The UN Commission on Life Saving Commodities 3 years on: global progress update and results of a multicountry assessment

Pronyk, Paul; Nemser, Bennett; Maliqi, Blerta; Springstubb, Nora; Sera, Diana; Karimov, Rouslan I.; Katwan, Elizabeth; Walter, Benedicte; Bijleveld, Pascal

doi:10.1016/s2214-109x(16)00046-2

Cited by 37 publications

(60 citation statements)

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“…Although the country has healthcare facility infrastructure at the community level, training and refresher trainings are lacking for HSPs in primary healthcare settings on understanding signs and symptoms of disease, treatment dosing, and follow-up. These findings are similar to results of a multi-country assessment [15]. We found that because of insufficient training, HSPs were not able to state the correct dose of amoxicillin for the case management of childhood pneumonia in Digholia, Khulna.…”

Section: Discussionsupporting

confidence: 85%

“…Through the UN Commission on Life Saving Commodities, significant progress has been made in the dissemination of WHO treatment policies globally and in policy change for childhood pneumonia and PSBI at the national level in target high-burden countries [15]. The accomplishments in these countries include updating lists of essential medicines to include amoxicillin DT, registering products, coordinating procurement and supply-chain logistics, revising clinical treatment guidelines, developing and delivering training for health workers, developing appropriate job-aids and support materials, and monitoring and evaluating policy implementation and impact [15]. However, these changes in policies and practices must be accepted and implemented at the primary healthcare level to achieve impact.…”

Section: Introductionmentioning

confidence: 99%

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Understanding key drivers and barriers to implementation of the WHO recommendations for the case management of childhood pneumonia and possible serious bacterial infection with amoxicillin dispersible tablets (DT) in Bangladesh: a qualitative study

Rahman

Delarosa

Luies

et al. 2020

BMC Health Serv Res

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Background: Pneumonia and possible serious bacterial infection (PSBI) are leading causes of death among underfive children. The World Health Organization (WHO) issued global recommendations for the case management of childhood pneumonia and PSBI when referral is not feasible with oral amoxicillin. However, few governments to date have incorporated child-friendly amoxicillin dispersible tablets (DT) into their national treatment guidelines and policies. We aimed to understand the key drivers to the implementation of WHO recommendations for childhood pneumonia and PSBI using amoxicillin DT in Bangladesh. Methods: A qualitative study was conducted from October 2017 to March 2018 in two districts of Bangladesh. Interviews were completed with 67 participants consisting of government officials and key stakeholders, international development agencies, health service providers (HSPs), and caregivers of young children diagnosed and treated with amoxicillin for pneumonia or PSBI. Data were analyzed thematically. Results: Policies and operational planning emerged as paramount to ensuring access to essential medicines for childhood pneumonia and PSBI. Though amoxicillin DT is included for National Newborn Health Programme and Integrated Management of Childhood Illnesses in the Operational Plan of the Directorate General of Health Services, inclusion in Community-Based Healthcare Project and Directorate General of Family Planning policies is imperative to securing national supply, access, and uptake. At the sub-national level, training on the use of amoxicillin DT as a first line intervention is lacking, resulting in inadequate management of childhood pneumonia by HSPs. Advocacy activities are needed to create community-wide demand among key stakeholders, HSPs, and caregivers not yet convinced that amoxicillin DT is the preferred formulation for the management of childhood pneumonia and PSBI.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Understanding key drivers and barriers to implementation of the WHO recommendations for the case management of childhood pneumonia and possible serious bacterial infection with amoxicillin dispersible tablets (DT) in Bangladesh: a qualitative study

Rahman

Delarosa

Luies

et al. 2020

BMC Health Serv Res

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“…We differentiated between items that relate directly to a P4P target and those which do not, to examine eventual spillover effects. Items were also classified according to their beneficiary/recipient group along the RMNCH continuum of care based on the WHO classification of priority medicines . For each of these groupings, we generated composite scores based on an unweighted mean score across items in the group, which can be interpreted as the mean percentage availability/stock‐out rate within the grouping across facilities.…”

Section: Methodsmentioning

confidence: 99%

“…According to the United Nations Commission on Life‐Saving Commodities, payment for performance (P4P) is a strategy to improve access to life‐saving commodities for maternal and child health . P4P provides financial incentives to providers and/or healthcare managers based on the achievement of pre‐defined performance targets and is currently being rolled out in many low‐income countries .…”

Section: Introductionmentioning

confidence: 99%

Improving quality of care through payment for performance: examining effects on the availability and stock‐out of essential medical commodities in Tanzania

