Background
Peru has a population of approximately 31 million.[1] In 2012, nearly 1 million cases of acute diarrheal diseases and 30,000 pneumonia cases were reported; the country also has persistent seasonal outbreaks of dengue and other vector-borne diseases.[2] Loreto, in northeastern Peru, is the country’s largest region and accounted for 90% of Peru’s malaria cases in 2013.[3] A baseline study in 2012 highlighted inadequate programing of medicines, delayed procurement, poor storage, absence of standardized distribution guidelines, and a low level of personnel training as major issues regarding the availability and use of antimalarials. SIAPS and its predecessor programs have been provided technical assistance through the USAID-funded Amazon Malaria Initiative in Peru to introduce artemisinin-based combination therapy (ACT) to treat malaria.
Project Highlights
SIAPS has been implementing systems strengthening approaches to improve the availability and use of ACT.
- To introduce the fixed-dose combination in 2012, SIAPS collected evidence, prepared policy briefs, undertook advocacy efforts for policy changes, and developed an introduction plan.
- National guidelines were developed to estimate the need for and distribution of antimalarials to low incidence areas.
- A regional stock monitoring system and quarterly information bulletin were developed and implemented and later transferred to PAHO.
- Through technical assistance from SIAPS, Peru now has a pooled regional procurement system in place through the PAHO strategic fund. Regional workshops and coordination meetings have been held with the PAHO strategic fund, and a regional scheme for the donation of medicines for severe cases has been introduced.
- Through operational research, SIAPS developed guidelines for good storage practices in primary health facilities and piloted them in Peru.
- A primary health level training guide for antimalarial management was developed.
Results
With the decentralized interventions in Loreto, a decrease in stock-outs from the second half of 2012 through the first quarter of 2014 was observed. Through better programming, purchases are now timely, the distribution network is optimized, and staff are trained using self-instructive material on strategic stock and improvement.
Project Legacy
Innovative pharmaceutical practices implemented through technical assistance from SIAPS have been incorporated into national norms and operational procedures and routinely implemented by health workers without external technical assistance under the leadership of the Ministry of Health. The data collection and reporting have been used by PAHO for continuous regional coordination and distribution of the regional bulletin.
Resources
- Decentralized technical assistance from the Amazon Malaria Initiative improves antimalarial supply management in Loreto, Peru
- Propuesta de Plan de Implementación del Esquema de Tratamiento para Malaria no Complicada por P. falciparum Basado en Medicamentos Combinados a Dosis Fija
- Historia de éxito: Asistencia técnica descentralizada de la Iniciativa para el Control de la Malaria en la Cuenca del Amazonas mejora la gestión del suministro de medicamentos antimaláricos en Loreto, Perú
- Información sobre actividades realizadas por SIAPS en Loreto, Perú, en el marco de la Iniciativa Amazónica de Malaria
[1] WHO Country statistics; http://www.who.int/countries/per/en/
[2] WHO Country cooperation strategy; http://apps.who.int/iris/bitstream/10665/246214/1/ccsbrief_per_en.pdf?ua=1
[3] https://siapsprogram.org/2015/04/24/decentralized-technical-assistance-from-the-amazon-malaria-initiative-improves-antimalarial-supply-management-in-loreto-peru/
