Despite being one of the most densely populated countries in the world, the overall health in Bangladesh has steadily improved over the last 30 years. While the Government of Bangladesh’s efforts have resulted in impressive gains in public health, weaknesses in pharmaceutical management, including logistics and supplies, infrastructure, and the low performance of health care providers, remain obstacles to obtaining access to efficacious medicines and quality health services, particularly for the poor. SIAPS has been working closely with the Ministry of Health and Family Welfare (MOHFW) since 2011 to implement a series of systems strengthening interventions to support the government’s health objectives. Using a systems-based approach, SIAPS catalyzes effective leadership, good governance, and evidence-based decision making to strengthen procurement and supply chain systems.
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Developing Better Terms of Reference to Improve the Performance of Pharmaceutical Sector Committees: Case Studies from South Africa
In South Africa, there are numerous governance structures that make crucial decisions about selection, procurement, distribution, and use of medicines, diagnostics, and other pharmaceutical products. A challenge commonly encountered is that critical committees either do not exist or where the committee is in place, it does not function optimally. One of the most underlying causes of poor functioning of committees is the absence of or weak terms of reference (TOR). In 2015, the Affordable Medicines Directorate (AMD) of South Africa’s National Department of Health (NDOH), requested assistance from SIAPS in strengthening the TOR of several national committees, including those involved in selection of medicines for inclusion on the National Essential Medicines List (NEML). SIAPS developed a TOR guidance document that can be used in the development or review of TOR. The purpose of this brief is to share the guidance document and the processes SIAPS and their counterparts followed to develop new and revise existing TOR for three different pharmaceutical sector committees in South Africa.
Human Resource Capacity Development for ART and Pharmaceutical Services in Namibia, October 2014-September 2015
SIAPS Namibia applied the capacity building approach to support the Ministry of Health and Social Services to enhance the capacity of two local training institutions—UNAM-SoP and the NHTC—to train pharmacists and PAs, respectively. With SIAPS technical assistance for defining a career path for PAs, UNAM-SoP started training pharmacy technicians, a new cadre in Namibia. SIAPS also continued its efforts to enhance the capacity of individuals through pre- and in-service training to ensure that health workers have adequate skills to administer quality pharmaceutical services. The capacity building interventions were done through training workshops and on-the-job technical assistance provided during support supervisory visits (SSVs) and remotely.
Analysis of Passive Surveillance Data Collected by the Swaziland Pharmacovigilance Unit, October 2016-March 2017
With support from SIAPS, the Swaziland National Pharmacovigilance Unit (NPVU) has been monitoring the safety of medicines used in the county by collecting and collating reports of adverse drug reactions (ADR) and other medicine-related problems through its spontaneous reporting system established under the country’s Ministry of Health in 2009. In addition, SIAPS has been supporting active surveillance for ARV and TB medicines. ADRs and other medicine-related problems are reported to the NPVU by health care providers using a paper ADR reporting form. Completed forms are sent to the NPVU or collected from health care facilities on a quarterly basis for data entry and analysis. SIAPS supports the collection of the forms and has seconded a data clerk to the NPVU to enter the data from the forms into Microsoft Excel. SIAPS support was further sought to analyze PV data and build the capacity of the PV team to undertake routine analysis of those data. The main objective of the work was to analyze PV data generated from the spontaneous reporting system in Swaziland to inform clinical practice (rational medicine use) and improve patient outcomes.
In May 2017, SIAPS held a Leadership Development Program (LDP) training to build the capacity of the Directorate of Drugs and Medical Supplies (DDMS), district and hospital pharmacists, and SIAPS field staff. It was the first such training in the country. The program aims to train pharmacists on basic principles and practices of good leadership, management, and governance to help them identify challenges like system and budget constraints—and to lead their teams in handling them with maximum efficiency, collaboration, and transparency. Another training goal is to help pharmaceutical managers optimize the SIAPS-supported Continuous Results Monitoring and Support System (CRMS), which has been implemented nationwide. The training created a pool of local LDP facilitators who can extend their knowledge to other DDMS staff and to pharmacists throughout all 13 districts in Sierra Leone.
The concept of a Barangay Health Management Council (BHMC) was developed by a working group comprising technical advisors from SIAPS and health staff from the Quezon City Health Department in late 2011. The BHMC initiative aims to strengthen the delivery of services under the national tuberculosis (TB) control program (NTP) in poor urban communities. This document was developed as a quick reference for those who plan to establish BHMCs. The contents of this guide are based on the insights and experiences of the people involved in the implementation of the BHMC initiative in Quezon City from 2012 to 2016. Described here are the practical steps for establishing, operationalizing, and sustaining a BHMC.
The availability of a unified essential medicines list (EML) with evidence-based clinical efficacy to be used by the Ministry of Health (MOH) for the state-guaranteed package of services is an essential part of the successful launch of the health care reform initiative in Ukraine. This required the development and institutionalization of a process to ensure sustainability into the future rather than a one-off list of essential medicines. The main task of SIAPS was the provision of technical assistance to the Government of Ukraine to solve the problem of medicines list harmonization, which was needed to review and update the NEML to be the sole list for procurement or reimbursement with public funds, and to develop legislative documentation to institutionalize the process. The work was performed in cooperation with the MOH and the State Expert Center.
As a pharmacist, Md. Jahidul Hasan has worked in several hospitals, but it was not until he joined Square Hospital Limited (SHL) that he learned about pharmacovigilance (PV). SHL is a 400-bed tertiary care private hospital in Dhaka, Bangladesh, that serves an average of 1,200 out-patients each day. The Directorate General of Drug Administration (DGDA), with technical assistance from SIAPS, officially launched Bangladesh’s national PV program in 2013. The DGDA first introduced the PV program at 20 private and public hospitals, including SHL, and 13 pharmaceutical companies. Since then, the DGDA and SIAPS have organized trainings for the PV focal persons in these hospitals and pharmaceutical companies to build their skills and knowledge on PV and increase adverse drug event (ADE) reporting.
Le Ministère de la santé guinéen a décidé d’élaborer un guide de renforcement de la surveillance en vue de consolider les acquis de la riposte contre d’éventuelles épidémies ainsi que la prise de mesures efficaces visant au relèvement du système de surveillance en Guinée. Outre les plans nationaux de distribution ordinaire élaborés, l’unité logistique, en collaboration avec ses partenaires, a élaboré un plan national de distribution d’urgence des intrants vers les structures périphériques en octobre 2015. Le plan a été validé et exécuté. Compte tenu des leçons tirées des précédentes opérations de distribution, il est important de faire suivre une supervision pour s’assurer de l’exécution correcte de l’opération.
Pour lutter contre le paludisme, le Ministère de la Santé à travers le Programme national de lutte contre le paludisme (PNLP) a élaboré un plan stratégique national de troisième génération couvrant la période allant de 2013 à 2017. Il a été approuvé en février 2014 lors de la signature de l’aide-mémoire de la revue de performance du PNLP. Pour réaliser cet important volet du PSN, le PNLP, en collaboration avec ses partenaires, a élaboré en octobre 2014 et amendé en 2016 une grille nationale de supervision formative intégrée. C’est dans cette optique que s’inscrit cette supervision formative intégrée dans les directions préfectorales de la santé de Labé et de Mali du 5 au 14 août 2016, qui doit déboucher sur l’élaboration des plans de résolution des problèmes identifiés au niveau des structures.
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