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Strengthening Governance in Pharmaceutical Systems: A Compendium of Country Case Studies

SIAPS and its predecessor programs have assisted numerous countries in strengthening governance to promote robust decision making, enhance accountability, reduce opportunities for corruption, and improve efficiencies to enable better access to and use of quality-assured medicines. This compendium draws on these experiences and provides a collection of examples of strategies and approaches for strengthening governance in pharmaceutical systems. The compendium highlights accumulated insights into factors that may have enabled or constrained the success of governance improvement initiatives. The intention is to systematically bolster knowledge, in alignment with USAID’s collaborating, learning, and adapting approach, so that stakeholders may examine the applicability of lessons learned and apply them in different settings to maximize resources and attain better development results. The compendium begins by defining governance, then explains its importance in pharmaceutical systems and introduces the framework SIAPS has used to guide its governance strengthening activities. It presents eight case studies on SIAPS’ work in enhancing governance in pharmaceutical systems, summarizes challenges commonly encountered and lessons learned, and closes with some reflections on the usefulness of SIAPS’ governance-strengthening framework.

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SIAPS concludes work in Bangladesh

Since September 2011, SIAPS has partnered with Bangladesh’s Ministry of Health and Family Welfare (MOHFW) and its key Directorates, including the Directorate General of Family Planning (DGFP); the Directorate General of Health Services (DGHS), the Directorate General of Drug Administration; and the National Tuberculosis Control Program, to address barriers to access to essential health commodities […]

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Warehousing Operating Procedures Manual

There has been a long‐recognized need of Central Medical Stores Depot (CMSD) staff for a complete collection of documents representing the up‐to‐date warehouse management
standard operating procedures (SOPs) of CMSD: there was no such resource capturing all the
operational procedures, circulars, registers, office orders, and so on used in the different sections
involved in CMSD’s logistical activities. In answer to this need, CMSD management has taken the initiative to develop a single volume containing all the required documents they have been adopted into existing procedures over the years of operation.

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National Guideline on the Pharmacovigilance System in Bangladesh

The objective of the National Guideline on the Pharmacovigilance System in Bangladesh is to guide health care providers (HCPs) and other key actors in the health and pharmaceutical sectors on the operations of the PV system. This document gives an overview of what PV is, how to detect and classify ADRs, and the structural organization of the system in Bangladesh. It also describes the reporting system to the NPC and expected outcomes. The document aims to help expand the roles and responsibilities of stakeholders in the country’s PV system to identify, analyze, and minimize the risks associated with pharmaceutical products. It also promotes better and broader use of PV data for patient safety.

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Process of implementing e-TB Manager, 2008-2016: a summary of 10 countries

multicountry user experience analysis of e-TB Manager and an in-depth study in Ukraine were published. However, the procedural aspects of e-TB Manager implementation in each country were not documented. While facilitators and barriers for eHealth implementation in resource-constrained settings are well known, the objective of this paper is to summarize the tailored implementation approaches given local context, which is a crucial consideration. The paper summarizes the key lessons learned and implications for other electronic health information systems.

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Mapping the Financial Flow and Expenditures for Select MNCH Medicines in Bangladesh

Since the report of the United Nations Commission on Life-saving Commodities for Women and Children (UNCoLSC) was published in 2012, much has been done to highlight the challenges countries face in ensuring the availability of essential commodities and to create resources to assist countries in this endeavor. In most settings, these commodities are procured with government funds, but there is a lack of documented evidence as to how decisions regarding financing for these commodities are made and executed. An understanding of the financial flows for MNCH commodities is critical as countries pursue the goals of ending preventable child and maternal deaths and of universal health coverage and as many go through processes of decentralization. Understanding financial flows for MNCH commodities may also assist the donor community in making smarter investments and assisting countries in mobilizing additional resources. The US Agency for International Development (USAID) commissioned this study in Bangladesh, Nepal, Kenya, and Uganda.

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Challenges to Ensuring Adequate and Timely Funding for MNCH Commodities

As countries pursue the maternal, newborn, and child health (MNCH) targets established under Sustainable Development Goal 3, they will need to ensure the continuous availability of essential health commodities to prevent and treat the conditions that cause morbidity and mortality in those groups. Since the report of the United Nations Commission on Life-Saving Commodities for Women and Children (UNCoLSC) was published in 2012, much progress has been made to highlight the challenges countries face in ensuring access to essential commodities and to create resources to overcome these challenges. A major issue yet to be adequately addressed is financing for these life-saving commodities. SIAPS mapped the budget allocation, approval, disbursement, and reporting processes in the public sector for essential MNCH commodities in four countries—
Bangladesh, Kenya, Nepal, and Uganda—to inform the development of strategies and
interventions that will improve access to these commodities.

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National Reproductive Health Commodities Forecasting Bangladesh 2017-2021

In 2012, SIAPS supported the Directorate General of Family Planning (DGFP) in conducting a five-year (2012-2016) forecasting exercise for reproductive health commodities and built the technical capacity of DGFP officials to manage the forecasting processes and analyze the FP2020 indicators pertinent to stock availability. SIAPS also assisted DGFP in forming the multi-stakeholder Forecasting Working Group (FWG) to annually review needs and facilitate data-informed procurement decisions. The FWG uses data collected through information management platforms and conducts quantification exercises on the basis of the consumption of RH/FP commodities. The 2012 forecasting exercise helped DGFP avoid redundant procurement decisions by using good-quality logistics data and saved money. However, after 2016, it had to be updated with the latest data. Therefore, at USAID’s request, SIAPS worked with FWG and developed another five-year (2017-2021) forecast of RH commodities to enable evidence-based contraceptive procurement decisions. The goal is to optimize a data driven procurement system and minimize losses through expiry from overstocking.

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Strengthening Governance in Procurement in Bangladesh

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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SIAPS Bangladesh Newsletter: January – June 2017

Inside this issue:

  • SIAPS Coorganizes D4D in Health Conference in Dhaka
  • Square Hospital Limited: A Journey Toward Medicine Safety in Bangladesh
  • 18th LCF Meeting Held
  • SIAPS Assists DGFP to Cope with Post-Fire Supply Management Challenges
  • DGDA’s GMP Inspection Capacity Strengthened
  • SIAPS Develops Interoperability between DHIS2 and e-TB Manager
  • Basic Logistics Management Capacity of DGHS Officials Enhanced
  • SIAPS Officially Hands Over SCMP to MOHFW
  • DGFP Officials’ Technical Capacity to Develop Quality Tender Documents Enhanced
  • Dissemination of DGDA’s Five-Year Strategic Plan in Bangladesh
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