Access to drugs |
• Develop and implement interventions to address the poor availability of drugs in public health facilities
• Identify and develop interventions to address the very long stock-out durations at most public health facilities
• Identify and develop interventions to ensure that all the prescribed medicines are dispensed to patients in public health facilities
• Develop and implement strategies to ensure equitable access to essential medicines through efficient andsustainable financing mechanisms. Such financing mechanisms should be affordable and ensure continuous access to essential medicines especially for the poor, disadvantaged and medically needy groups of the population
• Design, establish and maintain a system for the regular monitoring and effective dissemination of the cost of essential drugs to both suppliers and consumers to foster price awareness and ensure the availability of essential drugs to the community at the minimum possible prices |
Quality of drugs |
• Identify storage deficiencies and design interventions for implementation to address the poor or not adequate storage conditions in public health facilities
• The Ministry of Health and National Drug Authority should strengthen mechanisms to ensure that no expired drugs are found on the shelves in both the public and private sectors |
Rational drug use |
• Identify and develop interventions for implementation to address the significant increase in the number of drugs prescribed per patient contact
• Identify and develop interventions for implementation to address the significant increase in the number of antibiotics prescribed per patient contact
• Identify, develop and continue implementing interventions to further decrease the number of patients receiving injections
• Develop, disseminate and enforce clear guidelines and training on the importance of labelling for dispensed medicines
• Develop, disseminate and enforce clear guidelines and training on the importance of ensuring that patients know how to take their medicines correctly. These initiatives should include consumer-targeted and community-based information, education and communication campaigns
• Investigate and develop interventions for the treatment of diarrhoea in children under 5: Why are 40% of children receiving antibiotics? Why are 20% not receiving ORS? Why are 25% of facilities prescribing antispasmodics? Why are 10% of facilities prescribing antidiarrhoeals?
• Investigate and develop interventions to address the very poor adherence to the standard treatment guideline for ARI
• The Ministry of Health should ensure that the Uganda Clinical Guidelines (the replacement for the old NSTGs) and the EDLU are disseminated and distributed to all health facilities and that health staff are trained in their correct use
• Design and implement consumer-targeted and community-based information, education and communication campaigns to improve rational use of medicines in the community |
Household |
• Develop and implement strategies that ensure equitable access, affordability and sustainable financing for health services in general and access to essential medicines in particular |
The survey clearly indicates that drug management systems and capacity, especially at peripheral health units, need to be strengthened in all aspects of drug supply chain management, such as selection, quantification, procurement, inventory and stores management.
Urgently required reforms in policy and management of essential drugs to increase efficiency in the provision of pharmaceutical services are already being put in place by the Ministry of Health through the implementation of a comprehensive revised National Drug Policy (NDP) and additional funds are being earmarked by the Government for the procurement and supply of essential drugs to the population. NDP implementation activities should be intensified and strengthened.
The findings and recommendations of this survey should facilitate efforts to build on the significant progress already made in improving drug management in Uganda by strengthening institutional and human resource capacity to manage pharmaceutical supplies, service provision and regulation at all levels of the healthcare system.
There is need to design and implement district-focused capacity building and training in drug management procedures and promotion of rational drug use in order to improve the availability, management and use of essential drugs. The approaches should include public and private sector collaboration particularly with NGOs, Civil Society and Faith-Based Organisations.
