6 questions (18.1%) as having poor or bad knowledge (Figure 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2. The proportion of responses on the knowledge of health care providers regarding substandard and falsified medical products\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponses\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eWhat are substandard/falsified medicine, medical devices, and diagnostics products?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eAre products from an unknown source\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e26.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eAre placebo products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eAre orphan products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eAre fake medical products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e486\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e63.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eIn which areas do these substandard/falsified medical products are available?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eUrban areas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eRural areas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eBoth urban and rural\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e531\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e69.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eThe following are some of the medical products that may be falsified or produced as substandard, which ones are most common?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003elifestyle medicines\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e34.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eAntimalarial \u0026nbsp;and antibiotic medicines\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e204\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e26.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eDiagnostics like blood glucose test strip\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e13.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eProtective devices like Face Masks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e25.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eWhat factor contribute to the product of your choice above being at high risk of being falsified or being out of standard?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eUnavailable \u0026amp; unaffordable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e17.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eHighly demanded\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e60.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eHighly promoted on the internet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e15.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eDon\u0026apos;t Know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eThe following are the health impact of using substandard and falsified medical products, which one is correct?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eIncrease in mortality and morbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003ePromote drug resistance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e19.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003ePrevalence of diseases increases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eAll of the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e66.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eThe following are the economic outcome of SF \u0026nbsp;medical products, select the appropriate answer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eIncrease in productivity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e15.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eReduced poverty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eLimited resources are wasted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e407\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e53.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eAll of the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e228\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eFrom which source did you become aware/learned about substandard and falsified medical products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eDuring practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e532\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e69.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eFrom university\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eFrom conferences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eNot aware of it\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat factors contribute to the circulation of SF medical products\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eHighly-priced medical products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e588\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e76.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e23.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eInadequate control of medical products \u0026nbsp;by the regulatory authority\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e85.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePoor reporting culture \u0026nbsp;of identified SF medical products by HCPs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e702\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e91.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eAllowing patients to buy medical products anywhere due to stock out.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e582\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e75.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eLack of knowledge of SF medical products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e682\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e88.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.46153846153846%\" valign=\"top\" style=\"width: 46.041%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\" style=\"width: 13.709%;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.53846153846154%\" valign=\"top\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;The findings show that 92.5% of Pharmacists, 88.9% of Dentists, 84.9% of Medical laboratory scientists, 81.7% of Medical doctors, and 74.6% of Nurse Officers had good knowledge regarding substandard and falsified medical products. The difference in knowledge within the cadres was statistically significant with P = 0.003 (Figure 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Pharmacist\u0026apos;s knowledge regarding substandard and falsified medical products was significantly higher (92.5%) than other cadres (80.2%) with\u0026nbsp;P\u0026nbsp;= 0.003. However, the knowledge of Nurse Officers was significantly lower (74.6%) than other cadres (84.2%) with\u0026nbsp;P\u003cem\u003e= 0.004\u003c/em\u003e (Table 3). The age, experience, professional cadres, and facilities show a positive correlation to the respondents\u0026apos; knowledge of substandard and falsified medical products with P\u0026lt; 0.05 (Table 4).\u003c/p\u003e\n\u003cp\u003eTable 3. The knowledge between health professional cadres on substandard and falsified medical products\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.367346938775512%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.89795918367347%\" colspan=\"2\" valign=\"top\" style=\"width: 41.373%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge frequency(n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" rowspan=\"2\" valign=\"top\" style=\"width: 9.252%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.72727272727273%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"52.27272727272727%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.367346938775512%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePharmacists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\" valign=\"top\"\u003e\n \u003cp\u003ePharmacists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e8 (7.5 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e98 (92.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" rowspan=\"2\" valign=\"top\" style=\"width: 9.252%;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.818181818181817%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e131 (19.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.84848484848485%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e530(80.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.367346938775512%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMedical doctors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\" valign=\"top\"\u003e\n \u003cp\u003eMedical doctors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e74 (18.