Sustainable Drug Seller Initiatives

An Accredited Medicines Stores (AMS) seller receives an infrared thermometer to use in Ebola and other outbreak surveillance.

by Arthur Loryoun

Editor's note: This post originally appeared on the Bill & Melinda Gates Foundation's blog, Impatient Optimists. Funded by the Gates Foundation and led by Management Sciences for Health (MSH), the Sustainable Drug Sellers Initiative (SDSI) project worked to ensure the sustainability of public-private drug seller initiatives in Tanzania and Uganda, and to roll-out the initiative in Liberia.

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

MSH spoke with Fabio Castaño, MD, MPH, global technical lead of family planning and reproductive health about MSH’s approach to family planning and what will define the future of family planning and global health. Below is part one of the conversation. 

What is MSH’s approach to family planning and reproductive health?

[Dr. Fabio Castaño.]Dr. Fabio Castaño.Fabio:

First of all, I have to tell you that MSH has been working on family planning [FP] for over 40 years. Our first-ever international program was working with Korea! We supported their successful story of making FP an essential part of public health activities. At that time, we worked on FP from a standpoint of population control. Then, to help improve the health situation, and also contributing to reducing poverty. So, that is an interesting piece of history for MSH.

 {Photo credit: Rachel Lieber/MSH.}ADDO owners and dispensers in Mafia Island, Tanzania, learn to use the mobile applications developed by SDSI. The applications allow ADDO personnel to access an SMS-based Pharmacy Council helpline, send service utilization reports to the Pharmacy Council, and to pay annual licensing fees via mobile money.Photo credit: Rachel Lieber/MSH.

Cross-posted with permission from mHealthKnowledge.org.

In the private sector, Tanzania has more than 1,000 pharmacies, 2,500 pharmaceutical personnel, 6,000 accredited drug dispensing outlets (ADDOs), and more than 18,000 ADDO dispensers. The Pharmacy Council of Tanzania has overseen these facilities and personnel since 2011, but lacked a comprehensive system to manage regulatory information. Without such a system, basic facility and personnel information was inaccessible, the locations of rural ADDO facilities were unclear, and tracking business and professional licensing status, including fees collection, was difficult. Furthermore, the Pharmacy Council had no way to efficiently communicate directly with the outlets.

 {Photo credit: Rui Pires}An Accredited Drug Store in Uganda. MSH, through the Sustainable Drug Sellers Initiative, is helping scale-up access to medicines in Tanzania, Uganda, and Liberia.Photo credit: Rui Pires

Interested in a career in innovation and international development? You’re in luck, says Ingrid Ahlgren in Devex: “the need for new and improved development ideas isn’t going anywhere, and neither are the positions to facilitate them.”

Ahlgren of Devex shares advice on common innovation roles, what's required to land a position, and more from innovation and global development experts, including MSH President & CEO Jonathan D. Quick and Mac Glovinsky of UNICEF. Innovation, “is a big buzzword right now,” says Glovinsky. He says, donors wanting innovation embedded in key functions of development are a key driver of increased attention.

Innovation in development doesn’t mean only new technology, says Quick:

People tend to talk about product and technology innovation, but that’s only half the story.

 {Photo credit: Jafary Liana/MSH}Germana (right), ADDO owner and dispenser in Kipara Mpakani Village with full-time accredited dispenser (left).Photo credit: Jafary Liana/MSH

In developing countries, a community medicines shop often serves as the first point of contact for health care. Empowering the drug shop owner and dispenser to provide safe, quality medicines, and referrals to a health facility for more complex care, is key to improving maternal and children’s health in rural areas.

MSH’s Jafary H. Liana and Dr. Suleiman Kimatta visited two accredited drug dispensing outlet (ADDO) owners in Mkuranga District, Tanzania. One woman owns two ADDOs, while the other owns one. Both are also trained ADDO dispensers (an estimated 90 percent of ADDO dispensers are women).

Meet Germana Firmini Mroso

Germana Firmini Mroso, 31 years old, owns an ADDO named ROSALA DUKA LA DAWA MUHIMU, which is located at Kipara Mpakani Village, Vikindu ward, in Mkuranga District. Germana is both an owner and dispenser in her outlet. Germana holds a one year nurse assistant certificate. She manages a second small business making medicine-packaging envelopes which she uses in her outlet and sells to other outlets.

Why did you become an accredited drug shop owner?

 {Photo credit: Jafary Liana/MSH}Audensia Batholomew shares her path to accreditation as an drug shop outlet owner and dispenser with Dr. Suleiman Kimatta.Photo credit: Jafary Liana/MSH

In developing countries, a community medicines shop often serves as the first point of contact for health care. Empowering the drug shop owner and dispenser to provide safe, quality medicines, and referrals to a health facility for more complex care, is key to improving maternal and children’s health in rural areas.

MSH’s Jafary H. Liana and Dr. Suleiman Kimatta visited two accredited drug dispensing outlet (ADDO) owners in Mkuranga District, Tanzania. One woman owns two ADDOs, while the other owns one. Both are also trained ADDO dispensers (an estimated 90 percent of ADDO dispensers are women).

Meet Audensia Batholomew

Audensia Batholomew, MBIGI, a 45-year-old single mother, lives in Mkuranga district headquarters with two dependents and an adult son at university. She owns two ADDOs, one located in Chamazi village (20 km from her home) and one in Njopeka village (30 km away). Audensia also holds a one-year nurse assistant certificate.

Why did you become an accredited drug shop owner?

Celia Tusiime Kakande. {Photo: Tadeo Atuhura/MSH.}Photo: Tadeo Atuhura/MSH.

For most of my life, women in Uganda---as in most countries---were treated as inferior to men. Girls were less likely to be educated than their brothers, and had little control over the direction of their lives. Many girls grew up being told how to act, eat, and talk; many women were regarded as little more than domestic caregivers. However, in 1986 the ruling government radically changed the dynamics of Ugandan women in global development and their participation in decision-making at all levels of government. This International Women’s Day we, in Uganda, are celebrating this transformation with a theme of “connecting girls, inspiring futures,” and wishing women around the world similar progress and success.

Women Lead: Government

Women in Uganda now hold more leadership positions than ever before—35 percent of the seats in Parliament are now occupied by women, and our Speaker of Parliament and Minister of Health are women. The introduction of universal primary education has allowed more girls to begin their schooling, and affirmative action at the university level has provided more women the opportunity to realize their dreams for fulfilling professional careers.

Celia Tusiime Kakande. {Photo: Tadeo Atuhura/MSH.}Photo: Tadeo Atuhura/MSH.

For most of my life, women in Uganda---as in most countries---were treated as inferior to men. Girls were less likely to be educated than their brothers, and had little control over the direction of their lives. Many girls grew up being told how to act, eat, and talk; many women were regarded as little more than domestic caregivers. However, in 1986 the ruling government radically changed the dynamics of Ugandan women in global development and their participation in decision-making at all levels of government. This International Women’s Day we, in Uganda, are celebrating this transformation with a theme of “connecting girls, inspiring futures,” and wishing women around the world similar progress and success.

Women Lead: Government

Women in Uganda now hold more leadership positions than ever before—35 percent of the seats in Parliament are now occupied by women, and our Speaker of Parliament and Minister of Health are women. The introduction of universal primary education has allowed more girls to begin their schooling, and affirmative action at the university level has provided more women the opportunity to realize their dreams for fulfilling professional careers.

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