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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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DHIS2 and e-TB Manager Interoperability: Creating a Stronger Digital Health System in Bangladesh

In 2015, at the request of the Directorate General of Health Services (DGHS), SIAPS undertook a comprehensive mapping exercise of the existing HIS tools in the country to review their scopes and performances and explore opportunities to link the tools to improve efficiency.
The assessment included a deep dive into the DHIS2 platform to assess the system’s capacity, robustness, data security, and interoperability and strongly recommended that the country continue using DHIS2 for data aggregation, analysis, and reporting, with a caution that overload of individual patient data should be avoided. This recommendation triggered a thoughtful consideration to integrate the standalone e-TB Manager with DHIS2 so that patient summary data become available through DHIS2 for indicator reporting and decision making.

 

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Square Hospital Limited: a Journey toward Medicine Safety in Bangladesh

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.

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Measurement of TB Indicators using e-TB Manager (TB Patient Management Information System)

This document offers a wide selection of indicators relevant to the TB program in Bangladesh. To calculate the TB indicators, this document is based on the nationally adopted, web-based e-TB Manager, which is being implemented by the National Tuberculosis Control Program (NTP) with technical assistance from SIAPS.

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Implementing QuanTB to Improve Forecasting, Supply Planning, and Early Warning Systems for TB Medicines: Bangladesh Report

The goal of this project was to conduct a review of SIAPS TB technical assistance and QuanTB implementation in Bangladesh. Specific objectives were to determine:

  • Key achievements or results of SIAPS QuanTB technical assistance in Bangladesh
  • Experiences and perspectives of the beneficiaries from the NTP
  • Challenges and lessons learned

This brief summarizes key aspects and results of the analysis for Bangladesh.

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Dissemination of DGDA’s five-year strategic plan in Bangladesh

On June 8, 2017, SIAPS disseminated the Directorate General of Drug Administration’s (DGDA) five-year Strategic Plan (2017-2021) in the presence of the Honorable Major General Mohammad Mustafizur Rahman, Director General of DGDA. The dissemination of this plan is the result of a year-long process. In March 2016, WHO engaged with various stakeholders (SIAPS, USAID, the […]

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