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e331(81.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" rowspan=\"2\" valign=\"top\" style=\"width: 9.252%;\"\u003e\n \u003cp\u003e0.925\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.818181818181817%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e65 (18.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.84848484848485%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e297 (82.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.367346938775512%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eDentists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\" valign=\"top\"\u003e\n \u003cp\u003eDentists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e2 (11.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e16 (88.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" rowspan=\"2\" valign=\"top\" style=\"width: 9.252%;\"\u003e\n \u003cp\u003e0.755\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.818181818181817%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e137 (18.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.84848484848485%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e612 (81.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.367346938775512%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eNurse officers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\" valign=\"top\"\u003e\n \u003cp\u003eNurse officers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e47 (25.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e138 (74.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" rowspan=\"2\" valign=\"top\" style=\"width: 9.252%;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.818181818181817%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e92 (15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.84848484848485%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e490 (84.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.367346938775512%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMedical laboratory scientists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\" valign=\"top\"\u003e\n \u003cp\u003eMedical laboratory scientists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e8 (15.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e45 (84.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" rowspan=\"2\" valign=\"top\" style=\"width: 9.252%;\"\u003e\n \u003cp\u003e0.589\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.818181818181817%\" valign=\"top\" style=\"width: 23.7441%;\"\u003e\n \u003cp\u003e131 (18.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.84848484848485%\" valign=\"top\" style=\"width: 18.748%;\"\u003e\n \u003cp\u003e583 (81.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: P is significant at \u0026lt;0.05, n is the number of participants\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4. Factors associated with the knowledge of the respondents on substandard and falsified medical products\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.46938775510204%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.551020408163264%\" rowspan=\"2\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.775510204081634%\" colspan=\"2\" valign=\"top\" style=\"width: 40.6895%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge of SF medical products\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" rowspan=\"2\" valign=\"top\" style=\"width: 14.4355%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.351351351351354%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"48.648648648648646%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.711340206185568%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eAge groups (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.835051546391753%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e20-29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e14 (10.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e124 (89.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.309278350515465%\" rowspan=\"5\" valign=\"top\" style=\"width: 14.4355%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e30-39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e55 (15.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e309 (84.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e40-49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e52(28.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e132(71.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e50-59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e14 (21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e52 (78.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e\u0026ge; 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e4(26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e11(73.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.711340206185568%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.835051546391753%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e86 (18.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e390 \u0026nbsp;(81.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.309278350515465%\" rowspan=\"2\" valign=\"top\" style=\"width: 14.4355%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e53 (18.2)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e238 (81.8)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.711340206185568%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eProfessionals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.835051546391753%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003ePharmacists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e8 (7.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e98 (92.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.309278350515465%\" rowspan=\"5\" valign=\"top\" style=\"width: 14.4355%;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eMedical Doctors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e74 (18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e331 (81.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eDentists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e2 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e16 (88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eNurse officers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e47 (25.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e138 (74.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eMedical laboratory scientists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e8 (15.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e45 (84.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.711340206185568%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.835051546391753%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eBachelor degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e124 (19.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e530 (81.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.309278350515465%\" rowspan=\"2\" valign=\"top\" style=\"width: 14.4355%;\"\u003e\n \u003cp\u003e0.185\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eMaster degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e15 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e98 (86.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.711340206185568%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eExperience (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.835051546391753%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e\u0026le;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e32 (10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e266 (89.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.309278350515465%\" rowspan=\"6\" valign=\"top\" style=\"width: 14.4355%;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e6-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e42 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e180 (81.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e11-15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e32 (27.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e84 (72.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e16-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e13 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e37 (74.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e21-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e10 (23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e32 (76.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003e\u0026ge; 26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e10 (25.