Transcript Monitoring and Evaluating Pharmaceutical Situations Diane Whitney Drug Action Program (DAP) Essential Drugs and Medicines Policy (EDM) World Health Organization 1 -- (Monitoring & assessment -

Monitoring and Evaluating
Pharmaceutical Situations
Diane Whitney
Drug Action Program (DAP)
Essential Drugs and Medicines Policy (EDM)
World Health Organization
1 -- (Monitoring & assessment - 11/6/2015)
Geneva, 18 March 2004
WHO - EDM
Teaching Objectives
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At the end participants will understand:
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EDM’s tiered approach to monitoring and evaluation
EDM’s main core indicator tools
Key aspects of using the tools
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Why monitor and evaluate:
Evidence-based planning
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Using indicator-based monitoring
tools
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1. Assess and Monitor
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Who can use the results from
assessments?
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3. Implement
2. Plan
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Systematic data gathering
Raise awareness/numbers for advocacy
Enables comparisons between facilities,
districts, regions, countries depending
on sampling
Facilitates measuring trends
Provides evidence for prioritising
planning and interventions
Countries
National policy-makers
Health facilities
International agencies
Professional groups, NGO, academia
WHO - EDM
Core indicators to monitor national
pharmaceutical situations
Level I
Structures &
processes
Level II
Outcomes
Level III
Indicator tools for specific components of the
pharmaceutical sector such as
• Pricing
• Regulatory capacity
• HIV/AIDS
• Traditional medicine
• TRIPS
• Etc, etc.
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Level I: Questionnaire on structures and
processes of country pharmaceutical
situation
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6-page questionnaire, primarily yes/no format
Distributed to Member States every 4 years with a
subset receiving it every two years
Data used in tracking progress of WHO Medicines
Strategy
Results available in EDM database
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Level I: Indicators
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Covers key components of pharmaceutical system
National medicines policy
Legislation and Regulation
Quality control of pharmaceuticals
Essential medicines list
Medicines supply system
Medicines financing
Access to essential medicines
Production
Rational use of medicines
Intellectual property rights protection and marketing
authorization
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Level I: Using the data to monitor the
WHO Medicines Strategy
WMS 2000 - 2003 Indicators
1. Countries with an official NDP document—new or updated within the last
10 years
2. Countries with a national drug policy implementation plan—new or
updated within the last 5 years
1999
47%
2003
54%
40%
52%
7. Countries with public drug expenditure per capita of less than US$2.00
8. Countries with generic substitution allowed in private pharmacies
10. Countries with public sector procurement based on a national list of
essential drugs
11. Countries with at least 75% of public sector procurement carried out by
competitive tender
22. Countries with treatment guidelines updated within the last 5 years
23. Countries with national list of essential drugs updated within the last 5
years
30%
38%
61%
20%
77%
72%
91%
91%
65%
77%
78%
75%
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WHO - EDM
Level II: Operational Package for Monitoring
and Assessing Country Pharmaceutical
Situations
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Set of 15 survey forms to assess and monitor impact and
outcome of medicines interventions
Feasible tool that can be used by countries in regular
monitoring
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Designed around practical/operational system of managing
resources (time, people and money)
Step by step procedure and guidelines
• administrative preparation (coordination tools, budget,
training slides and schedule)
• technical requirements (training and field test, survey,
analysis tools, reporting framework, and identifying
recommendations for intervention)
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Level II: Indicators
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Availability, price, and expiry of key medicines
Affordability (child and adult moderate pneumonia and option for
other disease condition)
Cost of medicines and related fees
Stockout and record keeping
Conservation conditions and handling of medicines
Number of medicines prescribed, % dispensed, % antibiotics, %
injection, % on EML, % prescribed by generic name
Labelling and patient knowledge of how to take the medicines
Availability of EML and STG
Tracer cases of diarrhoea, pneumonia, ARI, and option for other
disease condition treated according to STG
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WHO - EDM
Level II: Sampling recommendations
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Sample
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6 regions/districts
From each region:
• 5 public health facilities with pharmacy/dispensary
• 5 private pharmacies
• 1 warehouses
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Option to add private facilities, mission clinics depending
on health service mix or provider
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Level II: Already implemented in:
AFRO: Chad, Ethiopia, Ghana, Mali, Nigeria, Tanzania,
Uganda, Cameroon, Kenya, Rwanda, Senegal
AMRO: Guatemala, Columbia (10 more countries in planning
stages)
EMRO: Iran, Oman
EURO: Bulgaria, Kyrgyzstan,
SEARO: Indonesia, Nepal
WPRO: Cambodia, China, Philippines, Malaysia
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Household survey to measure access and
use of medicines
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One-page survey (13 questions)
Collects information on:
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Field testing
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Health seeking behaviour leading to use or non use of drugs
Affordability, from where the medicines are obtained, and if not all
are obtained the reasons why not
in conjunction with Level II in 11 countries
Working group developing questionnaire, sampling framework,
and manual
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WHO - EDM
Household survey: Reasons households
reported for not being able to obtain all
prescribed medicines for most recent
illness: Tanzania
Other
5%
Felt better
5%
Not enough
money
15%
Price too
high
10%
Medicines
not available
65%
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The way forward on country monitoring
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Evidence through systematic but feasible data collection process
is necessary in policy making and activity implementation
Demonstration that in the long run regular monitoring is not
difficult and can be done in a cost efficient manner
Portion of country support budget and project grants should be
allotted to monitoring and evaluation using indicators
Information sharing
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WHO - EDM
For further information please contact:
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Daisy Carandang
EDM Focal Point for Monitoring and Evaluation
[email protected]
or
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Diane Whitney
[email protected]
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WHO - EDM