BASELINE SURVEYS AND MONITORING OF PHARMACEUTICAL SITUATION IN COUNTRIES.

1. BASELINE SURVEYS AND MONITORING OF PHARMACEUTICAL SITUATION IN COUNTRIES. Joseph Serutoke NPO/EDM WHO Uganda November 2002

2. 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.

3. 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.

4. 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

5. Why is it important to use indicators? • Indicators allow a standardized measurement: • to compare situations within and between countries • to measure trends over time

6. 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

7. 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

8. Core indicators to monitor National Drug Policy Level I indicators (structure & process)  Questionnaire Level II indicators (outcome)  Systematic survey • 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

9. 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

10. 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

11. 4. Monitor 1. Assess 3.Implement 2. Plan Planned Interventions following assessment to address under performing areas undermining access to medicines:

12. 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 accordingto needs and performance.

13. THANK YOU