Pharmaceutical Management: Our Impact

{Photo Credit: Michael Paydos/MSH}Photo Credit: Michael Paydos/MSH

Tuberculosis is one of the top causes of death globally. In many of the countries most affected by this disease, drug sellers—also known as private pharmacies—are the first point of contact for people seeking health care. By some estimates, about 50 percent of TB patients’ first contact with the health system is from a private pharmacy.

 {Photo Credit: Abraham Ayuen/MSH}Yohana sits with his mother near a pharmacy at Al Sabah Children's Hospital in Juba, South Sudan.Photo Credit: Abraham Ayuen/MSH

Six-year-old Yohana Peter clutched a bottle of mango juice as he waited for his medication outside a pharmacy at Al Sabah Children's Hospital in Juba, South Sudan. Seated next to his mother on a metal bench, Yohana looked anxious. "He had fever and stomach pain. I gave him some medicines at home, but his condition continued to worsen, so I brought him to the hospital to be seen by a doctor," said Asunta Wasuk, Yohana's mother.

 {Photo Credit: Mohammad Hossain/MSH}Tama with her daughter Sangita, who received treatment for potentially fatal, pneumonia-related complications.Photo Credit: Mohammad Hossain/MSH

Tama, a resident of Parokhali village in the Khulna district of Bangladesh, was devastated when her 15-day-old daughter was diagnosed with pneumonia-related complications and needed treatment, including immediate oxygen support. Following instructions from the local doctor, she and her husband rushed their newborn to Khulna Shishu Hospital, situated eight kilometers from her village. Thanks to the oxygen supply system that had been recently installed at the hospital, baby Sangita received a steady flow of medical oxygen and recovered.

 {Photo Credit: SIAPS Namibia} Senior Pharmacist Assistant George Lukonga dispenses ARVs using the EDT at Katima Mulilo HospitalPhoto Credit: SIAPS Namibia

George Lukonga, the senior pharmacist assistant at the Katima Mulilo Hospital in the Zambezi region of Namibia, is accustomed to dealing with 200 to 300 patients on antiretroviral therapy every day. The Zambezi region has an HIV prevalence rate of 23.7 percent. Dispensing antiretrovirals to the hundreds of patients who visit the pharmacy daily was a daunting task, so Lukonga's colleagues were trained to use the electronic dispensing tool, better known as EDT.

 {Photo Credit: Tsion Issayas/MSH}Aster Ammanuel (second from right) has more time to spend with her family now that the time needed for her visits to the hospital has decreased.Photo Credit: Tsion Issayas/MSH

Aster Amanuel Desalegn lives in Debre Markos, 190 miles from the Ethiopian capital of Addis Ababa. She is a 70-year-old mother of four and grandmother of two. Her granddaughters, Emuye, 6, and Blen, 8, live with her. On a trip back from visiting family in Addis Ababa 20 years ago, Desalegn fell ill and went to the nearest health center for help. Doctors said her blood sugar level was critically high and she needed to start treatment right away. For the past 12 years, Desalegn has been taking insulin.

 {Photo Credit: Ruhengeri Hospital staff}Patients waiting at Ruhengeri Hospital Internal Medicine Ward.Photo Credit: Ruhengeri Hospital staff

When Ruhengeri Hospital in northern Rwanda upgraded from a district to a referral hospital in 2014, it began receiving cases from 15 health centers in its own district and from five hospitals in surrounding districts. In 2015 alone, the hospital experienced close to 6,000 monthly outpatient visits, about 25 percent above previous levels and now among the highest in the entire country. Such numbers proved how important the status upgrade had been in relation to local health needs, but the facility struggled to consistently meet those needs.

 {<a href="http://siapsprogram.org/wp-content/uploads/2016/04/Guatemala_CV_Afiche_FINAL_R1.pdf">USAID SIAPS</a>}Identifying, Treating, and Preventing Malaria: a poster for community volunteersUSAID SIAPS

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.

{Photo: MSH staff}Photo: MSH staff

For the first time in Democratic Republic of the Congo (DRC), 13 life-saving health commodities for mothers and children have been included in the National Health Development Plan (NHDP). These medicines are recommended by the United Nations Commission on Life-Saving Commodities for Women and Children (UNCoLSC).

{Photo Credit: MSH Staff}Photo Credit: MSH Staff

Management Sciences for Health has been working closely in collaboration with the Global Alliance for TB Drug Development (TB Alliance) on the introduction of the new dispersible pediatric fixed-dose combination. Through MSH’s projects across identified high-burden countries, we have been providing assistance on updating treatment guidelines and essential medicines lists, registration of the reformulated product, financing and reprogramming grants, quantification, and training healthcare providers on the medicine and its use. 

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

Kwesi Eghan Kwesi Eghan, MSC, MBA, BPHARM, is portfolio manager for the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program in South Sudan and Afghanistan. A pharmacist by training, Eghan co-authored MSH’s recently published Management of Medicines Benefit Programs in Low-and Middle-Income Settings, which is designed as a manual for countries to implement health benefit packages that reduce out-of-pocket expenses for medicines in the context of universal health coverage (UHC).

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