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Proper stock management is essential for providing medicines to patients when and where they need them. This is especially important for people living with HIV because treatment is a lifelong commitment and adherence is critical to good outcomes. Pharmacists must be able to track, analyze, and manage stock information to prevent stock-outs, overstocks, and stock expiring on the shelf.

This standard operating procedure describes the procedures to be used by the members of Pharmacovigilance Department of National Medicines and Healthcare Products Regulatory Authority (NMHRA), Medicine Safety Committee (MSC) and by health care professionals for the recording, management and reporting of suspected adverse drug reactions and other suspected adverse events that are reported through t

Purpose:The primary use of the WCA is to measure workgroup climate. Its secondary purpose is to engage workgroup members in a conversation about their particular climate so that together, they can find ways to improve it.

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, November edition. 

Cote d’Ivoire health systems are being decentralized to prioritize decision making at the regional and departmental levels. Through strengthening leadership, management, and governance (LMG) skills of these decision makers, a stronger, self-sufficient system is created to be responsive to local needs.

Because resources available to improve global health are limited, it is becoming increasingly important for those who produce and disseminate health-related information and services to gauge the impact of their work.

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, December 2020 edition. 

To evaluate the integration of tuberculosis (TB) screening and contact investigation into Integrated Maternal, Neonatal and Child Illnesses (IMNCI) and TB clinics in Addis Ababa, Ethiopia, this study used mixed methods with a stepped-wedge design, where 30 randomly selected health care facilities were randomized into three groups of 10 during August 2016-November 2017. Overall, 180,896 children attended 30 IMNCI clinics and 145,444 (80.4%) were screened for TB. A total of 688 (0.4%) children had presumptive TB and 47 (0.03%) had TB. Integrating TB screening into IMNCI clinics and intensifying contact investigation in TB clinics is feasible for improving TB screening, presumed TB cases, TB cases, contact screening and IPT coverage during the intervention period. Stool specimen could be non-invasive to address the challenge of sputum collection.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions (SCARs). There is scant literature on the characteristics and causes of these conditions among the Nigerian population. Here, we describe the epidemiology, associated morbidity and mortality, and culpable drugs in SJS and TEN cases using the National Pharmacovigilance (NPC) database in Nigeria. Antiretroviral and antibiotics were the commonly reported offending group of drugs for SJS and TEN cases. Nevirapine and co-trimoxazole were the commonly reported suspect drugs. SJS and TEN were reported most frequently in females and in patients aged 19–40  years, indicating that drug surveillance and counseling in these groups of patients may be beneficial.

We describe a novel training programme, the tuberculosis Data Fellowship, designed to build capacity in low- and middle-income countries for tuberculosis data analytics. The programme was piloted in six countries (Bangladesh, Ethiopia, Ghana, Malawi, Mozambique) in July 2018 and Nigeria in September 2018; 20 participants completed the training. A number of key outputs have been achieved, such as improved instrument utilisation rates, decreased error rates, and improved instrument management. The training programme empowers local tuberculosis programme staff to discover and fix critical inefficiencies, provides high-level technical and operational support to the tuberculosis programme, and provides a platform for continued sharing of insights and best practices between countries. It supports the notion that connectivity can increase efficiencies and clinical benefits with better data for decision making, if coupled with commensurate capacity building in data analysis and interpretation.

To identify and to assess factors enhancing or hindering the delivery of breast and cervical cancer screening services in Malawi with regard to accessibility, uptake, acceptability and effectiveness, a search of six bibliographic databases and grey literature was executed to identify relevant studies conducted in Malawi in English. One hundred and one unique records were retrieved and 6 studies were selected for final inclusion in the review. Multiple factors affect breast and cervical cancer service delivery in Malawi, operating at three interlinked levels. At the patient level, lack of knowledge and awareness of the disease, location, poor screening environment and perceived quality of care may act as deterrents to participation in screening; at the health facility level, services are affected by the availability of resources and delivery modalities; and at the healthcare system level, inadequate funding and staffing and lack of appropriate monitoring and guidelines may have a negative impact on services. Convenience of screening, in terms of accessibility and integration with other health services, was found to have a positive effect on service uptake. Building awareness of cancer and related services and offering quality screening are significant determinants of patient satisfaction. Capitalising on these lessons is essential to strengthen breast and cervical cancer service delivery in Malawi, to increase early detection and to improve survival of women.

