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The availability of timely, high-quality health data remains a challenge in the Democratic Republic of the Congo (DRC), despite some significant progress. DRC is a vast, landlocked country where the distances between health facilities, especially at different levels of the health system, are often great.

To build capacity in medicines management, the Uganda Ministry of Health introduced a nationwide supervision, performance assessment and recognition strategy (SPARS) in 2012. Medicines management supervisors (MMS) assess performance using 25 indicators to identify problems, focus supervision, and monitor improvement in medicines stock and storage management, ordering and reporting, and prescribing and dispensing. Although the indicators are well-recognized and used internationally, little was known about the reliability of these indicators. An initial assessment of inter-rater reliability (IRR), which measures agreement among raters (i.e., MMS), showed poor IRR; subsequently, we implemented efforts to improve IRR. The aim of this study was to assess IRR for SPARS indicators at two subsequent time points to determine whether IRR increased following efforts to improve reproducibility. Initially only five (21%) indicators had acceptable reproducibility, defined as an IRR score ≥ 75%. At the initial assessment, prescribing quality indicators had the lowest and stock management indicators had the highest IRR. By the third IRR assessment, 12 (50%) indicators had acceptable reproducibility, and the overall IRR score improved from 57% to 72%. The IRR of simple indicators was consistently higher than that of complex indicators in the three assessment periods. We found no correlation between IRR scores and MMS experience or professional background.

In late 2010, Uganda introduced a supervision, performance assessment, and recognition strategy (SPARS) to improve staff capacity in medicines management in government and private not-for-profit health facilities. This paper assesses the impact of SPARS in health facilities during their first year of supervision. SPARS was effective in building health facility capacity in medicines management, with a median overall improvement of almost 70% during the first year. The greatest improvements occurred in prescribing quality and at lower levels of care, although the highest level of performance was achieved in storage management. We recommend broad dissemination of the SPARS approach in all Ugandan health facilities as well as in other countries seeking a practical strategy to improve medicines management performance.

A strong pharmaceutical sector is a precondition for effective and efficient health care and financing systems, and thus for achieving the best possible health of a population. Supported by visionary, long-term donor funds, in conjunction with mutual trust, the USAID-funded Securing Ugandans' Rights to Essential Medicines (SURE) and Uganda Health Supply Chain (UHSC) program engaged in a close, more than 10 year-long (in 2018) collaboration with the Ministry of Health of Uganda. Over time, the partnership implemented numerous multi-pronged comprehensive changes in the pharmaceutical sector and conducted research to document successes and failures. We describe the evolution and key characteristics of the SURE/UHSC interventions.

World Health Organization/International Network of Rational use of Drugs (WHO/INRUD) indicators are widely used to assess medicine use. However, there is limited evidence on their validity in Namibia's primary health care (PHC) to assess the quality of prescribing. An analytical cross-sectional survey design was used to examine and validate WHO/INRUD indicators in out-patient units of two PHC facilities and one hospital in Namibia from 1 February 2015 to 31 July 2015. Out of 1243 prescriptions; compliance to NSTG prescribing in ambulatory care was sub-optimal (target was >80%). Three of the four WHO/INRUD indicators did not meet Namibian or WHO targets: antibiotic prescribing, average number of medicines per prescription and generic prescribing. The majority of the indicators had low sensitivity and/or specificity. All WHO/INRUD indicators had poor accuracy in predicting rational prescribing.

Funded by USAID and led by Management Sciences for Health and its consortium of partners, the goal of the five-year Medicines, Technologies, and Pharmaceutical Services (MTaPS) program (2018–2023) is to help low- and middle- income countries strengthen their pharmaceutical systems to ensure sustainable access to and appropriate use of safe, effective, quality-assured, and affordable ess

Attaining the goals of universal health coverage requires clear policies, robust legislation, and sound management practices supported by good governance. This premise is relevant to pharmaceutical systems, which are particularly vulnerable to corruption due to the economic value of medicines and the multiplicity of stakeholders.

Following USAID’s Journey to Self-Reliance framework and the agency’s health system and disease-specific strategies, MTaPS strengthens country human resources and institutions to: develop sustainable, high-impact country capacity for transparent, accountable pharmaceutical systems-related law, policy, planning, leadership, and management; improve countries’ capacity to collect, a

USAID supports strategies to improve pharmaceutical-sector financing, including resource mobilization, allocation, and use.

