Structured Pharmaceutical Support Visits Help Maintain High Standards of Antiretroviral Treatment in Namibia

Structured technical support supervisory visits (SSVs) have helped pharmacists in Namibian public sector health facilities maintain high standards in managing the supply and dispensing of antiretrovirals (ARVs) and other essential medicines.

 SSVs keep us on our toes. They help us ensure that we adhere to the set standards, and we also learn from the various processes of maintaining our stock of medicines and related supplies”, said Muhloro Dziva, the Pharmacist-in-Charge at Katima Mulilo District Hospital, during the February 2016 SSVs in the Zambezi region.

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Each year, Namibia’s Ministry of Health and Social Services (MoHSS) collaborates with the USAID-funded Supply Chain Management System (SCMS) and the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) projects to conduct comprehensive pharmaceutical SSVs nationwide.

These structured visits provide technical support and mentorship to pharmacy staff at health facilities to strengthen the delivery of antiretroviral therapy (ART) and other pharmaceutical services to patients. Before and during the visits, the participating technical team members review selected pharmaceutical indicators based on data reported to the national office the previous year, observe practices, verify the data at the site, and use their findings to provide on-the-job technical assistance to staff.

To quantify a health facility’s performance for comparisons both over time and among facilities, a comprehensive scored checklist is used to assess the quality of pharmaceutical service delivery, including the storage of medicines and clinical supplies, human resources, inventory management (stock quantification and control), and the pharmaceutical management information system.

Other areas assessed using the checklist include the functionality of therapeutics committees, ART services, therapeutics information and pharmacovigilance activities, and the quality of dispensing practices. The checklist is also used to measure the progress made in implementing previous SSV recommendations.

Mr. Dziva credited the SSVs for helping him and other pharmacy staff maintain high standards for managing pharmaceuticals and improving the quality of services provided to approximately 10,000 ART patients in the Zambezi region. The Zambezi region is located in the northeastern part of Namibia and bears a disproportionately heavy burden of human immunodeficiency virus (HIV), with an estimated HIV prevalence of 24% compared to the national average of 14%.

Mr. Ahmad Zaman, the Regional Pharmacist for Kunene, also noted that the SSVs have helped onsite pharmacy staff ensure proper stock and inventory control. “During the visits, we always share the best ideas on how to organize the pharmacies and the best ways to store medicines. We have seen an overall improvement in stock management. Medicines are not expiring like before and good stock levels are maintained. Most of the health facilities are performing well even though most of them are understaffed”, he added.

Over time, the MoHSS has increased its share of funding for annual pharmaceutical SSVs, which serve as a continuous quality improvement mechanism for the Ministry. The SSVs have been institutionalized, and national- and regional-level managers rely on the recommendations from the SSVs to facilitate action planning and implement interventions for improving pharmaceutical service delivery.

(from left to right) Grace Adeniyi, Zambezi Regional Pharmacist; Muhloro Dziva, Pharmacist-in-Charge at Katima Mulilo District Hospital; Wuletaw Zeleke, MoHSS ART Logistics Pharmacist; and Benjamin Ongeri, SCMS Senior Technical Manager, discuss the findings and recommendations of the 2016 pharmaceutical SSV in the Zambezi region. Photo credit: MSH Namibia staff