A model to strengthen utility of quality pharmaceutical health systems data in resource-limited settings

Abstract

Background: Limited utility of quality health data undermines efforts to strengthen healthcare delivery, particularly in resource-limited settings. Few studies model the effective utility of quality pharmaceutical information system (PIS) data in sub-Saharan Africa, typified with weak health systems. Aim: To develop a model and guidelines for strengthening utility of quality PIS data in public healthcare in Namibia, a resource-limited setting. Methods: A qualitative model based on Dickoff et al. practice-oriented theory, Chinn and Jacobs’ systematic approach to theory, and applied consensus techniques. Data from nationwide studies on quality and utility of PIS data in public healthcare conducted between 2018 and March 2020 informed the development of the model concepts. Pharmaceutical and public health systems experts validated the final model. Results: Overall, four preliminary national studies that recruited 58 PIS focal persons at 38 public health facilities and national level informed the development of four model concepts. The model describes concepts on access, management, dissemination, and utility of quality PIS data. Activities to implement the model in practice include grass-root integration of real-time automated pharmaceutical intelligence systems to collect, consolidate, monitor, and report PIS data. Strengthening coordination, human resources, and technical capacity through support supervisory systems at grass-root facilities are key activities. PIS focal persons at health facility and national level are agents to implement these activities among recipients, that is, healthcare professionals at points of care. Guidelines for implementation of the model at point of care are included. Experts described the model as clear, simple, comprehensive, and integration of pharmaceutical intelligence systems at point of care as novel and of importance to enhance utility of quality PIS data in resource-limited settings. Conclusion: While utility of quality PIS data is limited in Namibia, advantages of the model are encouraging, toward building resilient pharmaceutical intelligence systems at grass roots in resource-limited countries, where there are not only weak health systems, but high burden of misuse of medicines.

Inventory Management Practices: Implications on the Pharmaceuticals Expenditure of Rabies Vaccine in Public Health Facilities, Namibia

“…Pharmacy personnel at different supply chain levels should receive intensive training on inventory management and SOPs to maximize performance on on-time recording of transactions on FESC, placing orders accurately, reducing volumes of expiry, and lowering the rates of stock-outs of pharmaceuticals. 3,9,11 The majority of the respondents (72.9%) agreed that trained staff availability is an important factor in the improvement of the inventory management and SOPs compliance. Most pharmacy staff did not receive adequate training on inventory management at the facility level.…”

“…Similarly, another study done in Namibia has revealed that employees at the healthcare facility level do not always follow SOPs, nor appropriately document pharmaceutical transactions to generate relevant reports. 9 Standardized guidelines to register patients for rabies vaccination should be in place at each health facility level, and the number of rabies cases and dog-bite patients should be reported on-time to the NHIS.…”

“…10 Poor inventory management practice and limited usage of pharmaceutical information system data for assessing medicine management activities have been reported at both national and healthcare facility level in Namibia. 9 This study assessed adherence to rabies vaccine SOPs for inventory management activities and, determine the expenditure on the rabies vaccine in comparison to the number of patients who received rabies vaccination at the MoHSS public healthcare facilities. The study provides an empirical snapshot of the current rabies vaccine inventory management practices and baseline information to track progress and improvement in rabies vaccine stock management over time.…”

“…8 Furthermore, there are signi cant challenges among healthcare workers regarding following standardized practice and appropriate documentation of pharmaceutical transactions to generate relevant reports. 9 In effort to address these challenges, the Management Sciences for Health (MSH) in collaboration with the United States Agency for International Development (USAID) assisted the MoHSS to implement an inventory management system in public health facilities to strengthen the supply chain for medicines. 10 Poor inventory management practice and limited usage of pharmaceutical information system data for assessing medicine management activities have been reported at both national and healthcare facility level in Namibia.…”

COVID-19 resilient pharmacy education: A grassroots work-integrated programme to strengthen the pharmaceutical workforce in Namibia

“…This is a concern during the current era of epidemics such as COVID-19, that requires efficient pharmaceutical supply chains and increased access to quality medicine for the public (Koehler & Brown 2017;Amimo, Lambert, & Magit 2020). Moreover, the burden of COVID-19 estimated at 1,727,837 cases in Africa and 12,675 in Namibia (as at midnight 26th August, 2020), has exposed the weak pharmaceutical systems in sub-Saharan Africa (Jernigan, 2020;Kagoya et al, 2020). Most African countries are unable to locally manufacture essential medicines, particularly those critical in the fight against…”