Pharmaceutical management considerations for expanded coverage of essential health services and financial protection programs

The UN adoption of the SDGs in 2015 signaled a strong commitment of member countries to the expanded access to essential health service agenda and definitively recognized the critical role of medicines in achieving UHC. The SDGs call for countries to “achieve universal health coverage, including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”. This paper seeks to highlight the key functional areas of pharmaceutical management, the critical components of the pharmaceutical system, and the management considerations needed to facilitate the attainment of UHC targets.

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Registration and Quality Assurance of ARVs and other Essential Medicines in Namibia

SIAPS provided technical assistance to facilitate the expedited assessment and registration of new and existing ARV formulations to support the implementation of the revised Namibian ART guidelines (dated January 2014). The technical assistance focused on improving the efficiency of the regulatory system so that the recommended new first-line fixed-dose combination ARVs that contain tenofovir and emtricitabine for adults; optimized ARV formulations for pediatric use; and other medicines for HIV and AIDS; TB; maternal, newborn, and child health (MNCH); and other public health diseases are assessed and considered for registration and made available for public procurement in a timely manner to benefit patients undergoing ART.

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Strengthening Registration and Quality Assurance Systems for Generic ARVs, Related Medicines, and Devices in Namibia

In Namibia, USAID has been providing funding for technical assistance in the areas of pharmaceutical management and systems strengthening since 2003. During this period, the Rational Pharmaceutical Management Plus (RPM Plus) and Strengthening Pharmaceutical Systems (SPS) programs were implemented. RPM Plus supported interventions that largely focused on strengthening systems for the antiretroviral therapy (ART) and prevention of mother-to-child transmission of HIV programs. SPS focused on strengthening systems based on World Health Organization (WHO) building blocks, increasing the number of pharmaceutical personnel available for service delivery, strengthening policy coordination, and improving the regulatory functions of the NMRC. SIAPS focuses on further strengthening of regulatory and management systems in the pharmaceutical sector under the governance and health systems strategic area to support HIV and AIDS and other public health services.

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

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

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 the process 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. SIAPS conducted an assessment of subnational procurement practices in Kenya. One component of that assessment is related to understanding the financial flows for MNCH commodities.

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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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Assessing Sub-National Procurement Practices of Maternal, Newborn, and Child Health Commodities in Kenya

The SIAPS Program works at both the global and country levels to improve pharmaceutical management systems that increase access to quality medicines. SIAPS has developed a methodology to assess sub-national procurement practices. This methodology was used in Kenya to assess county-level procurement practices for essential maternal, newborn, and child health (MNCH) commodities and to study the availability of essential MNCH commodities. The information gathered was used to generate recommendations to strengthen local procurement practices and overall procurement strategies.

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SIAPS Annual Report: Program Year 6

To learn more about SIAPS program activities worldwide, please read our annual report for program year 6.

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End of Project Report: Amazon Malaria Initiative

Project dates: January 2012 – September 2017