The aim of this paper is to explore the prevalence and factors associated with awareness of cervical cancer among women of reproductive age in Republic of Benin and Zimbabwe, sub-Saharan Africa. About 15,928 and 9,955 women aged 15–49  years were included in this study, respectively. While the majority (79.2%) of women from Zimbabwe have heard about cervical cancer, only about one-tenth (10.2%) of their Beninese counterparts have heard about the disease. The study has revealed that socio-demographical factors including geographical location and selected economic factors explained the inequality in distribution of women’s awareness on cervical cancer in both countries. Designing an effective population-based health education and promotion intervention programs on cervical cancer will be a great way forward to improving women’s awareness level on cervical cancer.

Tuberculosis (TB) is geographically heterogeneous, and geographic targeting can improve the impact of TB interventions. However, standard TB notification data may not sufficiently capture this heterogeneity. Better understanding of patient reporting patterns (discrepancies between residence and place of presentation) may improve our ability to use notifications to appropriately target interventions. Using demographic data and TB reports from Dhaka North City Corporation and Dhaka South City Corporation, we identified wards of high TB incidence and developed a TB transmission model. We calibrated the model to patient-level data from selected wards under four different reporting pattern assumptions and estimated the relative impact of targeted versus untargeted active case finding. Movement of individuals seeking TB diagnoses may substantially affect ward-level TB transmission. Better understanding of patient reporting patterns can improve estimates of the impact of targeted interventions in reducing TB incidence. Incorporating high-quality patient-level data is critical to optimizing TB interventions.

Seasonal malaria chemoprevention (SMC) aims to prevent malaria in children during the high malaria transmission season. The Achieving Catalytic Expansion of SMC in the Sahel (ACCESS-SMC) project sought to remove barriers to the scale-up of SMC in seven countries in 2015 and 2016. We evaluated the project, including coverage, effectiveness of the intervention, safety, feasibility, drug resistance, and cost-effectiveness. SMC at scale was effective in preventing morbidity and mortality from malaria. Serious adverse reactions were rarely reported. Coverage varied, with some areas consistently achieving high levels via door-to-door campaigns. Markers of resistance to sulfadoxine–pyrimethamine and amodiaquine remained uncommon, but with some selection for resistance to sulfadoxine–pyrimethamine, and the situation needs to be carefully monitored. These findings should support efforts to ensure high levels of SMC coverage in west and central Africa.

The objective of this study was to investigate the role stressors, sociodemographic characteristics and job tasks of health surveillance assistants (HSAs) and to explore major predictors of role stressors and job satisfaction of HSAs in Malawi. Data were collected from health centres and hospitals of three Malawi districts of Mangochi, Lilongwe and Mzimba. Respondents were 430 HSAs. The key findings of this study were role ambiguity and role overload were significantly negatively related to job satisfaction, while role conflict was insignificantly related to job satisfaction. Additionally, the clinical tasks of the HSAs and some of the sociodemographic variables were associated with the role stressors and job satisfaction of the HSAs in Malawi. Since the HSAs' clinical tasks were significantly related to all role stressors, there is need by the government of Malawi to design strategies to control the role stressors to ensure increased job performance and job satisfaction among HSAs. Furthermore, studies may be required in the future to assist government to control role stressors among HSAs in Malawi.

AbstractTo maintain momentum towards improved malaria control and elimination, a vaccine would be a key addition to the intervention toolkit.

