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Using Support Supervisory Visits for Monitoring and Mentorship for Pharmaceutical Services Delivery in Namibia

SIAPS has supported the Division: Pharmaceutical Services to conduct support supervisory visit (SSVs) to monitor and assess progress of the supported programs and provide recommendations to further strengthen implementation of pharmaceutical service delivery. The SSVs are used to monitor the extent of implementation of interventions aimed at strengthening pharmaceutical services in MRMDs, hospitals, and primary health care (PHC) facilities; identify challenges in the services; provide onsite support; and make recommendations to address the challenges. These visits are carried out once a year, and the SSV teams check whether issues identified from previous visits have been addressed. SIAPS has supported the MOHSS to implement strategies to strengthen the inventory management of antiretroviral (ARV) medicines and the ART pharmaceutical system. A stronger inventory management system will enable the country to cope with the scale-up of ART services, which increased quantities of health commodities and more complex inventory management tasks.

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Containing Antimicrobial Resistance through Rational Antimicrobial Use in Namibia

The SIAPS-developed AMR coalition-based strategy identifies educational institutions, such as UNAM; therapeutic committees (TCs); and key institutions involved in AMR, such as the National Institute of Pathology (NIP) as key players in the pre- and in-service training of health care professionals to enhance RMU and combat AMR. SIAPS collaborated with key institutions, including the MoHSS, Div:PhSs, UNAM-SOM, UNAM-SOP, NIP, and TCs in the Kunene and Karas regions, in activities to reduce hospital-acquired infections (HAIs); improve infection prevention and control (IPC); and promote RMU in Namibia.

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Decentralizing ART Services through the Differentiated Care Model in Namibia

SIAPS has supported the ART program and the Division of Pharmaceutical Services to implement ART decentralization strategies. SIAPS has collaborated with other USAID-funded implementing partners in the development of standard operating procedures (SOPs) for implementing CBART services and in designing process flows for the movement of patients between the community and ART facilities, including pharmacy visits for ARV refills. SIAPS trained more than 80 health workers in PEPFAR priority, high HIV prevalence regions on the SOPs and process flows for CBART implementation, dispensing tools, and procedures at NIMART sites. SIAPS has also supported the ART program by developing monitoring and evaluation tools to ensure that the care provided to patients accessing services from community service points and NIMART sites is well documented to allow health practitioners at the main ART sites to ensure that patients still receive the same high standard of care required in the delivery of ART services.

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Implementing a Dashboard for Pharmaceutical Information in Namibia

SIAPS supported the MoHSS to design and implement a web-based electronic information system (dashboard) for both patient and stock status in Namibia. It was designed to improve coordination among facility, district, regional, and national stakeholders involved in HIV commodity management; increase the use of pharmaceutical information for management decision making at all levels of health care; and improve planning for financial resources for pharmaceutical commodities. The dashboard comprises a module for monitoring 22 pharmaceutical services delivery indicators, a module that summarizes the number of people accessing ART services, and an early warning system against stock-outs of antiretrovirals (ARVs) and other essential medicines.

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Improving Infection Prevention and Control Practices at Health Facilities in Resource-Limited Settings: SIAPS Technical Report

Infection prevention and control (IPC) is essential to reduce the spread of health facility-acquired (nosocomial) infections, including drug-resistant ones.

The USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program’s goal in global technical assistance in IPC is to reduce the development and spread of nosocomial infections and antimicrobial resistance. This contributes to an improved quality of patient care and safety in public health facilities in resource-constrained countries.

This report summarizes key accomplishments and lessons learned in implementing SIAPS’ approach to improving IPC practices in four countries: South Africa, Namibia, Jordan, and Ethiopia. All activities address SIAPS’s overall objective to build or enhance national and facility capacity to develop, implement, and monitor IPC programs by focusing on the principles of health systems strengthening.

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National Pharmacists’ Forum 2014 Technical Report: Dissemination of Pharmaceutical Services Information

SIAPS and its predecessor projects—Strengthening Pharmaceutical Systems (SPS) and Rational Pharmaceutical Management (RPM) Plus—have worked extensively to introduce and support tools that capture dispensing and supply chain data from public health facilities. SIAPS supports the Ministry of Health and Social Services (MoHSS) to conduct periodic analyses of antiretroviral therapy (ART) data by using available data sources, specifically the Electronic Dispensing Tool (EDT) and national database. In order for such data to inform programmatic decisions, it needs to be actively disseminated to program managers. The Division of Pharmaceutical Services (Div: PhSs), with technical assistance from SIAPS and the Supply Chain Management System (SCMS), compiles a quarterly ART Logistics Management Information System (LMIS) feedback report, a quarterly Pharmaceutical Management Information System (PMIS) feedback report, and an annual supportive supervision visit (SSV) feedback report. Hard and soft copies of the ART LMIS and PMIS reports are disseminated quarterly to all regions of Namibia, and SSVs reports are disseminated annually.

To improve dissemination and stimulate discussions of results, SIAPS supported Div: PhSs to conduct the National Pharmacists’ Forum 2014. Findings from PMIS feedback reports and recommendations made by SSVs were discussed with participants of the forum, which took place from September 29 to October 3, 2014, in Otjiwarongo, Namibia. Participants included pharmacists and stakeholders from 13 of Namibia’s 14 regions. The forum also provided opportunities to disseminate, discuss, and analyze other pharmaceutical services information in reports, such as the standard treatment guidelines (STGs) post-assessment report, and to introduce new medicines added to the Namibia Essential Medicines List (Nemlist).

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Promoting the Prevention of Antimicrobial Resistance in Ohangwena Region, Namibia

SIAPS supported the University of Namibia School of Medicine (UNAM-SOM) to facilitate a continuing professional development (CPD) activity with health practitioners and regional management teams in Namibia’s Ohangwena region on strategies to combat antimicrobial resistance (AMR), including HIV drug resistance (HIV-DR), and the use of early warning indicators (EWI) for early detection and action. The UNAM facilitator at the CPD activity was a participant of the AMR/rational medicines use (RMU) workshop in 2013. A total of 25 participants including nurses, doctors, and pharmacy personnel were trained in AMR, HIV-DR, and EWIs. At the end of the one-day workshop, the participants designed an action plan to promote activities for reducing the development of AMR in their respective districts and health facilities.

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