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ICIUM 2011 Conference Antalya, Turkey. 4 th - 18 November 2011. Experiences and use of the MeTA Data Disclosure Survey Tools in GHANA. Daniel Kojo Arhinful No guchi Memorial Institute for Medical Research University of Ghana. Introduction.
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ICIUM 2011 Conference Antalya, Turkey 4th - 18 November 2011
Experiences and use of the MeTA Data Disclosure Survey Tools in GHANA Daniel Kojo Arhinful No guchi Memorial Institute for Medical Research University of Ghana
Introduction • MeTA’s overall goal is to increase access to essential medicines for the poorest of the poor in developing countries • Ghana and other MeTA pilot countries are developing strategies to promote greater transparency & accountability regarding policies, practices, and outcomes through data disclosure MeTA
Why Disclosure? • Objectives • Enable national MeTA stakeholders to prioritize country activities to facilitate progressive disclosure over time; • Create a baseline against which changes in transparency and disclosure during the MeTA pilot implementation can be measured • Consonance with MeTA’s overall goal to increase access to essential medicines for the poorest in developing countries MeTA
Core areas of Data Disclosure • Medicines registration and quality assurance • Availability of medicines • Price of medicines • Policies and practices concerning the promotion of medicines MeTA
Scope of Information Disclosure • Policies – the laws and regulations that are in place; • Practices – suggested procedures to follow and actual practices; and • Results –achievements in the core area MeTA
Scope of Questions • Policies: Do laws/policies exist? Are they published? Do associated regulations exist? • Practices: Are procedures published? How enforced? Which data exist? Who has access? • Results: Which data are available? Who uses data? Barriers to use? How to promote wider use? MeTA
Process of Data Collection • Tool developed by Harvard Group • Identification of Key Respondents • Questionnaire administered to key Informants • Initial discussion of results by technical sub-group • Re-Visits where necessary to validate results • Discussion of results by Governing Council • Dissemination and discussion by multi-stakeholder Group MeTA
How did the tools fare? Experience and use of the tool MeTA
Policies of Data Disclosure • Do Policies exist? Are they published? Do associated regulations exist? • Very useful in unearthing various policies practices and existing results. Examples of existing policies: • Drug regulation - Food and Drugs Law, P.N.D.C.L 305B, 1992 Customs Excise and Preventive Service (Management) Law 1993; Value Added Tax Act 1998 (Act 546); Public Procurement Act 663 (2003); National Health Insurance Act 2003 (Act 650) and Regulation 2004, (L.I.1809); National Drug Policy (MOH), 2004 MeTA
Are practices published? • YES • Available for sale at Assemblies Press, GPC • Distributed free of charge e.g. Drug Policy • Websites e.g.: http://www.fdbghana.gov.gh/ • http://ghanastandards.org/ • Standard Operating Procedures (SOPs) e.g. • Internal Document not usually in public domain • Egs. • Central Medical Stores Analytical Reports • Tender Procurement Evaluation reports • Quantities and cost of available medicines MeTA
Who has access to existing data? • Everyone? • Law makes it mandatory for anybody to have access but more often…… • Various entities (technical assistance providers and programme implementers, health care providers, regulators, importers, manufacturers, researchers, students, donors & multilateral agencies) MeTA
What are the barriers to disclosure • Culture of non-disclosure despite existing laws & policy • Dealing with sensitivities of various interest groups • Mistrust among stakeholders • Low literacy among the population • Dormant consumer groups • Key websites are not updated regularly • Lack of resources to disseminate widely • Right to Information Bill yet to be passed into legislation
Recommendations on how to promote wider disclosure • Broader engagement of key stakeholders in a very transparent manner • Promote public awareness & education on medicines access • More copies of reports printed to meet increasing demand. • Create more awareness in the media & community groups/CSO • Maintenance of key websites eg. MoH, FDB, GSS & NDIRC
Summary and Conclusions • Data disclosure among multi-stakeholder group provided the following benefits: • Stimulated discussion • Provided grounds to share and learn among various stakeholders • Provided understanding of existing problems • Highlighted challenges for working among multi stakeholder groups • Raised useful questions and led to important recommendations