We reviewed research repositories and compiled directories of research in Ethiopia from Jan 1, 2001 to Dec 30, 2017 to find evidence-based information for stakeholders and beneficiaries intervening in TB in Ethiopia. We presented literatures by four themes (biomedical and clinical; epidemiological; operational or implementation; and health systems). A total of 1,571 research studies and reports were accessed and revealed 635 epidemiological studies, followed by 538 clinical or biomedical studies, 257 operational or implementation research, and 141 health systems research. Interestingly, up to 2008 clinical or biomedical researchers were the leading researchers and from 2009 onwards, epidemiological researches held the largest constituency. TB or TB/HIV and MDR-TB literatures in Ethiopia have substantially increased over years. We suggest the need to focus on operational or implementation and health system research to decrease the spread and impact of the disease.

To delineate the prevalence and factors associated with antimicrobial use across six referral hospitals in Tanzania using WHO point prevalence survey (PPS) methodology to inform hospital-specific antimicrobial stewardship programmes, we conducted a cross-sectional analytical study. We analysed the prevalence of antibiotic use by referral hospital, ward, indication and patient characteristics as the main outcomes. We also described adherence to the Tanzania Standard Treatment Guidelines (STG) and WHO’s AWaRe categorisation of antibiotics. Approximately 62.3% of inpatients were prescribed antibiotics, predominantly from the Access group of antibiotics (ceftriaxone, metronidazole or ampicillin–cloxacillin). Empirical use of antibiotics is common, and the Access group of antibiotics is predominantly prescribed in children less than 2 years and patients admitted to surgical and paediatric wards. Lack of utilisation of antimicrobial susceptibility testing services in these hospitals requires urgent interventions. Routine monitoring of antibiotic use is recommended to be part of antibiotic stewardship programmes in Tanzania.

Human resources for health challenges related to training, deploying, and sustaining an effective health workforce have remained a barrier to successful program implementation at different levels of the health system.

While current introduction and availability have been limited to high-income countries, low-and middle-income countries must be ready to undertake the challenges of a COVID-19 vaccination campaign to reach global recovery from the pandemic. Making decisions on COVID-19 vaccine options, introduction, deployment, and monitoring poses complex challenges to governments.

In Uganda, various health system challenges impeded scale-up of DR-TB care in 2012; only three treatment initiation facilities existed, with only 41 of the estimated 1010 RR-TB/MDR-TB cases enrolled on treatment yet 300 were on the waiting list and there was no DR-TB treatment scale-up plan. To scale up care, the National TB and Leprosy Program (NTLP) with partners rolled out a DR-TB mixed model of care. In this paper, we share achievements and outcomes resulting from the implementation of this mixed Model of DR-TB care. Routine NTLP DR-TB program data on treatment initiation site, number of patients enrolled, their demographic characteristics, patient category, disease classification (based on disease site and human immunodeficiency virus (HIV) status), on co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) statuses, culture results, smear results and treatment outcomes (6, 12, and 24 months) from 2012 to 2017 RR-TB/MDR-TB cohorts were collected from all the 15 DR-TB treatment initiation sites. Over the period 2013–2015, the RR-TB/MDR-TB treatment success rate (TSR) was sustained between 70.1% and 74.1%, a performance that is well above the global TSR average rate of 50%. Additionally, the cure rate increased from 48.8% to 66.8% (P = 0.03). The Uganda DR-TB mixed model of care coupled with early application of continuous improvement approaches, enhanced cohort reviews and use of multi-disciplinary teams allowed for rapid DR-TB program expansion, rapid clearance of patient backlog, attainment of high cumulative enrollment and high treatment success rates.

Diagnostic tests for COVID-19 fall into three main categories: Molecular, Antigen, and Serological. Each category of tests comes with its own limitations, thus impacting how and where it can be used. Molecular tests based on Polymerase Chain Reaction (PCR) technology are the current ‘gold standard’ for COVID-19 testing.

The demand for COVID-19 diagnostics has exploded with the global impact of the pandemic, though this demand for diagnostics, reagents, and consumables for COVID-19 is causing shortages of commodities worldwide.

In a push to end the COVID-19 pandemic, the COVAX initiative, led by Gavi, the Coalition for Epidemic Preparedness Innovations, and WHO, is accelerating the process for rapid and equitable access to vaccines in low- and middle-income countries (LMICs). With several clinical trials completed and others under way, the first supply of the COVID-19 vaccine was available at the end of 2020.

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, January 2021 edition.