Pharmaceutical Management: Our Impact

 {Photo credit: Sheila Mwebaze/MSH}Community health worker Betty Achilla examines a baby at one of the 31 households she supports.Photo credit: Sheila Mwebaze/MSH

Eight years ago, Betty Achilla was selected by her community to be a volunteer community health worker. She is currently serving 31 households in the Abim district in Northeastern Uganda. Betty is one of more than 60,000 volunteer community health workers in Uganda who play a vital role in extending maternal and child health services to hard-to-reach communities.As a community health worker, Betty was trained in the basics of diagnosing and dispensing medicines to treat common childhood illnesses such as malaria, diarrhea, and pneumonia and to identify danger signs in children and refer them to nearby health centers. To do her work, Betty must have an adequate and consistent supply of malaria rapid diagnostic tests, antimalarial medicines, oral rehydration solution, zinc, and antibiotics.

 {Photo credit: UHSC/MSH staff}A pharmacist dispenses medicines to a patient at Arua Regional Referral Hospital.Photo credit: UHSC/MSH staff

Uganda experienced a large number of malaria cases in April and May 2019. While this would normally correlate with patterns of seasonality, the season’s peak extended past May, with the highest number of observed cases recorded in July 2019.

 {Photo credit MSH staff}National Medical Stores staff undergo a practical session on processing of orders for COVID-19 emergency supplies using the eELMIS with a trainer from MSH/UHSC.Photo credit MSH staff

As the COVID-19 pandemic continues to grow, access to timely and accurate supply chain data is critical to the success of Uganda’s response to the outbreak. The first COVID-19 case in Uganda was reported on March 21, 2020. Additional cases were reported days later, triggering the government to implement drastic measures to restrict the spread of the disease.

 {Photo credit: MSH staff}Pharmacists at KIU Teaching Hospital view data in the Pharmaceutical Information PortalPhoto credit: MSH staff

Until 2012, Uganda’s public health supply chain was uncoordinated because the information needed to estimate quantities of essential medicines and health supplies was not readily available. A national centralized platform to track routine monitoring of stock levels, share information to support data-driven decisions, and provide accountability of funds and commodities did not exist. Without knowledge of stock levels, funding could not be properly allocated to procure needed commodities.

{Photo Credit Fabrice Duhal}Photo Credit Fabrice Duhal

Monitoring patients who are taking a new medicine is critical for patient safety and an essential component of a well-functioning pharmaceutical sector. The USAID MTaPS Program is working in Mozambique to establish an active surveillance system to assess the safety of an HIV drug in HIV/TB co-infected patients, including pregnant women, that has recently been introduced in the country. The concern for pregnant women stems from earlier indications of neural tube defect in babies born to women taking the medicine and the fact that women are disproportionately affected by HIV in Mozambique.

 {Photo credit: Doris Bota/MTaPS}Participants relax after an infection prevention and control training in Kisii, Kenya.Photo credit: Doris Bota/MTaPS

Since March 18, 2020, the USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program has been collaborating with the Kenyan Ministry of Health (MoH) to roll out a series of training-of-trainers (ToT) courses to help the government contain and manage the COVID-19 pandemic.

 {Photo credit UHSC staff/MSH}Henry Oundo, UHSC staff member, reviews stock records with Opolot Grace, assistant inventory management officer at Princess Diana Health Center, Uganda.Photo credit UHSC staff/MSH

In the foothills of Uganda’s fabled Moon Rwenzori Mountains, in the far west of the country, sits Bundibugyo Hospital. From its front steps you can see the Democratic Republic of the Congo (DRC) in the distance. Many refugees who fled their homes during DRC’s internal conflict are treated here. The hospital regularly serves a population of nearly 49,000, many of whom rely on its HIV clinic for prevention, treatment, and care. Built in 1969, Bundibugyo Hospital had always faced the challenge of limited storage space for medicines and health supplies.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

The USAID MTaPS Program, led by MSH, is on the frontlines supporting USAID’s efforts to contain the spread of the COVID-19 virus in high-risk countries. The program’s mandate includes advancing the Global Health Security Agenda (GHSA) and is, therefore, well equipped to respond to global public health emergencies such as the current outbreak.  MTaPS has formed a COVID-19 response team to assist countries in developing a rapid response action plan to manage the outbreak.

{Photo Credit: Rui Pires}Photo Credit: Rui Pires

Excessive bleeding after birth is the leading cause of maternal mortality worldwide, killing nearly 200 women a day.

{Photo Credit: Rui Pires}Photo Credit: Rui Pires

In Uganda, 4 in 10 maternal deaths are caused by postpartum hemorrhage, or excessive bleeding after childbirth. Intravenous oxytocin is the treatment of choice for managing postpartum hemorrhage at a health facility but must be stored between 2oC and 8oC to remain effective. The country’s cold chain infrastructure is weak, however, particularly at lower level health facilities, where half of all assisted births occur. The majority of these facilities only have refrigerators that are specifically procured and used for the storage of vaccines.

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