This manual is intended for application not only in countries that have adequate monitoring infrastructure for drug policy, but also in those that currently lack this capacity. Where an organizational capacity for monitoring already exists, the manual can be used as a reference tool to review the existing systems for data collection, indicator analysis and report presentation. It may provide ideas for new indicators, sampling methods or report formats, for strengthening the capacity to monitor drug policy implementation.
In countries that lack this organizational capacity, the manual is intended to provide the basis for creating an institutionalized system for monitoring the implementation of national drug policy. The goal of such a system is to provide the essential information without the need for ad hoc studies. However, some data will need to be collected through specific surveys, at least during the first years, because existing systems will be inadequate. For these situations, the manual proposes methods that seek to balance the need for collecting accurate data with the need for logistical simplicity. In certain countries, a practical approach could be to begin with what is possible now and gradually increase the monitoring activities as the system develops.
The organizational unit in charge of monitoring the implementation of drug policy should be within the ministry of health, either in the pharmaceutical department or the planning department. Even in highly decentralized health systems, some central capacity for monitoring the implementation of national policy is desirable.
In general, once the organizational basis for a monitoring system is in place, the process of monitoring requires the following steps:
• defining the targets within each policy area and objective (this step must be carried out as part of policy formulation and planning);
• identifying the indicators and data needed;
• collecting the data;
• analysing and interpreting the data;
• using the results to propose changes, if needed.
The technical procedures for collecting and analysing the data are described in detail in Chapter IV and Annex 1. The issue of interpretation of changes in indicators is complex. Knowledge of the specific context in which the indicator has changed is crucial to any such interpretations. Examples of such interpretations are provided in Chapter V and in the report cited in footnote 1.
Finally, such an institution-building process will require the commitment of senior policy-makers as well as the support of external organizations. These will help ensure that an effective monitoring system can be created and sustained, and that it is used to improve both the equity and the efficiency of national drug policy. Ultimately, the system should be integrated into the national health information system.