Ethiopia

Strengthening Pharmaceutical Systems (SPS) Program

2007–2012

Strengthening Pharmaceutical Systems is a follow-on to the Rational Pharmaceutical Management (RPM) Plus Program. MSH is pleased to announce that the US Agency for International Development has awarded us the Strengthening Pharmaceutical Systems (SPS) Leader with Associates Cooperative Agreement. SPS will focus on four key results:

• Improve governance in the pharmaceutical sector
• Strengthen pharmaceutical management systems to support public health services
• Contain the emergence and spread of antimicrobial resistance
• Expand access to and improved use of essential medicines

The five-year, $147.5 million cooperative agreement is led by Dr. Douglas Keene as Program Director and Dr. Maria Miralles as Deputy Director.

To help meet goals relating to the key result areas, the SPS Program is building on the successes of RPM Plus while expanding the range of technical areas to include financing, pharmacovigilance, pharmaceutical care, integration of new health technologies, and increased use of the private sector, among others. MSH will accomplish this enhanced program of activities by collaborating with a number of new partner organizations.

The SPS core partner team includes:

• BroadReach Healthcare
• Ecumenical Pharmaceutical Network
• The Lewin Group
• LMI Government Consulting
• University of Washington Department of Global Health
• WHO Collaborating Center in Pharmaceutical Policy: Harvard University/Boston University

In addition to the core team, MSH is joined by a select group of organizations that will serve as specialized resources for SPS. These organizations include:

• African Medical and Research Foundation
• American Society of Health-System Pharmacists
• Euro Health Group
• Infectious Disease Institute at Makerere University
• Joint Commission International
• London School of Hygiene and Tropical Medicine

As we work toward the overall goal of SPS, the SPS team is striving to advance the science and "art" of strengthening pharmaceutical management systems. The SPS Program provides a great opportunity for MSH and USAID to continue supporting developing countries in their quest to increase access to essential medicines and facilitate the scale up of vital treatment programs.

International Network for Rational Use of Drugs Initiative on Adherence to Antiretrovirals (INRUD-IAA)

2006–2011

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The International Network for Rational Use of Drugs (INRUD) was established in 1989 to design, test, and disseminate effective strategies to improve the way drugs are prescribed, dispensed, and used, with a particular emphasis on resource poor countries.

Launched in September 2006, the INRUD-IAA initiative is funded by the Swedish International Development Cooperation Agency. The objectives of the five-year initiative are to—

• Develop and validate a set of indicators that can be used to monitor adherence to ART
• Investigate adherence rates and determinants for these rates for ART programs and individuals in two target countries
• Pilot interventions to improve adherence in individual patients and in programs in two countries
• Establish the process needed for national AIDS control programs to scale-up successful interventions as part of national policy in the two countries
• Work with the other three countries in the region to develop national adherence policies and implement interventions to improve adherence

Rational Pharmaceutical Management Plus Program

2000–2008

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RPM Plus works in more than 40 developing countries to provide technical assistance to strengthen pharmaceutical and health commodity management systems. The program works to improve the availability and use of quality medicines, supplies, and basic medical equipment in the public and private sectors and to promote practical, sustainable changes in pharmaceuticals management by developing capacity within cooperating countries and fostering collaboration between countries.

RPM Plus works on a variety of health issues in Ethiopia, including HIV & AIDS and opportunistic infections. The program works in all eleven regions of the country and is currently supporting about 100 hospitals and 280 health centers providing services for antiretroviral treatment (ART) and prevention of mother-to-child transmission (PMTCT)of HIV. This assistance includes training, procurement and distribution of antiretroviral (ARV) medicines for the President’s Emergency Plan for AIDS Relief (PEPFAR), provision of equipment for proper handling of pharmaceuticals, and data management.

Advance Africa

2002–2004

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Advance Africa was a family planning/reproductive health service delivery project designed to increase access to and improve the quality of clinical and nonclinical programs in sub-Saharan Africa. The project worked to increase capacity for informed decision-making by clients and communities, and for the public sector to sustain quality family planning/reproductive health service delivery programs. Advance Africa also worked with USAID missions to scale up existing efforts by closing gaps in service delivery, and building partnerships among public and private health and nonhealth organizations. The project implemented innovative approaches to revitalize family planning programs within the broad context of Africa’s HIV/AIDS pandemic. MSH was the prime of a consortium of six international organizations that managed implementation of the Advance Africa project.

Working in collaboration with other partners, Advance Africa provided technical assistance for a nationwide assessment of Ethiopia’s community-based reproductive health (CBRH) services. Although services had been ongoing, this assessment was the first evaluation of their quality, impact, and effectiveness. At the time of the assessment, CBRH services at the national level were being implemented by 30 different nongovernmental organizations (NGOs) that varied in levels of training and compensation, area of geographical focus, and data collection systems. Based on the lessons learned from its successful expanded Community-Based Distribution (CBD) program in Zimbabwe, the project developed and recommended methods for a more systematic and organized approach to CBRH services that would in turn strengthen and expand their overall quality in Ethiopia.

Basic Support for Institutionalizing Child Survival (BASICS)

1999–2009

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As a technical assistance partner for newborn and child health to the USAID Bureau for Global Health, the Basic Support for Institutionalizing Child Survival (BASICS) Project develops and implements strategies to reduce preventable infant and childhood deaths in the developing world. MSH works as a partner in BASICS, which began its third phase in October 2004. Under this indefinite quantity contract (IQC), BASICS assists USAID/Washington Bureaus, USAID field missions, host-country governments, donor agencies, NGOs, PVOs, research institutions, and the private sector to scale up and increase the use of newborn and child health and nutrition interventions by families, communities, and health systems.

Since 1993, BASICS has worked to achieve substantial improvements in coverage and to expand effective newborn and child health interventions. BASICS focus areas include newborn health, essential nutrition actions like vitamin A supplementation, immunization, integrated management of childhood illness, treatment of diarrhea and pneumonia, and malaria control. In addition to strengthening the delivery of basic newborn and child health services, BASICS has expanded its technical scope to include pediatric HIV & AIDS, birth spacing, and child survival and nutrition in complex humanitarian crises. BASICS areas of expertise include assistance to countries on comprehensive strategies or selected interventions for newborn and child health, building partnerships, delivery of quality newborn and child health services, community-based treatment and private sector approaches to expand access to services, and capacity building and training.

BASICS activities in Ethiopia from 1994 to 1999 focused on institutional capacity development at the central and regional levels to provide an appropriate package of primary and preventive health services for the predominantly rural population. Key achievements included the development of a pilot health management information system.

During BASICS' second contract phase (1999–2004), the project provided technical assistance to Ethiopia's Southern Nations, Nationalities and People’s Regional Health Bureau, and the Ethiopia Essential Services for Health Project to develop an integrated health information system (HIS) to monitor and provide data for managing health services at the community level. BASICS emphasized integrated management of newborn and childhood illness and the community-based treatment of pneumonia.

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