Weaknesses in pharmaceutical regulatory systems contribute to limited access to quality-assured, safe, and efficacious life-saving essential medicines, including those for malaria; HIV/AIDS; and reproductive, maternal, and childhood diseases, and to the disruption of health service delivery, thereby preventing achievement of better health outcomes.

Pharmaceutical systems and the health system in general in many low- and middle-income countries suffer from poor data availability and accessibility. Typically, data are manually collected at service delivery points and then sent to the district, regional, or Ministry level for processing and storage with the hope that they will be captured electronically and analyzed.

Ensuring the uninterrupted availability of quality-assured medicines and health technologies from the manufacturer to end users is the ultimate goal of pharmaceutical supply chain systems. However, strategies to strengthen key supply chain components are inadequate in many low- and middle-income countries (LMICs), and systems cannot effectively manage local and global health program demands.

USAID MTaPS supports the Global Health Security Agenda (GHSA), whose purpose is to help build countries’ capacity to protect themselves from infectious disease threats and to raise global health security as a national and worldwide priority. The GHSA has 11 action packages, including one to combat antimicrobial resistance (AMR).

USAID MTaPS applies systems-based approaches using proven tools, interventions, and quality improvement methodologies to strengthen in-country capacity and enhance patient-centered pharmaceutical care. In doing so, MTaPS embeds the culture of quality of care emphasized by the Sustainable Development Goals, the World Health Organization, and other global and national bodies.

This report summarizes significant USAID MTaPS achievements, key challenges, program performance, and adaptation in response to new demands and lessons learned for the January through March 2019 period. The report is organized by health area, objective, region, and country.

In Bangladesh, the Directorate General of Family Planning (DGFP), with assistance from the US Agency for International Development (USAID), is well ahead of other countries in its use of locally developed and automated inventory management tools, especially at the upazila (sub-district) and warehouse levels.

USAID’s Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Project supports reforms in managing medicines by strengthening pharmaceutical-sector governance, optimizing pharmaceutical-sector finance, and supporting improved availability and use of essential medicines in Ukraine.

In order to gain more in-depth understanding of the overall problem with substandard and falsified (SF) medical products and how other countries have combated the issue, USAID’s SAFEMed project carried out a landscape analysis that included a desktop review of policies and guidance on the subject matter coupled with interviews with relevant stakeholders in Ukraine to understand their perspec

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, October 2019 edition. 

USAID's SAFEMed Bioequivalence Report provides an in-depth analysis of current and future legislative requirements for better governance of bioequivalence in Ukraine.

An exciting aspect of USAID SAFEMed's workstream in Ukraine is around medicines supply chains and logistics.

The Leadership, Management, and Governance (L+M+G) Evidence Compendium draws upon existing evidence in peer-reviewed and grey literature to better articulate the links between L+M+G capacity-building efforts and health systems performance.This compendium was produced by the USAID-funded Leadership, Management, and Governance Project and is organized into five chapters exploring each of the health

This report summarizes significant USAID MTaPS achievements, key challenges, program performance, and adaptation in response to new demands and lessons learned for the July through September 2019 period. The report is organized by health area, objective, region, and country.

This report summarizes significant USAID MTaPS achievements, key challenges, program performance, and adaptation in response to new demands and lessons learned for the October through December 2019 period. The report is organized by health area, objective, region, and country.

Despite Uganda’s long-standing commitment to its medicines policy, the pharmaceutical supply chain has faced many well-documented constraints. In an effort to improve medicines management capacity at health facilities, Uganda developed and implemented a multi-pronged, evidence-based supervision, performance assessment, and recognition strategy (SPARS). We wanted to estimate the costs and cost effectiveness of SPARS implementation in public (government and private not-for-profit) health facilities in Uganda. This information is critical for further SPARS scale up in Uganda and for SPARS implementation in countries with similar contexts that want to consider rolling out SPARS as a national strategy. SPARS has been implemented by Uganda’s Ministry of Health since 2010 with support from the US Agency for International Development. SPARS is implemented by district-level health care staff who are trained as MMS to provide on-the-job supervision and training of health workers. Evidence shows that SPARS is an effective intervention to improve performance in key medicines management domains. Based on our estimates from this study, implementing and operating SPARS costs about US$370,000 annually for 1460 facilities, which would extrapolate to approximately US$760,000 for about 3000 government sector facilities or about 0.3% of the total government- and donor-funded EMHS budget.

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