SIAPS/PMI - AMDM Scale-Up Sites Baseline Assessment (Ethiopia)
(2014; 34 pages)

Hailu Tegegnework and Fikadu Deme. 2014. Antimalaria Drugs Management, Baseline Assessment Report, USAID/SIAPS/PMI–Ethiopia, August, 2014. Submitted to the US Agency for International Development by the Strengthening Pharmaceutical Systems Program. Arlington, VA: Management Sciences for Health.

Abstract

In 2007, the Ethiopia Malaria Operational Plan (MOP), which outlines activities to be supported by PMI, identified Strengthening Pharmaceutical Systems (SPS)/Management Sciences for Health (MSH) as its partner for providing technical assistance and support to PMI (The President’s Malaria Initiative) regarding antimalaria drugs management (AMDM). In 2012, Systems for Improved Access to Pharmaceuticals and Services (SIAPS), a successor of SPS implemented by MSH, continued to implement the AMDM activities to ensure the availability of high-quality pharmaceutical products and effective pharmaceutical services to achieve desired health outcomes. To that end, the SIAPS areas of focus include improving governance, building capacity for pharmaceutical management and services, addressing information needed for decision-making in the pharmaceutical sector, strengthening financing strategies and mechanisms to improve access to medicines, and increasing high-quality pharmaceutical services.

This is a focused, rapid, participatory, and comprehensive baseline assessment, intended to gather operational information for the purpose of identifying immediate gaps and undertaking appropriate interventions.

The assessment revealed that overall availability of AMDs is 83% at hospitals and 74% at HCs. However, some facilities reported stock-outs and shortages of the AMDs, including quinine tablets, for treatment of uncomplicated PF malaria in pregnant women during the first trimester and children under 5 kg. The shortages and stock-outs of medicines could arise as a result of several factors in the supply chain system. These include the use of a push system of distribution or improper quantification practices, which fail to address the HFs’ need for the medicines. A push system not only affects the availability of medicines but discourages the development of an active system of record-keeping, medication use monitoring, consumption-based ordering, and other more precise stock management procedures.

The overall availability of expired AMDs at the HFs assessed was found to be very low except at a few hospitals and HCs. However, the quantities of AL and quinine tablets that expired at HFs are greater than the others, which is significant. Proper quantification and active inventory management at all levels of the supply chain system will help increase availability of medicines and reduce risk of expiry at the HFs.

Therefore, it is advisable to establish and strengthen a system of good record keeping on the transactions made regarding medicines, including those dispensed to patients, to obtain reliable consumption data for resupply and quantification. In line with strengthening the supply chain system at all levels, regular stock rotation and the establishment of a uniform system for redistribution of excess and near expiry products will support efforts to reduce expiry and can contribute to improving availability at HFs. Finally, timely and safe disposal of unusable products will help to reduce risks to patients and free limited space occupied by these unusable products.

 
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