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e29 (74.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.711340206185568%\" rowspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003eZones\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.835051546391753%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eNorthern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e15 (18.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e65 (81.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.309278350515465%\" rowspan=\"7\" valign=\"top\" style=\"width: 14.4355%;\"\u003e\n \u003cp\u003e0.053\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eLake zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e21 (25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e63 (75.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eSouthern highland zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e25 (16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e128 (83.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eEastern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e40 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e257 (86.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eWestern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e10 (25.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e29 (74.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eSouthern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e13 (27.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e35 (72.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eCentral zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e15 (22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e51 (77.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.711340206185568%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eHealth facilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.835051546391753%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eHospitals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e101 (18.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e456 (81.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.309278350515465%\" rowspan=\"6\" valign=\"top\" style=\"width: 14.4355%;\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eHealth centers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e21 (27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e56 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eCommunity pharmacies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e36 (97.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eCommunity laboratories\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e3 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eDental clinics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e4(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.1875%\" valign=\"top\" style=\"width: 21.9492%;\"\u003e\n \u003cp\u003eOther clinics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.6875%\" valign=\"top\" style=\"width: 23.5352%;\"\u003e\n \u003cp\u003e16(18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" valign=\"top\" style=\"width: 17.8145%;\"\u003e\n \u003cp\u003e73 (82)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: P is significant at \u0026lt;0.05\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOn the other hand, the healthcare providers who responded to all twelve (12) practice questions regarding substandard and falsified medical product identification and reporting were 767. The proportions of the responses to the questions are shown in Table 5. Participants who scored 7-12 questions (71.2%) were considered to have good practice and 0 to 6 (28. 8%) as having bad practice (Figure 4).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 5. The proportion of responses on identifying and reporting practice of substandard and falsified medical products\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponses\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eWhat is the source of information you heard about the presence of substandard and falsified medicines, medical devices, and diagnostic tools?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eMedia and advertising materials\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e40.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003ePatients and Colleagues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e22.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eEncountered in routine work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e28.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNever heard\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eHow do you identify substandard/falsified medicine/medical devices/diagnostics from the original?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eThrough label\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e621\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e81.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e19.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eThrough packaging materials\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e578\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e75.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e24.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eThrough expire date\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e565\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e73.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e26.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eThrough cost/price of medical products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e462\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e60.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e39.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eThrough \u0026nbsp; \u0026nbsp; package insert( leaflet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e455\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e59.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e40.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eThrough unexpected adverse reactions to a few patients after using the same medical product of the same batch.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e610\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e79.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e20.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eWrong diagnosis through laboratory results\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e524\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e68.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e31.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eThrough reporting treatment outcomes to regulatory authorities\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e610\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e79.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e20.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e(When/if) you encounter SF medical products (do you/will you) report them?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e665\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e86.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eWhich form (do you use/will you use) to report them to the regulatory authority?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eYellow form\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e273\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e35.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eGreen form\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eBlue form\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e413\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e53.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eIn your opinion, what is the current situation regarding the circulation of substandard and falsified medicine, medical devices, and diagnostics in Tanzania?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eIt is a big problem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eSubstandard and falsified medical products are not existing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eThe products are existing but not identified and reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e344\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e44.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eDetection of SF medical products is increasing but reporting is a problem.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e27.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.795918367346935%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eIn which action do you suggest can help to reduce the penetration of substandard and falsified medical products in our country?