E-DRUG: Pharmacy system performance and integration- Côte d’Ivoir
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Dear all,
We would like to share with you a policy brief about a study on pharmacy
system in the context of free healthcare measures in Ivory Coast.
Please follow the link
http://www.equitesante.org/2013/09/19/pharmacy-system-performance-and-integration/
http://www.equitesante.org/2013/09/19/performance-et-integration-du-systeme-pharmaceutique/
The full report is available in French.
Best regards,
Marion Baudry, PharmMD
*Reference <<<
Pharmacy system performance and integration: two essential conditions for
the success of free healthcare measures in Côte d’Ivoire. Policy brief, 2013.
Belaid L., Baudry M., Queuille L. and V. Ridde.
CRCHUM/HELP/MDM/OXFAM/ECHO
The free healthcare measures decreed in 2011 and 2012 in Côte d’Ivoire further weakened a drug supply chain that had been precarious for several years. Rapid depletions of stocks of medical inputs and of financial resources paralyzed the healthcare system. The free healthcare measures need to be revisited and properly funded, and their implementation must be improved to meet the population’s health needs. The drug supply chain is also in need of its own reform.
INTRODUCTION
In April 2011, after the post-electoral crisis, the government of Côte d’Ivoire decreed health services to be free of charge in public health centres (HC) for the entire population and for all services, examinations, and drugs [1]. This “generalized free healthcare” measure was presented as the first step in a more comprehensive reform leading to universal medical coverage as part of the President of the Republic’s “Vivre Ensemble” (Living Together) program. This free healthcare immediately increased the use of healthcare services and brought the population’s healthcare needs into the spotlight. However, as the healthcare system had not been prepared, it encountered difficulties, and in March 2012 the Ministry of Health and AIDS Control (MSLS) and the Ministry of the Economy and of Finance were obliged to move instead to “targeted free healthcare” [2]. The problems persisted, especially the problem of drug shortages. In this policy brief, we analyze the effects of these two free healthcare measures on the drug supply chain [3].
METHOD
This was a multiple case study focused on free integrated healthcare for childhood illnesses, malaria, and childbirth services. Two cases were analyzed: generalized free healthcare and targeted free healthcare. The approach was qualitative, using documentary review, semi-structured interviews (n=33) and observations in two district distribution depots (DDD) for medical inputs and six HCs. Data were collected between May 23 and June 6, 2012, at the central level and in two health districts, one supported by a non-governmental organization (NGO) and the other not, thereby allowing comparisons to be made. The six HCs were selected in consultation with the district management teams and the managers of the NGO involved according to criteria related to geographic access and performance. The analysis described in this policy brief addressed the channels for pharmaceutical inputs: purchasing, distribution, management, use of pharmaceutical inputs, and coordination.
RESULTS
The figure illustrates the channels for pharmaceutical inputs from the international to local levels. The main functions studied for each level, and between levels, are indicated in blue. The black double arrows represent the normal channel for pharmaceutical inputs between levels. The public healthcare pharmacy (PHP) is the national procurement centre. It supplies the DDDs, which then supply the HCs. However, certain technical and financial partners (TFP) bypass all or part of the PHP (red arrows).
.......... continued at http://www.equitesante.org/2013/09/19/pharmacy-system-performance-and-integration/
Marion Baudry, PharmMD
Marion Baudry <baudry.marion@gmail.com>