Promoting Rational Medicine Use through Therapeutics Committees: Evidence from the Kunene Region of Namibia

Functional Therapeutic Committees (TCs) in public health facilities help to improve rational medicine use (RMU). RMU is necessary to prevent antimicrobial resistance, including HIV drug resistance.

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The inappropriate use of medicines in health care facilities may result in wastage of resources. However, this can be improved by adopting simple medicine management principles and policies. TCs can bring health workers together to formulate and implement policies and principles that govern medicine use.

TCs serve as a communication link between pharmacy and medical staff for all matters pertaining to RMU and promote the appropriate use of medicines at health facilities.

Since 2014, the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Project, which is supported by the US President’s Emergency Plan for AIDS Relief through the US Agency for International Development, has provided training and focused technical assistance to the Kunene Regional Health Management Team in Namibia to foster a culture of self-evaluation and continuous improvement toward promoting RMU within the region.

In line with the plan developed during the 2014 training, the Kunene Regional TC successfully conducted a medicines use evaluation (MUE) to investigate prescriber compliance to treatment guidelines. The MUE, which was conducted in the Opuwo district, showed high (83%) compliance with treatment guidelines.

Kunene Regional Pharmacist Ahmed Zaman attributed the high level of prescriber compliance with guidelines to more frequent and focused TC meetings that aligned with Ministry of Health and Social Services-established terms of reference, quarterly ward visits, and regular technical support from SIAPS.

In an interview with SIAPS staff, Zaman noted the improvements observed with the implementation of the TC interventions:

“The training provided by SIAPS in 2014 increased the proportion of planned TC meetings actually held from 11% in 2014 to over 80% in 2015. Our main problem was that staff did not understand the importance of TC meetings. We now meet once every month to discuss issues pertaining to patient care and also to review findings of Support Supervisory Visits, give recommendations and monitor progress. TCs are helping us to improve health service delivery and communication at district and regional level.”

Kunene is an expansive, sparsely populated region in northwestern Namibia, bordering Angola. It has an HIV prevalence rate of 9.7%. The region comprises three administrative health districts (Khorixas, Opuwo, and Outjo) and 1,512 outreach sites. A team from each district visits each outreach site at least monthly.