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.714285714285715%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eThrough public sensitization to raise their awareness against SF medical products.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e19.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eAdherence to ethics and reporting \u0026nbsp;the identified SF medical products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eThe strictness of entry points(Borders)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.32203389830509%\" valign=\"top\" style=\"width: 36.9355%;\"\u003e\n \u003cp\u003eAll of the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.033898305084747%\" valign=\"top\" style=\"width: 13.6035%;\"\u003e\n \u003cp\u003e503\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.64406779661017%\" valign=\"top\" style=\"width: 14.2715%;\"\u003e\n \u003cp\u003e65.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eMoreover, the findings show that 84% of Pharmacists, 75.5% of Medical laboratory scientists, 73% of Nurse Officers, 66.7% of Dentists, and 66.7% of Medical doctors had good practice in substandard and falsified medical product identification and reporting. The difference in practice within the cadres was statistically significant with P = \u003cem\u003e0.009\u003c/em\u003e (Figure 5).\u003c/p\u003e\n\u003cp\u003eIn between the cadres, the practice of Pharmacists was significantly higher (84%) compared to other cadres (69.1%) with\u0026nbsp;P\u0026nbsp;= 0.002. However, the practice among Medical doctors was significantly lower (66.7%) than for other cadres (76.2%) with\u0026nbsp;P =\u0026nbsp;0.004 (Table 6). The age, experience, and professional cadres revealed a positive association in identifying and reporting substandard and falsified medical products among the respondents with\u0026nbsp;P\u0026nbsp;\u0026lt; 0.05 (Table 7). The knowledge of the respondents regarding substandard and falsified medical products was found to affect the respondents\u0026rsquo; practice of identifying and reporting substandard and falsified medical products with \u003cem\u003eP\u0026lt; 0.001\u003c/em\u003e (Figure 6).\u003c/p\u003e\n\u003cp\u003eTable 6. Practice in identifying and reporting substandard and falsified medical products between the cadres.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"101%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.795918367346935%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePractice frequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.73684210526316%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBad practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"55.26315789473684%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.649484536082475%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePharmacists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003ePharmacists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e17 (16.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e89 (84.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.8135593220339%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e204 (30.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e457(69.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.649484536082475%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMedical doctors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003eMedical doctors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e135 (33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e270 (66.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.8135593220339%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e86 (23.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e276 (76.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.649484536082475%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eDentists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003eDentists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e6 (33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e12 (66.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.792\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.8135593220339%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e215 (28.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e534 (71.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.649484536082475%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eNurse officers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003eNurse officers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e50 (27.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e135 (73.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.577\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.8135593220339%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e171 (29.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e411 (70.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.649484536082475%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMedical laboratory scientists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003eMedical laboratory scientists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e13 (24.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e40 (75.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.533\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\"\u003e\n \u003cp\u003eOther cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.8135593220339%\" valign=\"top\" style=\"width: 23.7324%;\"\u003e\n \u003cp\u003e208 (29.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.59322033898305%\" valign=\"top\" style=\"width: 21.6426%;\"\u003e\n \u003cp\u003e506 (70.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: P is significant at \u0026lt;0.05\u003c/p\u003e\n\u003cp\u003eTable 7 Factors associated with identifying and reporting practice of substandard and falsified medical products\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.489795918367346%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.591836734693878%\" rowspan=\"2\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.673469387755105%\" colspan=\"2\" valign=\"top\" style=\"width: 41.8574%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePractice handling SF products\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" rowspan=\"2\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.875%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBad n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"53.125%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e20 \u0026ndash; 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e31 (22.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e107 (77.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"5\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e30 \u0026ndash; 39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e83 (22.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e281 (77.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e40 \u0026ndash; 49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e70 (38.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e114 (62.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e50 \u0026ndash; 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e29 (43.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e37 (56.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e\u0026ge; 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e8 (53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e7 (46.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e126 (26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e350 (73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"2\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e95 (32.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e196 (67.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eHealth facilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eHospitals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e175( 31.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e382 (68.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"6\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eHealth centres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e20 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e57 (74.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eCommunity Pharmacies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e6 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e31 (83.