MSH Contributes to Successful Scale-up of Electronic Antiretroviral Management System in Namibia

After several years of collaboration between Namibia’s Ministry of Health and Social Services (MoHSS) and MSH, a significant milestone was recently reached when a local telecommunications company, MTC, signed a contract with the MoHSS to continue the support of an electronic antiretroviral (ARV) management tool and a national database of ARV dispensing information. Both were developed by MSH in collaboration with the MoHSS—and fully handed off to the MoHSS by MSH earlier this year. With the hand-off completed and local support in place, responsibility for the ongoing use and maintenance of the tools now rests with the MoHSS and their in-country partners.

At the contract signing ceremony with MTC, Dr David Mabirizi of MSH, said “In the past five-six years, a number of achievements have been realized and we continue on the same path of growing sustainable systems that will ensure that the efforts and resources invested by the Government of Namibia for pharmaceutical services are optimally utilized.” (New Era, May 20, 2010).

Better Forecasting and Monitoring of Patient Adherence

Installed in 49 facilities across Namibia, the ARV management tool is built on MSH’s electronic dispensing tool (EDT). EDT is a real-time tool used to help pharmacy staff track their stock of ARVs and other medicines and monitor patient adherence through recording individual patient activity and the dispensing of medicines. Ensuring a continual supply of medicines and monitoring patients’ adherence to drug regimens is essential to maintaining the quality of antiretroviral treatment (ART) and improving HIV outcomes.

“EDT enables fast and easy dispensing with records that are easily accessible and accurate”
—Erastus Ndungu, pharmacist, Katutura Intermediate Hospital, Namibia

Through use of the EDT, pharmacy staff are able to forecast when to order medicines and in what amount, preventing stock-outs and disruption in treatment. Pharmacy staff and HIV program managers are able to determine adherence of individual patients through reports showing pill counts, number of days missed before a patient collects medicines, and whether a patient has remaining medicine at the time of refill. And, facilities are able to monitor the development of drug resistance using World Health Organization (WHO) early warning indicators.

To extend coverage to remote areas, handheld scanners are used to temporarily hold patient records and dispensing information gathered at outreach sites until they can be uploaded at a facility using the EDT.

Database Offers National Tracking of Antiretrovirals

The EDT and scanners are being used to record all dispensing activity of ARVs in Namibia. Information from the health facilities is aggregated in a national database housed in the MoHSS offices in Windhoek. As a result, the MoHSS is able to monitor the dispensing of ARVs by district, region, or for the whole of Namibia, as well as view data consumption patterns and adherence rates. This allows the MoHSS to get a full picture of antiretroviral treatment across the country and better forecast the need for ARVs nationally, as well to identify areas that may be developing ARV resistance according to WHO early warning indicators.

Both the EDT-adapted ARV management tool and national database were developed by MSH’s Strengthening Pharmaceutical Systems (SPS) Program, funded by the United States Agency for International Development.

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