Transforming Pharmaceutical Services in Ethiopia

Over the past two decades, Ethiopia has improved its delivery of primary health care services and begun to make great progress toward meeting the Millennium Development Goals, particularly with regard to maternal, newborn, and child health and the prevention and control of HIV and tuberculosis. Yet pharmaceutical services—a patient’s last point of care and one of the country’s single largest health care expenses—remain inadequate. While some medicines in stock expire, other needed medicines are frequently unavailable, and patients are dissatisfied with the poor quality of service they receive.

The ineffectiveness of medicine management at health facilities resulted in irrational practices and wastage. The traceability of pharmaceutical transactions at health facilities was poor, and accountability was not well defined. The absence of tools and systems for tracking products and financial information made auditing transactions and services almost impossible. The lack of transparency and accountability in managing medicines and financial transactions exposed the system to theft, pilferage, and misappropriations.

In response to these multifaceted and complex systemic problems, the Auditable Pharmaceuticals Transactions and Services (APTS), which is a package of proven interventions designed through SIAPS’ pharmaceuticals system strengthening approach, emerged as a vehicle for the transformation of pharmaceutical services in the country.

After piloting APTS in 2011, and witnessing its resounding success, the Federal Ministry of Health and regional health bureaus ratified an APTS regulation with the ultimate goal of implementing it in all health facilities in the country. More than 70 health facilities in Ethiopia are now implementing APTS, and scale up is progressing quickly.

SIAPS recently published a technical brief to document its approach to the design and implementation of APTS and to share successes, challenges, and lessons learned.

The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program is funded by USAID and implemented by MSH. This project works to assure the availability of quality pharmaceutical products and effective pharmaceutical services.