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eCommunity laboratories\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e1 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e2 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eDental clinics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e4 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eOther clinics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e17 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e70 (78.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003eZone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eNorthern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e31 (38.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e49 (61.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"7\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eLake \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e28 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e56 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eSouthern Highland \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e37 (24.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e116 (75.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eEastern \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e79 (26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e218 (73.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eWestern \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e14 (35.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e25 (64.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eSouthern \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e13 (27.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e35 (72.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eCentral \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e19 (28.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e47 (71.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eProfessional cadre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003ePharmacists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e17 (16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e89(84.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"5\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eMedical doctors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e135 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e270 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eDentists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e6 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e12 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eNurse officers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e50 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e135(73.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eMedical laboratory scientists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e13 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e40 (75.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eExperience(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e\u0026le; 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e67 (22.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e231(77.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"6\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e6-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e56 (25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e166 (74.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e11-15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e46 (39.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e70 (60.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e16-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e16 (32.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e34 (68.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e21-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e17 (40.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e25 (59.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e\u0026ge; 26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e19 (48.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e20 (51.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eBachelor degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e190 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e464 (70.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"2\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.738\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eMaster degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e31 (27.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e82 (72.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.489795918367346%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.591836734693878%\" rowspan=\"2\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.673469387755105%\" colspan=\"2\" valign=\"top\" style=\"width: 41.8574%;\"\u003e\n \u003cp\u003ePractice on handling SF products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" rowspan=\"2\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003eP \u0026nbsp;value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.875%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003eBad n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"53.125%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003eGood n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e20 \u0026ndash; 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e31 (22.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e107 (77.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"5\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e30 \u0026ndash; 39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e83 (22.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e281 (77.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e40 \u0026ndash; 49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e70 (38.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e114 (62.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e50 \u0026ndash; 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e29 (43.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e37 (56.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e\u0026ge; 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e8 (53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e7 (46.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e126 (26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e350 (73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"2\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e95 (32.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e196 (67.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eHealth facilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eHospitals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e175( 31.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e382 (68.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"6\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eHealth centers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e20 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e57 (74.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eCommunity Pharmacies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e6 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e31 (83.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eCommunity laboratories\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e1 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e2 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eDental clinics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e4 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eOther clinics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e17 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e70 (78.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003eZone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eNorthern zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e31 (38.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e49 (61.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"7\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eLake \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e28 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e56 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eSouthern Highland \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e37 (24.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e116 (75.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eEastern \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e79 (26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e218 (73.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eWestern \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e14 (35.