BASELINE SURVEYS AND MONITORING BASELINE SURVEYS AND MONITORING OF PHARMACEUTICAL SITUATION IN COUNTRIES.OF PHARMACEUTICAL SITUATION IN COUNTRIES.

Joseph SerutokeNPO/EDM

WHO UgandaNovember 2002

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Rationale for assessing,monitoring and evaluating the pharmaceutical situation in countries:

To get information and measure:

the access to essential medicines for the population the safety, efficacy and quality of medicines the appropriateness of medicines use

“If you don’t keep score … in a football or tennis match … you are only practising” – Jan Leschely.

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Assessment and monitoring: a tool

Countries: policy makers and managers

to assess performance of the sector (strong and weak points) to assess capacity (structures, strategies and resources) to set objectives and targets and decide about interventions to synchronize health and other policies, e.g. trade; economical

Does not tell the whole story; assist to a limited extent in understanding why a policy or strategy is successful or not.

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Assessment and monitoring: a tool

International Agencies / NGOs:

to assess performance and structure of the sector for developing new projects

to assess progress of projects to assess impact of aid and assistance to policies

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Why is it important to use indicators?

Indicators allow a standardized measurement:

to compare situations within and between countries to measure trends over time

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Indicator-based monitoring: Challenges

Selection of indicators adapted to a country context

Establish a sustainable system (assess & monitor): systematic process that can be repeated over time make resources available institute a monitoring culture

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Core indicators: rationale

To obtain most relevant information from simple survey 3 levels of indicators to be more specific and flexible Rapid assessments with small samples and simple survey

techniques Measure of key information to provide a comprehensive picture Enable systematic and standardised measurement methods Allow regular, sustainable and cost-effective monitoring of NDPs

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Core indicators to monitor National Drug Policy

Level I indicators

(structure & process)

Level II indicators

(outcome)

Level III• WHO & MSH NDP indicators• Indicators for specific pharmaceutical components:

• How to investigate drug use in health facilities;• Assessing regulatory capacity of countries.•Access indicators

Questionnaire

Systematic survey

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Level I core indicator on country pharmaceutical situation

To assess structures and processes in a national system Questionnaire (key informants); no field survey comparisons among countries Key components

National drug policy

Essential drug list

Financing & drug procurement

Rational use of drugs

Legislation and Regulation

Quality assurance

Production

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Level I: Example

Drug financing: national public sector expenditure for drugs (MOH) other public sector expenditure (insurance, local budget) value of international drug aid % of population covered by private/public insurance dispensing policy: drugs free; user fees

Rational use: EDL, Formulary Committees Drug information Centre

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Planned Interventions following assessment to address under performing areas undermining access to medicines:

1. Assess

2. Plan3.Implement

4. Monitor

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Future priorities

Strengthening National capacity of Health systems Human resources through partnerships and collaboration for successful NDP

implementation National EDM Managers and WHO EDM offices and staff

have a critical role to play - assessing and monitoring NDP Monitor impact, reassess and adjust plans according

to needs and performance.

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THANK YOU