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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.

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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.

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Leadership Development Program in the Northern/Tygerberg Sub-Structure, September 2012–May 2013

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.

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Using Electronic Pharmacy Dispensing Data for Surveillance of Outpatient Antibiotic Consumption and Monitoring of Antibiotic Prescribing Practices at District and Provincial Hospitals in the South African Public Sector

The primary aim of this study was to assess the feasibility of using electronic pharmacy dispensing data extracted from RxSolution® for the surveillance of outpatient (ambulatory) antibiotic consumption and monitor antibiotic prescribing practices at district and provincial hospitals in public health facilities in North West Province, South Africa, between April 2013 and March 2015. This was an exploratory project to develop hypotheses on the volume of antibiotics used and prescribing patterns.

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SIAPS Special Technical Brief Series

A new collection of technical briefs highlight strategic approaches, innovations, results and lessons learned in implementing systems-wide interventions to strengthen pharmaceutical systems and services in three countries: South Africa, Namibia and Ethiopia. Click on the thumbnails below to read the full technical briefs. Strengthening Namibia’s Pharmacy Sector and Workforce Strengthening the Leadership and Management of […]

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Technical Report: South Africa Pharmaceutical Leadership Development Program

The Pharmaceutical Leadership Development Program (PLDP) is a participatory training program using innovative strategies to strengthen health care professionals’ leadership and management skills. Based on the framework behind Management Sciences for Health (MSH)’s Leadership Development Program, the PLDP was developed at the request of South Africa’s provincial heads of Pharmaceutical Services to strengthen pharmacy managers’ leadership capacities and target key pharmaceutical management challenges.

The PLDP is delivered in a series of five workshops over a period of six to seven months. As an integral part of the program, participants, who work at different levels of service delivery, develop quality-improvement projects aimed at addressing a key challenge experienced within their workplace. Participants bring what they learn back to their workplaces, where they teach and inspire their coworkers to apply these practices to real challenges in priority health system strengthening areas. PLDP coaches provide feedback and support throughout the process.

The technical report describes the approach to the design and implementation of the PLDP in South Africa. The report shares lessons learned and efforts taken for sustainability and ownership.

 

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SIAPS Program Director’s Blog: Strengthening the Leadership and Management of Pharmaceutical Services in South Africa

In South Africa, the USAID funded SIAPS Program has provided technical assistance in leadership and management to improve the pharmaceutical sector. Through close collaboration with the government of South Africa, SIAPS adapted MSH’s Virtual Leadership Development Program (VLDP), creating the Pharmaceutical Leadership Development Program (PLDP). The PLDP combines technical pharmaceutical knowledge with training in leading […]

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Technical Brief: Strengthening the Leadership and Management of Pharmaceutical Services in South Africa

South Africa’s health system is under enormous strain. There is a sizeable and increasing number of people with chronic diseases, both communicable and noncommunicable. The country has the largest population living with HIV, estimated at 7 million; an HIV prevalence rate of 19.2%; and 180,000 HIV-related deaths in 2015. South Africa has the highest number of people on HIV treatment—nearly 2.6 million—and has committed to nearly doubling that number in the next few years. It also has a significant burden of tuberculosis (TB), including multi- and extensively-drug resistant TB.

According to the World Health Organization, South Africa ranks third in terms of TB burden, after India and China.3 There is also high maternal, neonatal, and child mortality. In partnership with civil society and development organizations, the country has made significant strides in reducing the tide of HIV, AIDS, and TB, thereby contributing to an increase in life expectancy. Nevertheless, the effectiveness and efficiency of the country’s health system remain a huge challenge. The burden of communicable and non-communicable diseases and the rapidly growing patient population have considerable implications for the delivery of pharmaceutical services.

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The Role of PTCs in Using Financial Resources Efficiently in South Africa

Using the pharmaceutical systems strengthening approach, SIAPS supported the GPPTC in three critical systems-strengthening areas. First, SIAPS facilitated the development and approval of provincial guidelines to establish pharmaceutical and therapeutics committees (PTCs) at all health facilities in Gauteng Province. The guidelines reinforce the governance mechanisms supporting the PTCs, outlining expected compliance to procurement practices and assessing pharmaceutical expenditures. Second, SIAPS strengthened human resources capacity through the implementation of a workshop on financial management for pharmacists, carried out in tertiary hospitals and at the district level. Third, SIAPS strengthened information systems through the implementation of financial reporting software at the depot level.

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Building Capacity in South Africa for the Development of Pharmaceutical Policies, Procedures, and Guidelines

Only with a holistic, systems-level approach can policies, procedures, and other guidance documents provide the direction, integration, and coordination required to meet the unique pharmaceutical needs of a country. Working with in-country partners, SIAPS helps to analyze each unique country context, identify priority issues, harmonize approaches, and develop well-informed and locally appropriate policy documents to support good governance, which help to strengthen the performance of the pharmaceutical system. SIAPS also supports health ministries to engage stakeholders, including civil society, in a collaborative and transparent way though consultative workshops, solicitation of feedback, and information sharing.

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