who medicines strategy - libdoc.who.int - World Health Organization
who medicines strategy - libdoc.who.int - World Health Organization who medicines strategy - libdoc.who.int - World Health Organization
WHO MEDICINES STRATEGY 2004-2007 | 30EO 1.2Implementation of medicines policyregularly monitored and evaluated,providing data that can be used inadjusting policy and interventionsto improve access to medicinesRationaleAs an integral part of a NMP, a system formonitoring and evaluation is a constructivemanagement tool that enables ongoingassessment of progress, and contributes tothe necessary management decisions, policydevelopment or reform. Standards can be setand comparison made between countries, areas,and facilities, as well as over time — providingevidence-based information on progress.There is also a need to measure household accessto medicines. While indicators measured atfacility/provider level have proved to be useful,the household survey is an important tool toobtain accurate information on how a populationgroup is accessing and using the medicines itneeds.ProgressA WHO survey package has been developedfor monitoring and assessing pharmaceuticalsituations through the use of measurableindicators. Until recently, efforts by countriesto monitor their pharmaceutical situation werehampered by the lack of time and resourcesneeded to carry out training, gather data inthe field, and analyse the results. The newtool, together with a detailed guide on how tocarry out technical preparation, training andfield surveys, has been used in 22 countries— resulting in savings in both time and cost. Thesystem and process has evolved into a practicaltool that can be used in countries. The surveyshave provided a wealth of information on issuessuch as access, rational use, and medicinessupply systems.Results from Bulgaria and the Philippines haveshown the value of repeating monitoring andassessment at diferent points in time. In the AfricaRegion, active involvement of health ministrypersonnel in the data collection teams has beenan impetus to review country pharmaceuticalaction plans and to direct activities to priorityareas identified in the survey. In Nepal, thesurvey package, including the household survey,
COMPONENTS OF THE STRATEGY | 31is to be adapted as a regular monitoring tool. Inaddition, several countries in the Americas Regionincluded in the European Commission (EC)-WHOjoint programme will undertake baseline countrysurveys.WHO is also developing a quantitative householdsurvey package that covers health-seekingbehaviour and the affordability, availability,source, and appropriate use of medicines.Household surveys have been carried out inseveral African countries and in Nepal.ChallengesOne of the key challenges is to persuade countriesand donors to recognize that investment of timeand finances in monitoring and evaluation isworthwhile. It is important that all countriescarrying out monitoring and assessment do so byusing or adapting the current survey tool. The useof a fixed set of key indicators is vital to ensurethat repeated and comparable monitoring canbe carried out. While qualitative and descriptiveassessment can be useful, it should not replacethe need to qualitatively measure actual impact.Another challenge is to find ways of movingbeyond data analysis to discussion, presentationof results to different groups in the country asevidence for use in planning, and identificationand prioritization of strategies. Clear presentationof data and information has proved to bevaluable in generating debate and in-depthdiscussion to identify what action is needed.A third challenge is the need to balance availableresources and local capacity to undertake thesurvey, including adequate training in gatheringsurvey data. Conducting surveys at the householdlevel is a complex task. Quantitative andqualitative questionnaires need to be carefullystructured in order to obtain reliable informationfrom respondents. There is also a need to ensureappropriate and manageable sampling.Meeting the challenges 2004-2007Over the next four years WHO will:> further refine and promote the monitoring anddata collection tools to develop an evidencebasedapproach to policy development.> provide support, where requested, to promotethe process of monitoring and evaluation andassist governments in developing a regularmonitoring process appropriate to countryneeds and available human and financialresources.> promote innovative methods for trainingcountry staff or other concerned groups whocan assist the government in efforts to gatherdata from health facilities and households.OUTCOME INDICATORS1999 2003 2007No. of countries having conducted a national assessmentof their pharmaceutical situation in the last 4 years#REPORTING % TARGET#REPORTING % TARGETna na na 47/90 52% 58%
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WHO MEDICINES STRATEGY 2004-2007 | 30EO 1.2Implementation of <strong>medicines</strong> policyregularly monitored and evaluated,providing data that can be used inadjusting policy and <strong>int</strong>erventionsto improve access to <strong>medicines</strong>RationaleAs an <strong>int</strong>egral part of a NMP, a system formonitoring and evaluation is a constructivemanagement tool that enables ongoingassessment of progress, and contributes tothe necessary management decisions, policydevelopment or reform. Standards can be setand comparison made between countries, areas,and facilities, as well as over time — providingevidence-based information on progress.There is also a need to measure household accessto <strong>medicines</strong>. While indicators measured atfacility/provider level have proved to be useful,the household survey is an important tool toobtain accurate information on how a populationgroup is accessing and using the <strong>medicines</strong> itneeds.ProgressA WHO survey package has been developedfor monitoring and assessing pharmaceuticalsituations through the use of measurableindicators. Until recently, efforts by countriesto monitor their pharmaceutical situation werehampered by the lack of time and resourcesneeded to carry out training, gather data <strong>int</strong>he field, and analyse the results. The newtool, together with a detailed guide on how tocarry out technical preparation, training andfield surveys, has been used in 22 countries— resulting in savings in both time and cost. Thesystem and process has evolved <strong>int</strong>o a practicaltool that can be used in countries. The surveyshave provided a wealth of information on issuessuch as access, rational use, and <strong>medicines</strong>supply systems.Results from Bulgaria and the Philippines haveshown the value of repeating monitoring andassessment at diferent po<strong>int</strong>s in time. In the AfricaRegion, active involvement of health ministrypersonnel in the data collection teams has beenan impetus to review country pharmaceuticalaction plans and to direct activities to priorityareas identified in the survey. In Nepal, thesurvey package, including the household survey,
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