Face to face interview method with some exit interviews, plus retrospective record data sampling were used to collect information. These methods used the standardized tools developed by the WHO, mainly to measure the degree of attainment of the strategic pharmaceutical objectives of improved access, quality and rational use.

Access was measured in terms of availability and affordability of key drugs, which are used to treat the top 10 diseases as recommended by the MoH Tanzania. These are: -

• Malaria
• URTI
• Diarrhoea
• Worms
• Pneumonia
• Eye infection
• Fungal
• Allergies
• Pain
• Anaemia

The key drugs to treat the above top ten diseases include: -

• Amoxycillin 250mg tablets or capsules
• Aspirin 300mg tablets
• Chlorpheniramine 4mg tablets
• Co-trimoxazole 400/80mg tablets
• Ferrous salts 200mg
• Folic acid 5mg tablets
• Mebendazole 100mg tablets
• Oral rehydration salts (ORS)
• Paracetamol 500mg tablets
• Povidone iodine
• Procaine penicillin 4mu injection
• Quinine injection 600mg/2ml
• Sulfadoxine-pyrimethamine 500/25mg tablets
• Tetracycline eye ointment 1%
• Whitfield ointment (benzoic acid compound)

Quality, on the other hand, was assessed by adequacy of handling and storage of drugs. Finally, rational use was measured by examining patterns of drug use, and the implementation of key strategies such as STGs and EDLs.

Surveys were conducted to measure the indicators as follows:

♦ Public health facilities were used to gather information about:

• % of expired drugs.
• Availability of key drugs.
• Stock out duration.
• Adequacy storage.
• Affordability of key drugs (Treating Pneumonia without hospitalization).
• Average number of drugs per prescription.
• % of patients receiving injections.
• % of drugs in EDL.
• % of patients receiving antibiotics.
• % of drugs dispensed.
• % of drugs with adequate label.
• % of patients who know how to take drugs.
• Availability of STG for common local conditions.
• Availability of EDL at the facility and other relevant materials.
• % of tracer cases treated using recommended treatment guideline (STG).

♦ Private retail outlets to assess:

• % of expired drugs.
• Availability of key drugs.
• Stock out duration.
• Adequate storage.
• Affordability of key drugs (Treating pneumonia without Hospitalization).
• % of expired key drugs
• Availability of key drugs.

♦ Household around each health facility was conducted to assess:

• Household access and use of medicines.

Before implementing the survey, the top ten diseases in Tanzania were listed and the key drugs to manage them were also identified. These key drugs were listed on the survey forms 1a, 1b, 2a and 2b (Annexes 1-4). Likewise, drugs and preparation for standard treatment of pneumonia were identified and listed on survey form 4. Altogether ten (10) survey forms were used for monitoring and assessing the pharmaceutical situation in Tanzania. (Forms: survey forms 1a-10 in annexes).