PATHS Final programme report: "Togetherness in Health" the Enugu ...

Production of a Drug DirectoryNigeria is renowned for its preponderance of fake drugs, which are freely available across the country.PATHS supported the development of a Drug Directory of information on genuine medicines andconsumables. This involved identifying available generic and brand dosage forms, their compositionsand strengths, NAFDAC numbers, manufacturers, Nigerian representatives, agents, importers and theirdistributors and contact addresses.It was hoped that the Directory would help to:• Improve the quality of care provided by private or public medical practitioners, pharmacists etc;• Alert all stakeholders in health to their duties in checking fake, counterfeit, substandard orunwholesome drugs;• Improve the co-operation of pharmaceutical companies in making available all addresses of theircompanies, agents and distributors so that public sector drugs procurement could avoid the opendrug market;• Remove the doubt of some pharmaceutical manufacturers that the initiative intended to provethat they dumped their products in open markets and lacked distributors.Copies of the Drug Directory were widely circulated to pharmacists across the public and privatesectors, pharmacy outlets, and the National Council for Pharmacists for Nigeria. The Directory was wellreceived.Development of Laboratory ServicesThe laboratory strengthening initiative commenced early in the programme. The idea was to developlaboratory services linked to the private sector in Nsukka. For a number of reasons, however, theinitiative was not taken forward and the direction changed in 2006 when all the PATHS states cametogether to agree a way forward. The outcome of the discussions was implementation of a communitydiagnostic programme (CDP) to improve the testing of malaria, TB and Hb estimation. Much of thein-state TB work was managed in conjunction with German Leprosy Relief Association (GLRA) and theSMoH TB Supervisor, who provided the data and microscopes.A programme of work was agreed including:• Provision of equipment, reagents and Malaria Rapid Diagnostic Tests (RDTs)• Training of laboratory scientists/technicians/assistants from the public and private sectors• Community mobilisation to encourage utilisation of laboratory services• Provision of TB/DOTS (Directly Observed Treatment Shortcourse) signage and InformationEducation and Communication materials• Provision of motorcycles for TB & Leprosy supervisors• Development of standard operating procedures• Establishment of a quality assurance scheme• An independent review of all the SMOH-listed TB laboratories.A survey of TB/DOTS clinics/laboratories across the state found that of the 112 facilities that weresupposed to be providing these services, in practice only 25% were offering a genuine service. As aresult, a decision was made to focus the laboratory strengthening work on 20 laboratories (eight PHCand 12 SHC facilities: of which six were in the faith-based sector).“Togetherness in Health” the Enugu Experience in Health Sector Reform, 2002-2008 45