Q&A with Jude Nwokike: Building the Capacity of the Government of Namibia to Train Pharmaceutical Staff

MSH: What is your role at MSH?
JN: I am the Country Program Manager for Namibia for the Strengthening Pharmaceutical Systems (SPS) Program.

MSH: What is MSH doing in Namibia?
JN: MSH is working in Namibia under the centrally funded SPS Program. SPS implements the support of the US Agency for International Development (USAID) to the Ministry of Health and Social Services (MoHSS) to strengthen pharmaceutical systems for the delivery of antiretroviral therapy programs.

MSH: What are the priority health issues in Namibia? What has been the situation for human resources for pharmaceutical management in Namibia?
JN:  HIV & AIDS is the number one health issue in Namibia and the main focus of USAID support in the area of health. However, Namibia, like other resource-constrained countries, is also confronted by weak health systems and other infectious and chronic diseases. When MSH began working in Namibia in 2004, several positions for pharmaceutical personnel in the public health facilities were not filled. Part of the problem is that about 80 percent of indigenous pharmacists work in the private sector. In addition, Namibia does not train enough pharmacists because there is no professional pharmacy training institution; pharmacists are trained abroad or come from other countries. So, at the beginning of the AIDS epidemic, there was already a lack of pharmaceutical personnel and the growing epidemic exacerbated the situation.

MSH is collaborating with MoHSS to provide pharmaceutical personnel to address this gap. This collaboration started with support for the recruitment of urgently needed pharmaceutical personnel to fill MoHSS positions. The first group of pharmacists recruited through this agreement arrived in Namibia in September 2004, and the collaboration is continuing. MSH is also working with the National Health Training Centre (NHTC) to increase production of mid-level pharmacy staff to address the shortage and support the Ministry’s efforts to decentralize services. The collaboration with NHTC has already increased its capacity to train more pharmacist’s assistants.

MSH: Why pharmacist's assistants?
JN: For a country with such a lack of pharmaceutical personnel and considering the many years required to train a pharmacist, we decided, in collaboration with MoHSS and USAID/Namibia, to invest in increasing the capacity of the local institution to train mid-level pharmacy staff. After a two-year certification course, the pharmacist’s assistants are readily available to work in health facilities. They are usually supervised by pharmacists.

MSH: Where do you find candidates for training? How does becoming a pharmacist’s assistant impact the individual? His or her community?
JN: Qualified high-school graduates are admitted into the program. With local, immediate employment opportunities and a career path in the MoHSS, pharmacist’s assistants are well recognized and remunerated, so they become respected members of the community.

MSH: Ambassador Mark Dybul, Ambassador Dennise Mathieu, and Mr. Denis Weeks recently visited Namibia and saw the Pharmacist Assistant Training Unit renovated by MSH. Why did they decide it was important to visit the facility?
JN: The SPS Program, with funding from PEPFAR through USAID/Namibia, provided technical and financial support to the center to renovate classrooms and offices and provide tutors and consultants. Activities include revising the pharmacist’s assistant training curriculum and developing standards and qualifications for the pharmacist’s assistant course, paving the way for national accreditation.

This initiative is well regarded by both MoHSS and the USAID, as one practical step that affects several key areas. The Ministry is interested in building institutional capacity, decentralizing of antiretroviral therapy (ART) services, promoting sustainability, improving pharmaceutical services, and so on.

The National Health Training Centre has indeed become a cornerstone institution to train health care providers throughout Namibia. It plays a vital role, particularly in the battle against HIV & AIDS and tuberculosis.
US Ambassador to Namibia, Dennise Mathieu

MSH: What are the MoHSS and MSH doing to recruit newly trained pharmacist’s assistants and keep them from leaving Namibia or going into the private sector?
JN: MSH worked with a local Namibian human resource firm to recruit and hire new staff to fill government vacancies, while USAID provided financial support for the positions. MSH collaborated on developing the job descriptions with the MoHSS, and the new staff, although not government employees, work within the government structure and under the supervision of the MoHSS. In two years, 28 new recruits doubled the number of government pharmaceutical staff, and none left for the private sector. To foster sustainability, the MoHSS agreed to eventually absorb the positions into the government system—64 percent of the new staff has already been added to public service. This collaboration created a new mechanism to help the government quickly fill urgent personnel needs in the public pharmaceutical sector, while allowing it to gradually absorb the positions into its existing structure.

In two years, 28 new recruits doubled the number of government pharmaceutical staff, and none left for the private sector.

Through these efforts, the NHTC increased the number of graduating pharmacist’s assistants by 300 percent, from the previous 8 per year to the current 24 per year. The next phase will double the capacity to 50 pharmacist’s assistants per year by 2010. The new pharmacist’s assistants have already contributed to the government’s efforts to decentralize ART services by deploying to remote areas. 

We are also fostering collaboration among universities to build long-term institutional capacity in pharmaceutical management. For instance, the Regional Technical Resource Collaboration for Pharmaceutical Management comprises groups from Makerere University, Muhimbili College of Health Sciences in Tanzania, the University of Nairobi, and the National University of Rwanda. These institutions collaborate on tools and training approaches, then lead initiatives in their home countries to build the skills of local health care workers to manage HIV & AIDS medicines and other health care commodities.

For more information about MSH’s work in pharmaceutical management in Namibia, please go to:

http://windhoek.usembassy.gov/august_1_2008.html

http://projects.msh.org/projects/sps/News-and-Stories/Featured-Country.cfm

 

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