Pharmaceutical system assessments are useful to diagnose problems, plan major projects and interventions, monitor progress, and compare the performance of one system with that of another. Recent years have seen a growth in demand for such assessments because of the Global Fund to Fight AIDS, Tuberculosis and Malaria’s policy to conduct procurement and supply management (PSM) assessments as a grant condition.
To produce useful results, all assessments should be structured. Two approaches may be useful -
- Comprehensive structured assessment, which generally involves a full-time, dedicated team using structured survey instruments to gather data through site visits, but may be done as a selfassessment exercise by managers
- Limited assessment, which uses interviews and document reviews
Four major categories of issues should be addressed in a comprehensive pharmaceutical sector assessment -
- The functionality of the entire pharmaceutical system
- The capacity of the private sector
- "Political mapping" to understand the important actors and their attitudes and the feasibility of successfully implementing changes in the pharmaceutical system
- Total operating costs of the existing pharmaceutical system and projected costs of potential alternative options
Special-purpose assessments, such as the Global Fund’s PSM reviews, may be more limited in scope.
Specific information objectives should be set in advance, incorporating quantitative as well as qualitative data, performance indicators, and special-purpose analyses. The most important methods for collecting information are likely to be document review, key informant interviews, collection of data from existing records, and prospective observation.
Key issues in planning and managing the assessment are listed in this chapter, but readers should obtain one or more of the manuals mentioned throughout the chapter and in References and Further Readings for full details on organizing and conducting an assessment. When the data are in hand, they must be analyzed efficiently, and a user-friendly report should be produced, supplemented by presentations using graphic aids to help key decision makers absorb the findings. The assessment results must be used in developing new policies and procedures for the pharmaceutical system; otherwise, the process is a waste of resources.