Pharmaceutical Management: Our Impact

{Photo credit: MSH staff/ SIAPS Ethiopia.}Photo credit: MSH staff/ SIAPS Ethiopia.

The US Agency for International Development (USAID)-funded Systems for Increasing Access to Pharmaceuticals and Services (SIAPS) Program has partnered with the Government of Ethiopia to bring a 100-year-old pharmaceutical management system into the 21st century. The Auditable Pharmacy Transactions and Services (APTS) is a package of data-driven interventions that ultimately result in a continuous supply of essential medicines, optimal budget utilization, and improved pharmacy services.

{Photo credit: MSH staff/SIAPS Burundi.}Photo credit: MSH staff/SIAPS Burundi.

Malaria is the leading cause of death for adults and children under five in Burundi. One hundred percent of the population in Burundi is at risk of contracting malaria. Despite the efforts of Burundi’s Ministry of Health (MoH), timely access to health care is limited by financial constraints, geographic inaccessibility, and lack of awareness about malaria complications. Community Case Management

{Photo credit: SCMS}Photo credit: SCMS

The Supply Chain Management System (SCMS) case story, “Saving Lives Through Stronger Supply Chains” (PDF), was selected as one of the top five winners of the Procurement for Complex Situations Challenge. The Challenge aims at collecting and disseminating practical experiences with lessons of failure or success from designing and implementing procurement in complex situations. Case stories will be used to empower procurement practitioners with solutions and tools to improve procurement performance in complex situations, fostering the science of delivery.

Figure 1: Percentage of diarrhea cases that are appropriately treated

The MSH-led, USAID-funded Securing Ugandans’ Right to Essential Medicines (SURE) program registered significant improvements in rational prescriptions for diarrhea and cough after introducing on-the-job training to health workers. The training, which is a component of SURE’s supervision, performance assessment, and recognition strategy, was introduced in collaboration with the Ministry of Health to improve medicines availability, storage, and appropriate use.

 {Photo credit: MSH}Medicines management supervisors receive computer training for collecting, submitting, and analyzing SPARS data.Photo credit: MSH

Districts in Uganda faced many problems in managing medicines and health supplies. Health facilities often placed orders for medicines and health commodities without reviewing their consumption rate­—how much they had been using—which led to both the expiration and stock-out of vital medicines. Medicines were also prescribed without following treatment guidelines, which when coupled with inadequate information and instructions during dispensing,  left patients dangerously confused.

 {Photo credit: MSH}BEFORE: Drugs in boxes placed on the floor in Kisoro HospitalPhoto credit: MSH

Shelves may seem very basic and not particularly worthy of note. In fact, shelves can transform how medicines and supplies are organized by making it easier for a hospital to keep track of how many drugs it has and prevent wasteful expiry.  For nearly 16 years, all drugs and health supplies in Kisoro Hospital were stored on the floor, which was inefficient and a challenge for staff members who had to manage the stock. 

{Photo credit: MSH}Knud Rhyl was brought on board by SURE and NDA to help devise the new guidelines and inspection tool. Knud helped adapt international best practices to the Ugandan context. He is pictured presenting at the meeting with key wholesalers in Uganda.Photo credit: MSH

In Uganda, although wholesale and retail pharmacies are legally distinct, their practices are indistinguishable and their customer base overlaps. Wholesalers’ service should be business-to-business only, but they often sell to the public. This division of responsibility is crucial in assuring the quality and safety of drugs; without accountability, substandard and counterfeit medicines can too easily slip through the cracks.

 {Photo credit: MSH}District Inspector, Daniel Isabirye, inspecting Misima HC II in Jinja, while Esther Mugadya, the In-charge, helps find stock cards for review.Photo credit: MSH

The National Drug Authority (NDA) has minimum standards and inspects facilities to certify that they meet those standards. Inspections, therefore, are important in ensuring good pharmacy practices. Until now, NDA had only inspected private sector pharmacies who had more resources to achieve what was required to be certified.

 {Photo credit: Aurélie Jousset/MSH}Joseph Borgelain inserts the cartridge into the PIMA machine to perform a rapid CD4 test for Paul.Photo credit: Aurélie Jousset/MSH

Two-year-old Paul had been sick for several days. On October 12, 2013, his aunt Marie brought him to the Jules Fleury Hospital in the Nippes department of Haiti. Two weeks prior, Paul’s mother, who is HIV-positive, had left for Port-au-Prince in search of work, leaving Paul in the care of his aunt.

 {Photo credit: MSH}Before the historic approval this September, stateholders met to dicuss the draft national strategic framework for pharmaceutical human resources.Photo credit: MSH

The Executive Board of Afghanistan’s Ministry of Public Health (MoPH) formally approved the country’s first national strategic framework for pharmaceutical human resources (HR) on September 28, 2013. The framework helps strengthen the pharmaceutical system and health workforce.

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