The main purpose of this inventory is to serve as a reference to help stakeholders working in the pharmaceutical sector easily access and use already available SIAPS resources, including tools, experiences, and results. The document is also intended to serve as a technical legacy for SIAPS to support knowledge exchange and sustainability of related work. The inventory is organized around the key program technical intervention areas as defined previously by the program. The document captures all key tools/approaches used by SIAPS (whether produced by SIAPS, a predecessor program, or a partner); selected country experiences in the form of technical reports or relevant materials; and other materials such as presentations, publications, technical briefs, and success stories that capture some of the results achieved by SIAPS.
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Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program Inventory of Key Technical Resources
This policy guidance document is divided into 13 different areas:
- Country policy development
- Revised program guidelines, Essential Medicines List (EML), and reporting and recording forms
- Training of health workers and community partners (community health worker/relais)
- ACSM strategies
- Forecasting and quantification
- Health system strengthening
- Quality and safety
- Monitoring and evaluation
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.
The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program proposed a methodology for reviewing lists of essential medicines (LEM) and formularies, with the potential to achieve optimum results in short periods of time and with a minimal investment of resources. The methodology consisted of identifying an expert international pharmacologist with experience in the LEM process and the following procedural steps: Design of an instrument for drafting the proposal, drafting and review of proposal by the expert, and national workshop to review and validate the proposal.
This guide provides national stakeholders and advocates with information and guidance to update the national EML to include a new commodity, a new indication, or a new formulation based on the available evidence and based on country need and disease burden. While the actors, timeline, and process may vary from country to country, this guide presents the broad steps involved in revising an EML for any health commodity. Additional resources and a glossary are included to provide supplemental information and to clarify key terms.
The Systems for Improving Access to Pharmaceuticals and Services (SIAPS) Program Mozambique has been working with DFH and partners in the pharmaceutical sector and in priority health programs to assist pharmaceutical services in improving the availability of pharmaceutical products and appropriate use at the service delivery points with the aim of achieving desired health outcomes. SIAPS technically assists hospitals to create DTCs to improve medicine use, as well as the collection and analysis of medicine use information for decision-making as part of its support to its counterparts in the pharmaceutical sector.
In August 2013, SIAPS supported the DFH to conduct a two-day DTC orientation workshop. This orientation covered the DTC’s main functions, roles, and responsibilities, as well as how to monitor and identify medicine use problems, and to implement interventions and strategies, including use of standard treatment guidelines (STGs) and essential medicine list, to improve medicine use. During the workshop, the participants presented the status of their hospital DTC, and reviewed Mozambique’s current official DTC’s terms of reference (TOR) and made recommendations for additions and modifications. In addition, with SIAPS technical guidance, the participants conducted a brief study on prescribing indicators in a clinic in Maputo. The study found that more than 60% of patient encounters received an antibiotic. This orientation was attended by 49 health professionals, including physicians, pharmacists, dentists, laboratory technicians, and hospital administrators from the 11 hospital DTCs, the Ministry of Health (MOH), and nongovernmental organizations that support clinical services and supply chain operation.
In South Africa, the provision of pharmaceutical services is guided by the National
Drug Policy (NDP), which was adopted in 1996. The health goal of the NDP is ―to
ensure the availability and accessibility of essential medicines to all citizens. Within a
resource-constrained environment, irrational medicine use has the potential to
compromise available health care resources, hence posing a serious threat to the
functioning of the health system. The development and use of national essential
medicines lists (EMLs) as well as the establishment of pharmaceutical and
therapeutics committees (PTCs) have been identified as key interventions to
promote rational medicine use (RMU).
Review of the List of High-Cost Medicines used by the Dominican Republic’s Protected Diseases Program and Planning of Purchases for 2015
The Dominican Republic’s Ministry of Public Health (MPH) is currently implementing an Integrated System for Medicine and Supply Management (known as SUGEMI, for its Spanish acronym) as part of the Ministry’s Public Service Network. Its objective is to improve public access to essential medicines and quality health supplies while promoting the decentralized management and optimum use of available resources. SIAPS is providing support to SUGEMI and collaborated with the Protected Disease Program to procure medicines for 2015. This is a report of the process used to: 1)facilitate for the various PP scientific committees the selection of medicines to be procured in 2015, using medical criteria based on evidence and cost-effectiveness; and 2) estimate and plan for purchases to be made for 2015 of medicines recommended for permanent inclusion on the PP list of medicines.
An alarming number of countries are not on target to meet Millennium Development Goal to reduce maternal mortality despite efforts and investments made at both the global and national levels. Increasing access to and use of essential commodities for maternal health have recently gained attention as key concerns of several international initiatives. The United Nations (UN) Commission on Life-Saving Commodities for Women and Children acknowledges supply and demand challenges as among the main barriers to access and use of these life-saving commodities.
A basic step in improving access to these commodities is making sure they are available where and when women need them. This requires proper supply planning which, for various reasons, has been a challenge in procuring essential maternal medicines.
The purpose of this document is to present an approach that will allow national program managers and other key stakeholders to assess a country’s theoretical need for the three overlooked life-saving maternal health commodities–oxytocin, magnesium sulfate, and misoprostol–and compare this with actual procurement data.
Presented at Global Maternal Health Conference 2013 during the session Improving Access to Essential Maternal Health Medicines. Read more about the conference here.
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- Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program Inventory of Key Technical Resources
The main purpose of this inventory is to serve as a reference to help stakeholders working in the pharmaceutical sector […]