Binyaruka

Borghi

2016

Tropical Med Int Health

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Abstractobjective To evaluate the effects of payment for performance (P4P) on the availability and stockout rate of reproductive, maternal, newborn and child health (RMNCH) medical commodities in Tanzania and assess the distributional effects.methods The availability of RMNCH commodities (medicines, supplies and equipment) on the day of the survey, and stock-outs for at least one day in the 90 days prior to the survey, was measured in 75 intervention and 75 comparison facilities in January 2012 and 13 months later. Composite scores for each subgroup of commodities were generated. A difference-in-differences linear regression was used to estimate the effect of P4P on outcomes and differential effects by facility location, level of care, ownership and socio-economic status of the catchment population.results We estimated a significant increase in the availability of medicines by 8.4 percentage points (P = 0.002) and an 8.3 percentage point increase (P = 0.050) in the availability of medical supplies. P4P had no effect on the availability of functioning equipment. Most items with a significant increase in availability also showed a significant reduction in stock-outs. Effects were generally equally distributed across facilities, with effects on stock-outs of many medicines being pro-poor, and greater effects in facilities in rural compared to urban districts.conclusion P4P can improve the availability of medicines and medical supplies, especially in poor, rural areas, when these commodities are incentivised at both facility and district levels, making services more acceptable, effective and affordable, enhancing progress towards universal health coverage.

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“…Too often, most of the rural health facilities hardly have all these elements needed for delivery of quality healthcare services. In fact, in Uganda like many other LMIC, health facilities frequently lack lifesaving commodities to be able to provide maternal and newborn quality care services [ 16 ]. The 2013 and 2014 national service availability and readiness assessment (SARA) reports highlighted inadequacies in the availability of lifesaving drugs and equipment in most of the health facilities including higher-level referral health facilities [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study

et al. 2017

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BackgroundThe slow progress in reducing maternal and newborn death in low and middle-income countries is attributed to both demand and supply-side factors. This study assessed the changes in maternal and newborn services in health facilities as well as demand for maternal and newborn health services in Eastern Uganda.MethodsThe health assessment data were collected in August 2013 and September 2015 in the districts of Kamuli, Pallisa, and Kibuku. We purposively collected data on the availability of services from 40 health facilities that provided maternal and newborn services. In addition, we conducted 24 focus group discussions (FGDs) with women and men; and 18 key informant interviews (KIs) with health workers.ResultsOn the supply side, most health facilities persistently lacked lifesaving medicines such as misoprostol, IV Ampicillin, IV Gentamycin, IV Metronidazole, Magnesium Sulphate, Ergometrine, Corticosteroids, ferrous Sulphate, Folic Acid, Combined ferrous, Benzyl penicillin, and Diazepam (IM or IV). Basic newborn equipment such as stethoscope, fetal scope, working baby scale, newborn suction devices, newborn resuscitation device, and thermometer were persistently not available in most of the health facilities. Binders for Kangaroo Mother Care, blanket to wrap newborn, baby warmer or heat lamp were persistently not available in at least 80% of the health facilities. Other equipment for the management of labor and abortions such as Manual vacuum aspirator for abortion care, blank partographs and vacuum extractor were not available in most of the health facilities including referral facilities at baseline and follow-up. On the demand side, the qualitative interviews exposed long distances and inadequate transport to the health facilities, inadequate information, poverty, and poor services at the health facilities as major factors that impede women to utilize/access maternal and newborn services.ConclusionThere are distinct influences on both demand and supply side, which restrain both health care uptake and its quality. The frequent disparity between the health facility readiness to provide services and the women readiness to utilize them needs to be addressed as the country intensifies its efforts to reduce maternal and newborn deaths through boosting facility deliveries.

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The UN Commission on Life Saving Commodities 3 years on: global progress update and results of a multicountry assessment

Abstract: Governments of Norway (NORAD) and the UK (DFID).

Cited by 37 publications

References 1 publication

Understanding key drivers and barriers to implementation of the WHO recommendations for the case management of childhood pneumonia and possible serious bacterial infection with amoxicillin dispersible tablets (DT) in Bangladesh: a qualitative study

Understanding key drivers and barriers to implementation of the WHO recommendations for the case management of childhood pneumonia and possible serious bacterial infection with amoxicillin dispersible tablets (DT) in Bangladesh: a qualitative study

Improving quality of care through payment for performance: examining effects on the availability and stock‐out of essential medical commodities in Tanzania

Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study

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