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e25 (64.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eSouthern \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e13 (27.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e35 (72.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eCentral \u0026nbsp;zone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e19 (28.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e47 (71.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eProfessional cadre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003ePharmacists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e17 (16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e89(84.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"5\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eMedical doctors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e135 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e270 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eDentists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e6 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e12 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eNurse officers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e50 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e135(73.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eMedical laboratory scientists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e13 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e40 (75.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eExperience(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e\u0026le; 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e67 (22.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e231(77.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"6\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e6-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e56 (25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e166 (74.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e11-15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e46 (39.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e70 (60.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e16-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e16 (32.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e34 (68.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e21-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e17 (40.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e25 (59.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003e\u0026ge; 26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e19 (48.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e20 (51.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.742268041237114%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.896907216494846%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eBachelor degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e190 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e464 (70.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" rowspan=\"2\" valign=\"top\" style=\"width: 12.7676%;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.738\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.540983606557376%\" valign=\"top\" style=\"width: 21.2461%;\"\u003e\n \u003cp\u003eMaster degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59016393442623%\" valign=\"top\" style=\"width: 23.7109%;\"\u003e\n \u003cp\u003e31 (27.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.868852459016395%\" valign=\"top\" style=\"width: 18.7324%;\"\u003e\n \u003cp\u003e82 (72.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: p is significant at \u0026lt;0.05\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe World Health organization (WHO) recommends the need for healthcare providers to have high knowledge and appropriate practice on substandard and falsified medical product identification and reporting\u0026nbsp;[4].\u0026nbsp;This study has explored Tanzanian healthcare providers\u0026apos; knowledge and practice in identifying and reporting those products. The findings have indicated that the majority of Tanzanian healthcare providers have good knowledge and practice regarding substandard and falsified medical products. Both the knowledge and practice of the healthcare providers appear to be influenced by factors such as\u0026nbsp;age, working experience, the type of facility where a respondent is stationed,\u0026nbsp;and\u0026nbsp;the type of\u0026nbsp;professional cadres.\u003c/p\u003e\n\u003cp\u003eThe overall level of knowledge among healthcare providers on substandard and falsified medical products was high with 81.9% of the respondents having good knowledge (Figure 2). This is contrary to other studies that have reported the knowledge of substandard and falsified medical products to be low among healthcare providers in various countries\u0026nbsp;[23-29].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eHowever, about 69.4% of the respondents reported learning it during practice. Similar findings were also reported from Sudan where 76% of healthcare providers reported having learned about the products during practice\u0026nbsp;[21].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eThe result shows the knowledge of the respondents to be significantly influenced by age (P\u0026nbsp;\u0026lt; 0.001), experience (P\u0026nbsp;= 0.001), professional cadres (P\u0026nbsp;\u003cem\u003e= 0.003\u003c/em\u003e), and health facilities type with\u0026nbsp;P\u0026nbsp;= \u003cem\u003e0.029\u003c/em\u003e (Table 4). The relationship between knowledge and factors such as age and experience is known to be due to changes in the cognitive process. This has been stated by theories of mind\u0026nbsp;[28-31]\u003csup\u003e\u0026nbsp;\u003c/sup\u003eand the WHO report\u0026nbsp;[32].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eSimilar findings were also reported in studies conducted in Lebanon\u003csup\u003e\u0026nbsp;\u003c/sup\u003e[17], Iran\u0026nbsp;[23], and Italy\u0026nbsp;[34].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eThe healthcare providers from health centers were revealed to have significantly lower knowledge than those from other facilities (\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u003cem\u003e= 0.029\u003c/em\u003e). This could be due to the limited number of medical products in health centers which limits exposure to substandard and\u0026nbsp;falsified medical products\u0026nbsp;among the healthcare providers in those facilities\u0026nbsp;[35].\u003c/p\u003e\n\u003cp\u003eConcerning practice, the findings show that 71.2% of the respondents had good practice in identifying and reporting substandard and falsified medical products (Figure 4). This is because the respondents\u0026apos; knowledge regarding substandard and falsified medical products was also proportionally high. This is comparable to findings from some other studies, where the practice of healthcare providers in handling such products was reported to be poor [21, 24, 36].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eHowever, 53.8% of the respondents reported having no idea of the tool to use for reporting\u0026nbsp;substandard and falsified medical products when encountered. Findings similar to these were also reported in Sweden where 66.9% of the healthcare providers reported having no idea of the reporting tools\u0026nbsp;[37].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eOther studies have reported that healthcare providers are in a hurry with no time for identifying the authentic features of medical products\u0026nbsp;before healthcare service provision\u0026nbsp;[9, 24, 38].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eThe practice among Health care providers was significantly associated with age (P\u0026nbsp;\u0026lt; 0.001), experience (P\u0026nbsp;\u0026lt; 0.001), and professional cadres with\u0026nbsp;P\u0026nbsp;= 0.009 (Table 7). The influence of practice with age and experience can also be related to cognitive changes in the healthcare provider\u0026nbsp;[27-31].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eA similar trend of observation has been reported in Iran in which an increase in working time was also found to affect the practice of healthcare providers in identifying and reporting these products [21].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe knowledge and practice regarding substandard and falsified medical products within professional cadres were found to be good except for only a few respondents (Figures 3 and 5). The findings of this investigation are somewhat contrary to other studies where healthcare providers were reported to have limited knowledge and practice regarding substandard and falsified medical products [21, 24, 36].