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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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SIAPS’ Technical Assistance to Strengthen Medicines Regulation in Namibia 2011-2017

SIAPS helped improve pharmaceutical product quality by building the capacity of the Namibia Medicines Regulatory Council (NMRC) to review medicine registration dossiers; inspect pharmaceutical manufacturing facilities and finished (imported) products at ports of entry and in the marketplace; to chemically test medicines compliance with established standards; and monitor overall compliance with applicable regulatory standards and norms. In addition, SIAPS supported MOHSS in strengthening the management and regulation of medical devices and support equipment in Namibia, and in revising the National Medicines Policy, a crucial of pharmaceutical regulation and governance. SIAPS supported the reconfiguration of the desk-top Pharmadex tool to a web-based application. In general, the six-year support of the SIAPS project to the NMRC contributed to the strengthening of this regulatory agency, which in turn, contributed to improvements in service delivery to the clients. The registration process improved, to decrease the long-standing backlog of dossiers; PMS ensured safety and quality of pharmaceuticals; and implementation of web-based Pharmadex provided a means for clients/applicants to upload applications and follow up the progress of dossier review, which reduced workload for NMRC staff. SIAPS provided continuous TA for the restructuring of the NMRC.

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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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Capacity Building for Healthcare Personnel to Manage Pharmaceutical Services at ART and NIMART Sites, October 2015 to September 2016

SIAPS supported the Ministry of Health and Social Services to enhance capacity of pharmaceutical HR to manage pharmaceutical services in public health facilities in Namibia. The major objectives of the activities were to build HR capacity in pharmaceutical management and service delivery for improved HIV and AIDS treatment outcomes and improve availability and use of pharmaceutical service data for improved quality of ART services. Activities comprised onsite staff mentoring through supportive supervision visits and training sessions adapted to the needs of the target healthcare workers.

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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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Human Resource Capacity Development for ART and Pharmaceutical Services in Namibia, October 2014-September 2015

SIAPS Namibia applied the capacity building approach to support the Ministry of Health and Social Services to enhance the capacity of two local training institutions—UNAM-SoP and the NHTC—to train pharmacists and PAs, respectively. With SIAPS technical assistance for defining a career path for PAs, UNAM-SoP started training pharmacy technicians, a new cadre in Namibia. SIAPS also continued its efforts to enhance the capacity of individuals through pre- and in-service training to ensure that health workers have adequate skills to administer quality pharmaceutical services. The capacity building interventions were done through training workshops and on-the-job technical assistance provided during support supervisory visits (SSVs) and remotely.

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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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Assessment of Compliance of Outpatient Prescribing with the Namibia Standard Treatment Guidelines in Public Sector Health Facilities

The Ministry of Health and Social Services (MoHSS), in partnership with the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, funded by the US Agency for International Development (USAID) and implemented by Management Sciences for Health (MSH), conducted an assessment of compliance of prescribers with the Namibia Standard Treatment Guidelines (STG) and changes in prescribing practices for selected conditions. The first comprehensive Namibia STGs were launched and distributed to all health facilities in the country in 2011. The main objectives of the assessment were to determine the extent of compliance of prescribers with the STGs, and to compare prescribing practices before and after the roll out of the STGs. The assessment also aimed to explore factors associated with compliance and to find out what activities were implemented in health facilities and regions to promote compliance with the STGs.

 

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