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Document du projet ODM (2)

Project overview

The participants of the WHO/EPN study met for a feedback meeting in Nairobi, Kenya in June 2004, to review the study findings and identify a way forward. Working together, they identified priority steps to increase their sustainability and capacities.

The priority areas identified by the group were as follows.

  • Quality assurance
  • Sustainability
  • Access to medicines
  • Staff and organisational training
  • DSO storage and management capacities
  • Collaboration
  • Distribution services.

This project particularly focuses on those interventions that benefit from economies of scale by being achieved centrally, while benefiting organisations across the region and, indeed, in other resource-poor regions, with advice and information.

This project draws together the recommendations into a plan of action and seeks support for this work in the area of increasing the impact and sustainability of DSOs. The project has the following outline.

Goal:Increasing access to medicines and positive health outcomes.
Purpose:Enhance the capacity and sustainability of faith-based DSOs.
Objectives:

  1. Increased capacity of DSOs to monitor and evaluate themselves for better feedback and management information

    Impact indicator
    • Re-use of the tool, comparability of data over time, usefulness of results to intervention planning.
    • Commitment of DSOs to using the tool.

  2. Increased capacity of DSOs in key organisational, service, and staffing areas

    Impact indicator
      • Increased capacity of staff and DSO institutions involved in using the capacity building tool in Key areas, verified through self-assessment and post process feed back
      • DSOs re-examine their distribution approaches and are able to make well informed decisions about the most appropriate model for their environment. Verified through self-assessment and examination of case studies indicating DSO follow-up.
      • DSOs re-examine their stock management computer software and are able to make well informed decisions about the most appropriate model fro their environment. Verified through self-assessment and examination of case studies indicating DSO follow-up.

  3. Increased networking between DSOs that supports information sharing and capacity development

    Impact indicator
    • DSOs updated and responsive to new information, verified through a self-assessment survey and examples of use of information.

Activities:
[Objective 1]

  1. Creation of a self-assessment tool to be used to monitor progress against the characteristics of a functioning DSO.

    Output indicator
    • Completion and testing of tool

[Objective 2]

  1. Design and draw together more detailed DSO-specific capacity building tools and “how to” manuals, focussing on quality assurance and other key areas.

    Output indicator
    • Completion and testing of tool and manuals

  2. The facilitation of processes that develop DSO staff and institutional capacities.

    Output indicator
    • Number of such activities facilitated

  3. Undertake a feasibility study that details the most common distribution models for the DSOs, and compares the strengths and weaknesses behind current DSO distribution services and contracting out options.

    Output indicator
    • Document available

  4. Identify appropriate stock management computer software options and make the information available to the DSOs.

    Output indicator
    • Document available

[Objective 3]

  1. Support DSOs’ access to information through the provision of information portal services through the EPN website.

    Output indicators
    • EPN website constructed, regularly updated, and carrying relevant information
    • Levels of usage of the website and satisfaction of DSOs with the website.

Rationale

The project is designed to address those areas where the potential of DSOs to provide services is limited in some way. The needs assessment undertaken by the DSO group, and informed by the WHO/EPN study, is detailed fully in Appendix 1.

From this needs assessment, the group produced a list of recommended activities for the individual DSOs, the EPN Secretariat, and for WHO. The recommendations are detailed below and those specific to EPN are highlighted. The highlighted recommendations have provided the core activity areas of the project’s objectives.

Quality assurance

SOPs for quality assurance

Recommendations

Commitment/Action by:

  • Provide background and reference materials

WHO

  • Develop training on development of SOPs

EPN Secretariat

  • Development of SOPs at DSO level

CHAZ, CHAM, Ghana

  • Implementation of SOPs at DSO level

DRC, CHAM, CHAN, JMS, CHAZ, Ghana

  • Development of monitoring (self-audit) of use of SOPs

TZ, MEDS

  • Development of non-testing quality assurance SOPs

JMS, Ghana

Addressing qualified staff needs

Recommendations

Commitment/Action by

  • Short-term technical assistance to develop staff capacities is required from the wider sector

 

  • DSOs should employ and retain qualified staff

TZ, CHAN

  • DSOs to take steps to be an 'attractive' employer e.g.:
    • Provide good working environment
    • Institute good system of benefits
      • Training
      • Staff development
    • Supporting allocating budgets for training
    • Provide attractive uniform for staff
    • Investigate and learn about other employer’s “attractiveness”