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eHowever, the knowledge among the five health professional cadres shows that Pharmacists\u0026rsquo; knowledge is higher (92.5%) than other cadres (80.2%) with P = 0.003 (Table 3). This is contrary to a study done in Qatar which showed that only 18% of Pharmacists have sufficient knowledge about substandard and falsified medical products [24]. \u0026nbsp;On the other side, the knowledge of Nurse Officers was lower (74.6%) than other cadres (84.2%) with P = 0.004 (Table 3). A comparable gap in the Nurses\u0026rsquo; knowledge regarding substandard and falsified medical products was reported to be low in Medina [9]\u003csup\u003e\u0026nbsp;\u003c/sup\u003eand the International Council of Nurses (ICN) [39].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eAgain, the practice of substandard and falsified medical products identification and reporting among the cadres revealed that the Pharmacists have better conduct (84%) than other cadres (69.1%) with\u0026nbsp;P\u0026nbsp;= 0.002 (Table 6). This can be related to the fact that in most cases Pharmacists assume the major role in preventing the entry, distribution, and dispensing of medical products [23].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eMoreover, another reason for this observation could be because to some extent the University curriculum for Pharmacists in some postgraduate courses incorporated some topics about substandard and falsified medical products [35, 39].\u003csup\u003e\u0026nbsp;\u003c/sup\u003eHowever, the practice among Medical doctors was significantly lower (66.7%) than in other cadres (76.2%) with P = \u003cem\u003e0.004\u003c/em\u003e (Table 6). Some studies have shown that in most circumstances, Medical doctors overlook the identification of substandard and falsified medical products when in a hurry with a huge patient load [9, 24, 39].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings revealed that 81.9% and 71.2% of HCPs have good knowledge and practice regarding substandard and falsified medical product identification and reporting. However, only 13.2% of respondents reported learning it at Universities and only 5.9% of the respondents reported using the right form to report the products. Therefore regulatory authorities in the country are recommended to ensure the availability of Standard Operating procedures (SOP) for identifying and reporting the products in all health facilities. Higher learning institutions are recommended to include modules on substandard and falsified medical products in their curricula. This study further presents an alert and a need for medical product surveillance and legal implications from the responsible Tanzanian authority. \u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding statement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for this study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflicts of interest for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe data utilized to draw this conclusion are accessible from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCode availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVPM\u003c/strong\u003eand \u003cstrong\u003eSN participated in conceptualization, study design, data collection, data analysis and writing the\u0026nbsp;\u003c/strong\u003einitial draft of the manuscript\u003cstrong\u003e. \u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eID participated in study design, data collection and data analysis. YM, EY, GGN, PMM, RS, NEM, NN and JS participated in data collection and data analysis.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eEK\u0026nbsp;\u003c/strong\u003eparticipated in guiding the study design, data analysis, manuscript writing and ensuring integrity of the research. The submission of the final version of the manuscript followed the approval of all authors of this research work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to acknowledge all healthcare providers who participated in this study. We wish to thank registrars of Medical doctors and dentists, Pharmacists, Nurses, Midwifery, and Medical laboratory scientist’s councils for providing statistical data on registered personnel. We also thank all staff from MUHAS for their dedicated cooperation during the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNaira G. Substandard and falsified medicines: Global and local efforts to address a growing problem. Pharm. J. 2019;1-11 \u003c/li\u003e\n\u003cli\u003eYadav S, Rawal G. Falsified drugs : the problem of developing and developed countries. J Pharm Anal. 2015; 2:46-50.\u003c/li\u003e\n\u003cli\u003eNafiu A, Abubakar S, Abdulhakim A, et al. Unveiling the peril of substandard and falsified medicines to public health and safety in Africa: Need for all-out war to end the menace.Wichtig International. 2017; 1:145-154. \u003c/li\u003e\n\u003cli\u003eWorld Health Organization.WHO Global Surveillance and Monitoring System for substandard and falsified medical products. 2017. ISBN 978-92-4-151342-5\u003c/li\u003e\n\u003cli\u003eUbajaka CF, Obi-okaro AC, Emelumadu OF, et al. Factors Associated with Drug Falsified in Nigeria : A Twelve-Year Review. BMJ. 2016; 12:1-8.\u003c/li\u003e\n\u003cli\u003eNayyar GML, Breman JG, Mackey TK, et al. Falsified and Substandard Drugs : Stopping the Pandemic. Am. J. Trop. 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Curriculum for pharmacy students on substandard and falsified medicines. Pharm. Res, 2021; 85:1-80.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":false,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Substandard, Falsified, Medical products, Health care providers, Knowledge, Practice","lastPublishedDoi":"10.21203/rs.3.rs-4270746/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4270746/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe circulation of substandard and falsified medical products in the pharmaceutical markets is a global health problem. The existence of these products undermines the efficiency of the healthcare delivery system and economic development. This research aimed at assessing the level of knowledge and practice among Tanzanian healthcare providers on the identification and reporting of substandard and falsified medical products. Participants included pharmacists, medical doctors, nurses, dentists, and medical laboratory scientists holding bachelor\u0026rsquo;s degrees and providing health services in Tanzania. Google forms were used for data collection and the Statistical Package for Social Sciences (SPSS) 23 was used for data analysis. About 81.9% and 71.2% of respondents were found to have a good level of knowledge and practice on substandard and falsified medical products identification and reporting respectively. However, 92.5% and 84% of the pharmacists were having higher knowledge and practice than other cadres. The age, experience, facility type, and professional cadres were significantly associated with both the respondent\u0026rsquo;s knowledge and practice. Furthermore, only 13.2% of the respondents reported having learned about substandard and falsified medical products from universities and 53.8% reported having no idea of reporting tools for these products. The level of knowledge and practice of Tanzanian healthcare providers on identifying and reporting substandard and falsified medical products was good. However, regular training and improvement of the medical school's curriculum are necessary to equip Tanzanian healthcare providers with the necessary knowledge and good practice in identifying and reporting Substandard and falsified medical products.\u003c/p\u003e","manuscriptTitle":"Assessment of knowledge and practice on the identification and reporting of substandard and falsified medical products among Healthcare providers in Tanzania","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-09 18:26:15","doi":"10.21203/rs.3.rs-4270746/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorAssigned","content":"","date":"2024-05-02T11:30:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-05-02T11:29:48+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2024-04-15T15:38:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6fcfa8ca-3fc7-4c87-a30c-2b45ed67fca9","owner":[],"postedDate":"May 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-05-09T18:26:20+00:00","versionOfRecord":[],"versionCreatedAt":"2024-05-09 18:26:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4270746","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4270746","identity":"rs-4270746","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}