Strengthening Medicines Management Systems to Fight Malaria in Guatemala
In Guatemala, a network of community volunteers who diagnose and treat malaria in their communities are mainstays of the Ministry of Health’s malaria strategy to ensure timely access to appropriate treatment, a key strategy to eliminate malaria. However, an assessment identified weaknesses in the volunteers’ management of antimalarials and diagnostic supplies.
To address this challenge, US Agency for International Development's Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, implemented by Management Sciences for Health, has been providing technical assistance to the Ministry of Health’s malaria program for a nationwide rollout of interventions to improve management of malaria commodities at all levels of the health system.
Quantifying need for malaria commodities
After suffering several months of stock-outs at the national level and depending on donations from Pan American Health Organization (PAHO), the malaria program requested that SIAPS conduct a quantification exercise to ensure availability of commodities. The quantification methodology was documented and local staff were closely involved in the process to build capacity for quantification and facilitate the continued use of a standard method. Going forward, commodities will be procured in part by The Global Fund to Fight AIDS, Tuberculosis and Malaria and in part by the ministry.
Sustaining commodities management standards
There was a clear need for standardization of malaria commodities management at all levels, particularly given frequent staff turnover at the ministry level and the need for additional training for community volunteers. In collaboration with the Ministry of Health logistics unit, SIAPS supported the national malaria program to develop a manual for management of malaria medicines and supplies (Norma técnica para la gestión de medicamentos y productos afines en Direcciones de Áreas de Salud Ministerio de Salud Pública y Asistencia Social, Guatemala 2014). To empower the health workers at all levels, SIAPS developed job aids, such as guides and posters on the management of antimalarials and diagnostic supplies, for the community volunteers and their supervisors, as well for the health centers and district teams. These materials are being disseminated nationwide in a series of regional workshops.
Monitoring and evaluating stock levels
Simultaneously, SIAPS supported the Ministry of Health’s malaria program to set up a reporting system for monitoring availability of malaria commodities including at the community level and pilot the system in two health regions: Escuintla and Alta Verapaz. After only three months of implementation, both pilot regions reported good availability: 100 percent of 184 observed community volunteers in Escuintla reported stock levels in the target range for malaria commodities as specified by the program; Alta Verapaz reported that 66 percent of 173 observed community volunteers had more than the minimum stock of the stipulated supplies.
Additional job aids are available for download from the SIAPS Program website.