A strategy to improve skills in pharmaceutical supply management in East Africa: the regional technical resource collaboration for pharmaceutical management

Abstract

BackgroundInternational initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the President's Emergency Plan for AIDS Relief and the President's Malaria Initiative have significantly increased availability and access to medicines in some parts of the developing world. Despite this, however, skills remain limited on quantifying needs for medications and ordering, receiving and storing medications appropriately; recording medications inventories accurately; distributing medications for use appropriately; and advising patients on how to use medications appropriately. The Regional Technical Resource Collaboration for Pharmaceutical Management (RTRC) has been established to help address the problem of skills shortage in pharmaceutical management in East Africa.MethodsThe initiative brings together academic institutions from four East African countries to participate in skills-building activities in pharmaceutical supply management. The initiative targeted the institutions' ability to conduct assessments of pharmaceutical supply management systems and to develop and implement effective skills-building programmes for pharmaceutical supply chain management.ResultsOver a two-year period, the RTRC succeeded in conducting assessments of pharmaceutical supply management systems and practices in Kenya, Rwanda, Tanzania and Uganda. In 2006, the RTRC participated in a materials-development workshop in Kampala, Uganda, and contributed to the development of comprehensive HIV/AIDS pharmaceutical management training materials; these materials are now widely available in all four countries. In Tanzania and Uganda the RTRC has been involved with the training of health care workers in HIV/AIDS pharmaceutical management. In Kenya, Tanzania and Uganda the RTRC has been conducting operations research to find solutions to their countries' skills-shortage problems. Some of the interventions tested include applying and evaluating the effectiveness of a novel skills-building approach for pharmaceutical supply management.ConclusionNurturing collaboration between regional institutions in resource-limited countries to build in-country skills in pharmaceutical supply management appears to be an effective intervention. Support from local programmes and technical assistance from organizations and institutions with the necessary expertise is critical for success, particularly at inception. The skills acquired by local institutions can be incorporated into both pre-service and in-service teaching curricula. This ensures long-term availability of skills in-country. The ability of trained institutions to mobilize their own resources for skills-building activities is crucial for the success and sustainability of these programmes.

An analysis of policies for cotrimoxazole, amoxicillin and azithromycin use in Namibia's public sector: Findings and therapeutic implications

“…Overall, CAA antibiotics are indicated for use in 75% (9/11) of indications by body systems with the respiratory, genitourinary and musculoskeletal disorder systems having the most indications for CAA antibiotics. The wide number of indications of CAA antibiotics by level of healthcare and disease is a risk factor for overuse and the development of AMR, with misuse linked to limited prescriber and diagnostic capacity as well as pressure from patients . In Namibia, with the current human resource issues, nurses are the main prescribers at the lower levels of care, eg, PHCs, where antibiotic prescribing is mainly empiric.…”

“…One of the factors driving increased prescribing of antibiotics in Namibia is the burden of infectious diseases particularly HIV/AIDS, which may well aggravate resistance to essential antibiotics . Of concern are the primary healthcare centres (PHC) with gaps in laboratory diagnostics, education regarding appropriate antibiotic use and human capacity . Among PHCs, the risk of antibiotic misuse is exacerbated by the high workload for health workers with limited training on antibiotic pharmacotherapy as recommended by WHO and Medicines and related Act of Namibia .…”

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“…However, in the later study the main reason was insufficient deliveries of medicines from the regional medical stores. Taken together, these findings emphasize the need to build capacity of drug store managers for quantification and forecasting of medicines through provision of continuing education and professional development 22 .…”

Information management for essential medicines supplies in public primary care facilities in Nairobi County, Kenya

“…This could mean that whatever little training is done may be having little impact. Related studies have previously indicated weaknesses in training in aspects of pharmaceutical management and suggested strengthening in service training of different cadres of health workers (Matowe et al, 2008;Waako et al, 2009).…”