In Bangladesh, the government health facilities face a wide variety of health-related challenges and the Ministry of Health and Family Welfare (MOHFW) must have reliable and timely data on the performances of different parts of the health system to plan, implement, and measure health interventions. Even though the MOHFW procures a large number of medical and non-medical equipment, including IT equipment, there is no systematic process of deploying, operating, maintaining, upgrading, and disposing of those assets cost-effectively. This major part of the public-sector health investment was not addressed in previous health sector programs. The MOHFW worked together with SIAPS in 2016 to address the gap in systematic procedures. They developed and piloted an electronic Asset Management System (AMS) in the 250-bed Moulvibazar District Hospital (MDH) to manage assets in different facilities from registering stage to decommissioning.
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Introduction of an Electronic Asset Management System in Bangladesh Health Systems: Completion of the Tool Pilot in Moulvibazar District Hospital
Report on Routine Supportive Supervision Visits to Health Facilities in the Hhohho and Lubombo Regions, Swaziland
Since October 2015, SIAPS has been supporting hospitals, health centers, and high volume clinics at the request of regional implementing partners in the Hhohho and Lubombo regions. This report documents the support that facilities have received, progress made, and recommendations for future support.
This report presents highlights of SIAPS’ work to capacitate health workers on proper pharmaceutical service delivery and stock management over a four-year period (2012 to 2015). SIAPS did a baseline assessment at health facilities (HF) in 2012, and then from 2013 to 2015, its technical advisors provided assistance to address the identified performance gaps. The objectives of this evaluation were to document results achieved from implementing mentorship and supportive supervision (SS) visits in supply chain management and pharmaceutical services; and present lessons learned from the implementation of these visits.
Pharmaceutical Leadership and Governance Initiative in the Free State Province, November 2015–May 2016
The PLGI was implemented in the Free State Province from September 2015 to May 2016. Thirty-two pharmacists from primary health care (PHC) centers, hospitals, districts, and the provincial health depot successfully completed the program. The results achieved, together with the challenges faced by the pharmacy district teams, were presented at a final presentation workshop held in Bloemfontein in May 2016.
The LDP was offered to health care professionals in the Northern/Tygerberg Sub-Structure (NTSS), Western Cape Province. Twenty-four health care professionals (12 facility managers and 12 pharmacy supervisors) from primary health care facilities across the sub-structure were enrolled in the program in September 2012. The results achieved, together with the challenges faced by the NTSS facility teams, were presented at a final presentation workshop held in Cape Town in November 2014. Seven of the twelve teams (58%) had achieved their desired measurable results by the end of the six-month period.
Consolidating SIAPS’ Five-Year Support to the Ministry of Health and Social Services for Strengthening Pharmacovigilance in Namibia
The goal of SIAPS in Namibia was to improve the quality and safety of pharmaceutical services to achieve sustained HIV epidemic control. Since 2012, SIAPS focused on interventions that increased the availability of quality antiretrovirals (ARVs), other essential medicines, and services to sustain more than 80% ART coverage of patients in need. SIAPS activities also contributed to ensuring patient safety through pharmacovigilance (PV) activities.
Swaziland is one of three remaining countries in the Southern Africa Development Community Region that do not have adequate regulatory and legislative frameworks to control the use, importation, manufacturing, and exportation of medicines. This is in the face of increased incidence of counterfeit medicines in the region; up to 25% of marketed medicines are substandard, and this is up to 64% for antimalarial medicines, according to a study conducted in 2011. Use of counterfeit and substandard medicines increases the burden of disease because of therapeutic failure, exacerbation of disease, and resistance to medicines. Swaziland’s weakness in medicines regulation and limited regulatory enforcement is also exploited by those smuggling prohibited and counterfeit medicines into neighboring countries.
Technical Brief: Strengthening Drug and Therapeutics Committees to Promote Rational Medicine Use in Mozambique
Mozambique is one of the poorest countries in the world, with approximately 70% of the population living below the poverty line. Many women and children are unable to access essential health services and medicine due to inadequate geographic coverage, financing, and available health professionals. Neonatal mortality is 30 deaths per 1,000, and under-five mortality is 90/1,000. Malaria accounts for approximately 26% of hospital deaths. Dual infections of tuberculosis (TB) and HIV and the threat of increasing multidrug-resistant TB complicate the national TB program response. To support priority programs such as HIV prevention and treatment and maternal and child health, Mozambique’s Ministry of Health and SIAPS are establishing Drug and Therapeutics Committees (DTCs) and training committee members to improve medicine management and use, thereby helping to achieve good health outcomes.
This summary provides examples of best practices for improving accountability and transparency in supply chain management that have been implemented in developing countries with technical assistance from the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. These best practices have improved governance in supply chains and helped eliminate opportunities for corruption and undetected mismanagement, thereby helping to reduce the loss of pharmaceutical products.
Systems thinking is now a widely accepted concept in global health. Governments, donors, and other actors in global health recognize that guaranteeing the availability of medicines is a necessary, but insufficient component to improving health outcomes. Rather, medicines availability must be bolstered by other components, such as ensuring that quality medicines are available and prescribed and dispensed appropriately by health care workers; patients must also use medicines properly. In order to achieve improvements in health for their populations and address health inequities, governments and donors must invest in strengthening health systems. A health system depends on its subcomponent, a pharmaceutical system, for the continuous availability of safe, effective, and affordable essential medicines and other health technologies of assured quality to deliver effective health interventions that improve health outcomes. This is in alignment with USAID’s Vision for Health Systems Strengthening (2015-2019). To this end, the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program focuses on achieving positive health outcomes by assuring the availability of quality pharmaceutical products and effective pharmaceutical services.