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HIV/TB Pharmaceutical Management and Supply Chain Training Report

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HIV/TB Pharmaceutical Management and Supply Chain Training Report HIV/TB Pharmaceutical Management and Supply Chain Training Report August 2017 HIV/TB Pharmaceutical Management and Supply Chain Training Report Kholiwe Shongwe Wenzile Mthimkhulu Alemayehu Duga August 2017 HIV/TB Pharmaceutical Management and Supply Chain Training Report This report is made possible by the generous support of the American people through the US Agency for International Development (USAID), under the terms of cooperative agreement number AID-OAA-A-11-00021. The contents are the responsibility of Management Sciences for Health and do not necessarily reflect the views of USAID or the United States Government. About SIAPS The goal of the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program is to assure the availability of quality pharmaceutical products and effective pharmaceutical services to achieve desired health outcomes. Toward this end, the SIAPS result areas include improving governance, building capacity for pharmaceutical management and services, addressing information needed for decision-making in the pharmaceutical sector, strengthening financing strategies and mechanisms to improve access to medicines, and increasing quality pharmaceutical services. Recommended Citation This report may be reproduced if credit is given to SIAPS. Please use the following citation. Shongwe K, Mthimkhulu W, Duga A. 2017. HIV/TB Pharmaceutical Management and Supply Chain Training Report. Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program Arlington, VA: Management Sciences for Health Systems for Improved Access to Pharmaceuticals and Services Pharmaceutical Health Technologies Group Management Sciences for Health 4301 North Fairfax Drive, Suite 400 Arlington, VA 22203 USA Telephone: 703.524.6575 Fax: 703.524.7898 E-mail: [email protected] Web: www.siapsprogram.org ii ACRONYMS AND ABBREVIATIONS AHF AIDS Healthcare Foundation AIDS acquired immunodeficiency syndrome ART antiretroviral therapy ARV antiretroviral CMS Central Medical Stores HIV human immunodeficiency virus IEC information, education, and communication MOH Ministry of Health LMIS logistics management Information system MDT multi-drug therapy MSH Management Sciences for Health PEPFAR US President’s Emergency Plan for AIDS Relief PTC Pharmacy and Therapeutics Committee QIP quality improvement plan RFM Ralegh Fitkin Memorial [Hospital] SHIMS Swaziland HIV Incidence Measurement Survey SIAPS Systems for Improved Access to Pharmaceuticals and Services TB tuberculosis UNAIDS Joint UN Programme on HIV/AIDS USAID US Agency for International Development iii CONTENTS Acronyms and Abbreviations ........................................................................................................ iii Introduction ..................................................................................................................................... 1 Background ................................................................................................................................. 1 Objectives of the Training .............................................................................................................. 2 Opening the Training Session ......................................................................................................... 3 Training Format .............................................................................................................................. 5 Target Audience .............................................................................................................................. 6 Pre- and Post-Test Results .............................................................................................................. 8 Next Steps ..................................................................................................................................... 10 Photos ............................................................................................................................................ 11 Annex A. Training Agenda ........................................................................................................... 13 iv INTRODUCTION Background According to the Swaziland HIV Incidence Measurement Survey (SHIMS) report, Swaziland had the most severe HIV epidemic in the world, with a measured HIV prevalence of 26% among adults aged 15–49 years in 2006–2007.1 To combat this epidemic, in 2009, the Government of the Kingdom of Swaziland initiated support for scale-up of national HIV prevention and treatment programs.2 The US President’s Emergency Plan for AIDS Relief (PEPFAR) was implemented through the US Agency for International Development (USAID) in 2003 in 50 countries, including Swaziland, to fight the epidemic. The implementation plan included the training of health professionals to reduce the transmission of HIV and also assist countries by providing health commodities to treat HIV infections and reduce transmission. Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, supports the Ministry of Health (MOH) in strengthening pharmaceutical systems to improve availability of HIV and tuberculosis (TB) medicines, from the central level to the facility level. The MOH is implementing antiretroviral therapy (ART) services through the Swaziland National Aids Program (SNAP). SNAP was established in 1987 to respond to the HIV epidemic. The core mandate of the program is to coordinate health sector interventions, as they account for more than 70% of the total HIV response. The program is responsible for implementing ART services in health facilities; it provides in-service training for HIV management to prescribers (doctors and nurses), accredits health facilities, and manages the HIV guidelines for safe prescribing and use of antiretrovirals (ARVs). Currently, the MOH has 264 health facilities (inclusive of clinics, health centers, and hospitals, both public and private) that provide TB and ART services to patients. Of these, 43 (hospitals and health centers) are “mothers” to the ministry’s clinics. The mother facilities are responsible for monitoring ART services provided by their respective baby clinics and managing their patient and stock data, and then placing orders to Central Medial Store (CMS) on their behalf. According to the World Health Organization, many countries spend 30–40% of their health care budgets on medicines and medical commodities, and a significant amount of the funds are wasted because of irrational medicines use and inefficiencies in stock management due to lack of skills. Other serious problems that health care organizations face include the overuse of antimicrobials, which increases the risks of antimicrobial resistance, leads to increased adverse drug reactions (ADRs), and results in considerably higher costs associated with drug use. Training pharmacy personnel on proper handling of medicines can help improve the proper handling and dispensing of medicines, rational use of medicines, and adherence to treatment to improve patient health outcomes. 1 Central Statistical Office (CSO), Swaziland, and Macro International. 2008. Swaziland demographic and health survey 2006–07. Mbabane, and Calverton, MD: CSO and Macro International; c2008. Chapter 14, HIV prevalence and associated factors. 2 Government of the Kingdom of Swaziland (GKOS) and Government of the United States of America (USG). Partnership framework on HIV and AIDS, 2009–2013. Mbabane and Washington, DC: GKOS and USG; 2009. 1 OBJECTIVES OF THE TRAINING The primary objective of the training was to develop the skills of the pharmacy personnel on proper management of HIV and TB medicines in health facilities. The specific objectives of the training were to: • Improve the skills of health workers handling pharmaceuticals in health facilities on inventory management of TB and HIV health commodities • Ensure that pharmacy personnel are able to complete logistics management information systems (LMIS) forms for ordering and reporting of TB and HIV health commodities • Ensure that pharmacy personnel are able to properly label medicines, and provide medicines information and proper counseling on medicines use to patients to help achieve improved adherence to treatment • Ensure that pharmacy personnel understand the importance of reporting ADRs for TB and HIV medicines to improve patient outcomes 2 OPENING THE TRAINING SESSION The training was carried out in four sessions, one for each project region, held August 7–17, 2017. Each session took place over two days. The training schedule is presented in table 1; the facilitators and scope of training are presented in table 2. The training agenda is shown in annex A. Table 1. Training dates and number of participants trained Region Training dates Venue Number of pharmacy personnel trained Lubombo August 7–8, 2017 George Hotel 21 Manzini August 9–10, 2017 George Hotel 31 Shiselweni August 14–15, 2017 George Hotel 30 Hhohho August 16–17, 2017 Happy Valley Hotel 22 Total 104 Ms. Fortunate Bhembe, Deputy Director for Pharmaceutical Services in the MOH, opened the training and welcomed everyone who had come to participate in the two-day event. She mentioned that for the country to achieve the UNAIDS 90-90-90 goal target for HIV infection diagnosis and treatment, availability of medicines was an important component—hence the need to periodically build capacity of pharmacy personnel on pharmaceutical management and supply chain practice in order
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