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Multi-country study on drug supply and distribution activities of faith-based supply organizations

Promoting use of effective medicines supply strategies in Africa. Multi-country study on drug supply and distribution activities of faith-based supply organizations in sub-Saharan African countries, 2003 Sophie Logez / Marthe Everard EDM/PAR. Outline. Objectives Methodology Results

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Multi-country study on drug supply and distribution activities of faith-based supply organizations

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  1. Promoting use of effective medicines supply strategies in Africa Multi-country study ondrug supply and distribution activities of faith-based supply organizations in sub-Saharan African countries, 2003 Sophie Logez / Marthe Everard EDM/PAR

  2. Outline • Objectives • Methodology • Results • Next step

  3. Objectives of the MC Study • Document experiences and practices of FB DSOs • Strengthen EPN’s technical capacity by evaluating drug supply systems existing in the Network • Strengthen collaboration between WHO/EDM and EPN

  4. Outline • Objectives • Methodology • Results • Next step

  5. Methodology • Sample: 16 DSOs in 11 African countries reviewed (Feb-Dec 2003) • Data collection tool: structured questionnaires (4) • Data collection: Paired country assessments by FB DSO staff • Data management: WHO database • Joint analysis of results with all participants (EPN/WHO feedback meeting, June 2004)

  6. Methodology Selected countries Ghana Nigeria Tanzania Kenya Uganda Malawi Zambia S Africa Cameroon Rwanda DR Congo

  7. Methodology Issues Investigated • Role, functions and perspectives of DSOs • Procurement management • Founding Bodies's opinion • Government’s view • Customer's view

  8. Outline • Objectives • Methodology • Results • Next step

  9. Founding bodies expectations Providing medicines to FB facilities Generating funding to support other projects Type of boards 44% elected (7DSOs) 38% nominated (6DSOs) 13% committees (2DSOs) 1 DSO with no board Board meeting: 4times a year (10DSOs) Twice a year (4DSOs) Once a year (1DSO) Results Governance and Administration

  10. Results Infrastructure • 13 DSOs have storage capacity • 13 DSOs have cold storage capacity • 5 DSOs have regional stores • 16 DSOs have necessary utilities • 2 DSOs do not have regular email

  11. Results Services provided by the 16 DSOs

  12. Customers Served Results

  13. Results Procurement: Drug Selection By whom? • Drug committees: 7 DSOs (44%) • DSO's procurement team: 5 DSOs (31%) • Individual decision by DSO: 2 DSOs (13%) • Customers themselves: 2 DSOs (13%) Selection principles • 14 DSOs select medicines based on EDL • 5 DSOs also supply medicines out of EDL • 3 DSOs use kit systems Drug donations • 5 DSOs (38%) received donations for free distribution

  14. Results Drug Procurement Methods 3 DSOs buy exclusively locally, 1 DSO exclusively internationally

  15. Results Price information

  16. Results Criteria for prequalification of suppliers

  17. Results Quality Assurance: SOPs for 7 DSOs

  18. Results Human Resources • 13 DSOs employed at least one pharmacist (up to 6) • 13 DSOs have staff policy • All 16 DSOs use selection committees for recruitment • 15 DSOs have staff wages higher than public sector • Wide range of pharmacist annual wages in EPN (from US$2,400 to US$13,450)

  19. Results Donor Support 12 DSOs reported receiving donor support 9 DSOs received support from FBOs in Europe and the USA and some from bilateral agencies (USAID, KfW and DfID)

  20. External factors economic situation political situation poverty of population no tax exemption for imported medicines Internal factors inadequate financing drug donations lack of qualified staff for management and activities reluctance to change mentality Results Factors Affecting DSOs Operations

  21. Results Governments’ view • Acknowledge great contribution of FB DSOs to national drug supply system • Lack of formal reporting/communication • Lack of formal collaboration • Perception of governments: • quality of medicines supplied by FB DSOs questioned • distribution of donated medicines not always found appropriate

  22. Results Customers’ view • Good quality of medicines • Medicines supplied • quantities (50 - 75% of needs met) • range of items (to be increased) • Need for technical assistance • regular supervision • training (drug management/RDU) • Better communication/relation

  23. Results Future Perspectives (1) Objectives for 15 DSOs: • Increase number of customers: 12DSOs (80%) • Improve delivery services for customers: 7DSOs (47%) • Collaborate with other DSOs: 7DSOs (47%)

  24. Results Future Perspectives (2) 15 DSOs (94%) planning to scale up of their activities

  25. Outline • Objectives • Methodology • Results • Next step

  26. Next step: Feedback meeting June 2004 • Recommendations drafted • Quality assurance (SOPs) • Sustainability of DSOs (financial/organizational) • Training (sharing tools) • Procurement and storage capacity • Collaboration (DSOs/EPN) • Distribution service (feasibility study) • Activities identified for DSOs/EPN/wider sector

  27. EPN/WHO Feedback meeting, Nairobi, Kenya, June 2004

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