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The Role of a Comprehensive Pharmaceutical Sector Development Programme in Improving Rational Use of Drugs: The Ghana Example. Authors. David Ofori-Adjei Martha Gyansa-Lutterodt Divine Asiama Alex Dodoo Francis Aboagye-Nyame Enoch Osafo Daniel Arhinful. Background.

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  1. The Role of a Comprehensive Pharmaceutical Sector Development Programme in Improving Rational Use of Drugs: The Ghana Example

  2. Authors • David Ofori-Adjei • Martha Gyansa-Lutterodt • Divine Asiama • Alex Dodoo • Francis Aboagye-Nyame • Enoch Osafo • Daniel Arhinful

  3. Background • Development of Master Plan for the Pharmaceutical Sector (1994) • First 5-Year Medium Term Strategic Plan (1997 – 2001) • Establishment of Ghana National Drug Programme (1997) • Funded by the Royal Netherlands Embassy • Operated as a project • Implementation Arrangement • Implementing Partners • Coordinating Unit • Secretariat • Rational Use of Drugs

  4. Key Interventions - RUD • Sponsorship of Doctor-Pharmacist pair from each of 10 regions and 2 teaching hospitals to INRUD-PRDU Course in Ghana • Further local training in data collection for WHO drug use indicators & RUD: using modified INRUD training materials • Focal persons for RUD at the regional level with budget • Re-training

  5. Sources of Data • MSH Pharmaceutical Sector Assessment – 1993 • Baseline Study for the implementation of GNDP – 1998 • WHO/GNDP Assessment of the Pharmaceutical Sector – 2002 • GNDP interventions started from 1999 • RUD activities carried out by Regional Focal Persons

  6. Results • No difference in 1993 and 1998 indicators • Comparing 1993/8 with 2002: • Average number of drugs (4.3/3.5) • % antibiotic use (46.6/42.5) • % injection use (55.7/33.5) • % prescribed drugs dispensed (86/91.2) • % availability of STG (45/90) • % correct drug labeling (12/0.2) • % prescribing by EDL (95/94.2)

  7. Lessons • Need for trained focal persons • Re-training important • Budgetary support for local activities • Potential accounting problems • Doctor-Pharmacist pair arrangement culturally acceptable • Pool of data collectors for pharmaceutical sector surveys

  8. Implications • Examine intervention assumptions and match with resources • The rhetoric versus the reality • Make model sensitive to local situation • Long incubation period • Convert from project to programme mode • Clearly define a home for the programme with a mandate and funding

  9. Future studies • Conduct a formal study to verify results • Establish an effective monitoring system – Observatory of pharmaceutical practice • Role of DTCs in promoting rational use of medicines • Behaviour change formative and intervention studies

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