A survey on monitoring and assessing the pharmaceutical sector in Tanzania was carried out so as to know whether or not the population has access to essential drugs that are of good quality, efficacious and are being used properly. The survey also aimed at generating current information on the pharmaceutical situation in Tanzania. The information so gathered will form a basis for the review of the National Drug Policy (NDP) of 1991 and the Pharmaceutical Master Plan of 1992-2000.

This survey was carried out in October - November 2002 involving four purposely selected geographical areas, ie Mwanza, Kilimanjaro, Mbeya and the capital city, Dar es Salaam. From the four areas a total of 20 public health facilities were randomly selected (five from each study area). Around each of the health facilities visited, 15 households and one private pharmacy/drug outlet were surveyed.

Since the survey focused on monitoring and assessing the access, quality and rational use of medicines, the WHO level II core indicators were used. Face to face interviews, exit interviews plus retrospective record data were used to collect the required information.

A summary of key results of this survey report is as follows:

It has been noted in this survey that there are more areas of the pharmaceutical sector in Tanzania which have shown improvement than those which raise concern of every stakeholder of the sector. The evidence for this deduction is based upon the indicators which have shown positive results and these are:

• Availability of key drugs in health facilities
• Stock out duration
• Affordability of key drugs in health facilities
• Adequacy of drug storage
• Patient knowledge
• Adequately labeled drugs
• Average number of drugs per encounter
• Percentage of prescribed drugs dispensed
• Patients receiving injections
• Prescribing according to EDL
• Percentage of expired drugs

The areas of concern as evidenced by those indicators which, showed negative trends are:

• Tracer cases treated according to STGs
• Adherence to recommended treatment guidelines in treating diarrhoea in children
• Number of patients receiving antibiotics in one encounter and
• Availability of Guidelines, STG, EDL etc.

On the basis of the above results, the following conclusions and recommendations have been drawn:

• The availability of/and access to key drugs has improved in primary health facilities however, there is still room for the situation to be even better especially on the area of appropriate drug supply management

• Rational Use of Drugs is improving and again, efforts should be made to further raising the standards and sustain them accordingly

• Adherence to prescribing according to EDL is excellent and need to be encouraged and sustained/maintained

• Adherence to STG is low and the situation has some areas whose poor status has remained so for about ten (10) years! The people concerned should institute corrective measures. The typical example here is the over usage of antibiotics.

• Prescribers and dispensers need further training and continuing education especially on areas of Rational Use of Drugs and Management of Drug Supply

• Preventive services need to be strengthened to improve the general sanitation in the community

• The laboratory services need to be strengthened so as to support rational prescribing of drugs

• The availability of STG, EDL and other National Guidelines is unacceptably low, efforts to improve the situation should be made which should include mounting of inspection exercises to health facilities for this purpose.

The general analysis of the survey data shows a considerable improvement in the performance of the pharmaceutical sector. The major recommendation is that, those indicators which, depicted unfavourable results should be addressed with new strategies of a revised NDP and the Pharmaceutical Master Plan.