Adverse Drug Reaction Reporting among Healthcare Professionals in Private Health Facilities in Mbarara City, Uganda: A Cross-sectional Study
Despite good knowledge and favorable attitudes, adverse drug reaction reporting among healthcare professionals in private health facilities in Mbarara City, Uganda, remains critically low (12.9%) due to systemic barriers such as the unavailability of reporting tools, lack of feedback, and insufficient training, highlighting an urgent need to strengthen pharmacovigilance infrastructure in the private sector.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Every day, millions of people rely on medicines to heal infections, manage chronic conditions, and save lives. Yet, even when used correctly, these powerful tools can sometimes cause unexpected harm. These harmful and unintended responses are known as adverse drug reactions. While doctors and pharmacists are trained to anticipate many risks, the full picture of how medicines affect different people only emerges when these unexpected events are noticed and shared. This process of watching for, recording, and analyzing these reactions is called pharmacovigilance. It is a quiet but vital safety net that allows health authorities to spot dangerous patterns, update warnings, and keep medications safe for everyone. However, this safety net only works if the people on the front lines—doctors, nurses, and pharmacists—actually report what they see. Without their voices, the system remains blind to the very dangers it is meant to catch.
In Uganda, a national agency called the National Drug Authority manages this reporting system, but a significant gap has long existed between the public and private sectors. While government hospitals have been the primary source of reports, the private sector, which includes a vast network of private clinics and hospitals, delivers a huge portion of the country's healthcare. Until now, it was unclear how often professionals in these private facilities were spotting and reporting these dangerous reactions. To fill this gap, researchers from Mbarara University of Science and Technology and Kampala International University traveled to Mbarara City in southwestern Uganda. They set out to understand the reality of reporting in the private sector: how many professionals were seeing these reactions, how many were actually reporting them, and what was stopping them from doing so.
The team conducted a detailed survey in March 2026, visiting private hospitals and clinics across the city. They spoke with 233 healthcare professionals, including nurses, doctors, and pharmacists, asking them about their experiences over the previous year. The results revealed a striking disconnect between what these professionals saw and what they reported. More than 60 percent of the participants said they had observed at least one suspected adverse drug reaction in the last twelve months. This means that for the majority of these workers, these safety concerns were a regular part of their daily routine. Yet, when asked if they had formally submitted a report to the national authority, only about 13 percent said yes. Among those who had actually seen a reaction, fewer than one in five had taken the step to file an official report. This suggests that for every reaction that was reported, four went unrecorded, leaving a silent trail of potential safety issues.
Despite this low reporting rate, the study found that the problem was not a lack of knowledge or a negative attitude. In fact, nearly 80 percent of the participants demonstrated a strong understanding of how to report these reactions, and most agreed that reporting was a professional duty that helped keep patients safe. They did not view the task as a waste of time, nor did they lack the motivation to act. Instead, the barriers were practical and systemic. The most common obstacle cited was the simple unavailability of reporting guidelines and forms; nearly 70 percent of participants said they could not find the necessary tools to file a report. Another major hurdle was the absence of feedback. Over half of the respondents noted that they never received any response from the national authority after they submitted a report, leaving them unsure if their efforts made any difference. Additionally, half of the group felt they had not received enough training on the specific reporting process.
The researchers also looked at what made reporting more likely to happen. They found that professionals with more years of experience were significantly more likely to report an adverse reaction than those who had just started their careers. Similarly, those who had received specific training on pharmacovigilance in the past five years were much more likely to file a report than those who had not. This points to a clear path forward: the gap between seeing a problem and reporting it is not caused by ignorance, but by a lack of support and tools. The study suggests that to fix this, the system needs to provide reliable access to reporting forms, ensure that professionals receive regular training, and create a functioning feedback loop where the national authority acknowledges and responds to the reports they receive. By addressing these practical constraints, the private sector could become a much stronger partner in keeping medicines safe for the entire population.
Drowning in papers in your field?
Get daily digests of the most novel papers matching your research keywords — with technical summaries, in your language.