Abstract
The success of the Namibian government's "treatment for all" approach to control and stop the country's HIV epidemic is dependent on an uninterrupted supply of antiretrovirals (ARVs) for people living with HIV. The public health system in Namibia, however, was constrained by an inefficient paper-based pharmaceutical information system resulting in unreliable and inaccessible data, contributing to persistent stock-outs of ARVs and other essential pharmaceuticals. This article describes the incremental implementation of an integrated pharmaceutical management information system to provide timely and reliable commodity and patient data for decision making in Namibia's national antiretroviral therapy (ART) program and the Ministry of Health and Social Services (MoHSS). The system has 4 interlinked information tools: (1) the Electronic Dispensing Tool (EDT) that manages the dispensing and inventory of antiretrovirals at service delivery points; (2) the EDT national database, which facilitates the flow, storage, and collation of ART data at the central level; (3) the Facility Electronic Stock Card used to manage pharmaceutical stocks and report inventory movement data to the national level; and (4) the Pharmaceutical Management Information Dashboard that integrates all 3 tools plus the warehouse management tool used by the central and regional medical stores into 1 dashboard that serves as a platform for the analysis and dissemination of pharmaceutical information throughout the health system. Implementing the pharmaceutical management information system was a prolonged and complicated process, with key challenges related to user acceptance and human resource constraints. The integrated pharmaceutical management information system enables Namibia to collect more than 90% of transactional commodity and patient dispensing data from more than 85% of all ART sites. Health managers use information from the system for medicine quantification decisions and to improve pharmaceutical service delivery. The MoHSS and its partners in the national ART program use the information for monitoring the World Health Organization early warning indicators for HIV drug resistance; ART defaulter tracing; and for planning, reporting, and research purposes. Namibia's pharmaceutical management information system demonstrates the feasibility and benefits of integrating related tools while maintaining their specialized functionality to address country-specific information and inventory management needs.
Highlights
Global Health: Science and Practice 2018 | Volume 6 | Number 4 households are 114 minutes away from the nearest public health facility.[1]
The key objective of the 2010–2016 national strategic framework for HIV and AIDS was to achieve universal access to care and treatment for people living with HIV.[7]
Namibia has successfully achieved integration of all its pharmaceutical information tools (Figure 1). This integrated pharmaceutical management information system enables Namibia to collect more than 90% of commodity and patient dispensing data from more than 85% of all antiretroviral therapy (ART) sites within 15 days of each month
Summary
Global Health: Science and Practice 2018 | Volume 6 | Number 4 households are 114 minutes away from the nearest public health facility.[1]. To the near elimination of mother-to-child transmission of HIV.[5] The government has decentralized antiretroviral therapy (ART) services beyond district hospital and health center pharmacies to include outreach sites, communitybased dispensing and prescription refill, and nurse-initiated and nurse-managed ART sites.[6] The key objective of the 2010–2016 national strategic framework for HIV and AIDS was to achieve universal access to care and treatment for people living with HIV.[7] These objectives and strategies are aimed at achieving the broader global goal of 90-90-90, requiring 90% of HIV patients knowing their HIV status, 90% accessing ART, and 90% achieving viral suppression.[8] To achieve these objectives, Namibia’s public health system faces the challenge of sustainably ensuring uninterrupted access to antiretrovirals (ARVs) for 90% or more people living with HIV
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