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View the framework document (PDF, 740KB)
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View the framework model (PDF, 51KB)
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The SEAM Program provides technical assistance in designing
and implementing strategies that improve access to and use of medicines, and other essential health commodities in selected countries. SEAM intends that its evolving public-private sector models also be available for adapted use in other country
contexts throughout the developing world.
Developing a Framework
In December 2000, SEAM collaborated with the World Health Organization (WHO) and more than 40 leading experts to develop a framework (PDF, 740KB) for measuring access. The results of this collaboration serve as the basis for SEAM country program development and evaluation.
Providing a Baseline, Presenting Results
 After discussions and consultations with experts from WHO, the World Bank, and developing countries, SEAM identified six countries for field-testing the framework: Brazil (state of Minas Gerais), Cambodia, El Salvador, Ghana, India (state of Rajasthan), and Tanzania.
Between February and May 2001, SEAM staff visited each of the countries participating in the assessments to explain the objectives of the SEAM Program and to gain each country's full cooperation in conducting the assessments. Follow-up visits provided additional data on access to pharmaceuticals and helped formulate ideas for potential interventions to improve access. Assessment results, along with analyses of potential interventions, were presented and discussed at the November 2001 SEAM Conference.
Developing Country Strategies
SEAM identified opportunities for public-private collaboration to improve access to medicines, and other essential health commodities in each of the six cooperating countries—Brazil (state of Minas Gerais), Cambodia, El Salvador, Ghana, India (state of Rajasthan), and Tanzania.
As part of these efforts, SEAM has also developed a franchise business model for distributing medicines and other essential health commodities through private retail outlets in underserved population areas. Initial pilot testing of this model is underway in Ghana . At the same time, SEAM is working with the Sustainable Healthcare Enterprise Foundation (formerly Cry for the World Foundation) on a franchising initiative to expand and improve access to essential medicines in Kenya.
Selecting Countries
Recommendations from the 2001 SEAM Conference, along with input from the SEAM Advisory Committee, helped SEAM shape proposed strategies for each country and determine which countries would be most appropriate for full-scale programs. The most important factors for selecting which countries SEAM would work in were strong in-country support, the probability of sustainable and replicable success, and the availability of sufficient funds to complete the work within the life of the project.
Based on this input and review, the SEAM Program has implemented full-scale, countrywide programs in Tanzania and Ghana. A smaller-scale, focused project is being implemented in El Salvador. The remaining three countries that participated in field-testing the framework (Brazil, Cambodia, and India) have the opportunity to use SEAM's assessments and proposed strategies to establish their own initiatives and approach other donors and lenders for support.
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