TZ

Quality control laboratories

Recommendations

Commitment/Action by:

  • Strengthen existing DSO QC labs

MEDS

  • Set standards for QC labs

WHO, AMFA

  • Map existing QC labs for collaboration

AMFA

  • EPN to provide updated information on issues related to QC, e.g. counterfeit drugs

EPN Secretariat

  • DSOs to contract QC laboratory services

TZ, DRC, CHAN

  • DSOs to collaborate with existing laboratories for QC, e.g. government and private

CHAM, TZ

 

Sustainability

Recommendation

Commitment/Action by:

  • EPN to solicit for funds from the wider sector for capacity building in planning and financial management

EPN Secretariat

  • EPN to facilitate the exchange of existing tools and best practice in financial management and planning.

 

EPN Secretariat

  • Equip the DSO management with planning and financial management skills

TZ, CHAN

  • Equip the DSO with knowledge of the revolving fund concept for sustainability

TZ, CSSC, CHAN

  • DSOs to involve the founding body in planning

TZ, CSSC, CHAN

  • DSOs and the wider sector should organise regular meetings with stakeholders

TZ, CSSC, CHAM, Ghana

  • EPN to develop training on collaboration techniques

EPN Secretariat

Access

Recommendations

Commitment/Action by:

  • Need to verify use of inventory consumption data for placing orders.

TZ, DRC, Ghana

  • Development of training in drug procurement management

WHO, TZ

  • The network supports exchanges between DSOs

EPN Secretariat

  • DSOs need to advocate for the reinforcement of the skills of the management committees governing them, with the goal of increasing sustainability

 

  • Advocate for DTCs and the use of EDL for placing orders

CHAM, TZ, Ghana

  • DSOs need to have clear understanding of various methods of financing (including Revolving Drug Funds) and the implementation of such solutions

TZ

  • Build-up FBO capacities to receive international funding

 

  • Study successful fundraising organisations for lesson learning

 

  • DSO negotiate with quality local suppliers for reduced prices

Ghana

  • Organise pooled procurements

Ghana, TZ, CHAM

  • Encourage local production by first carrying out a feasibility study

Ghana, CHAZ, TZ

Training

Recommendations

Commitment/Action by:

  • DSOs and EPN should develop in-service training tools for
    • Rational use of drugs
    • Drug management
    • Management and leadership

EPN Secretariat, Ghana
TZ, CHAZ, CHAM (rational use of drugs)
TZ, CHAZ (drug management).

  • Regional/sub-regional rational drug management courses should be facilitated and coordinated.

WHO

  • Funds for training of DSOs and customers should be advocated for and EPN should facilitate lesson learning

CHAM, EPN Secretariat

Storage capacities and management

Recommendation

Commitment/Action by:

  • EPN should provide information on good drug management storage practice to DSOs

WHO, to support EPN in the dissemination of the recent booklet on the subject.

  • DSOs should improve physical infrastructure and storage conditions

CHAM, Ghana

  • EPN should provide guidance on best practice so that DSOs can efficiently develop written SOPs for storage, inventory control, etc., in a participatory manner including all staff

CHAZ, TZ, Ghana, CHAN, CHAM EPN Secretariat

  • DSOs should develop DMIS, defining data collection requirements, analysis, use, and reporting.

Ghana, CHAZ, DRC, CHAM, CHAN, TZ

  • EPN, WHO, and DSOs should identify appropriate stock management computer software and mobilise funding and technical assistance.

EPN Secretariat

  • DSOs should improve communications to customers on stock position and other complementary information

DRC, Ghana, TZ, MEDS

  • EPN should design or identify and organise training and technical assistance on procurement.

EPN Secretariat.

Collaboration

Recommendations

Commitment/Action by:

  • Representatives of DSOs should increase awareness on the importance of collaboration among managers and owners of DSOs, moving their organisations from competition to cooperation

TZ, Ghana

  • EPN should organise networking and regular exchange visits among DSO managers

EPN Secretariat

  • EPN should turn EPN website into an information portal

EPN Secretariat

Distribution

Recommendations

Commitment/Action by:

  • A feasibility study should be undertaken by EPN that details the most common distribution models, and compares the strengths and weaknesses behind DSO distribution services and contracting out options.

EPN Secretariat, JMS

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