Systems for Improved Access to Pharmaceuticals and Services │Sierra Leone

Sierra Leone Project Overview

May 2017

SUMMARY

The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program,

implemented by Management Sciences for Health received two years of funding in September

2015 from the US Agency for International Development (USAID) to provide technical assistance

to rebuild and strengthen the post-Ebola pharmaceutical supply chain management system in

Sierra Leone. The project covers health management teams, medical stores, hospitals, and

peripheral health units (PHUs) in all 13 districts. It is led by the country’s Directorate of Drugs and

Medical Supplies (DDMS), which is responsible for coordinating and providing pharmaceutical

services (including promoting rational medicine use) in Sierra Leone; the National Pharmaceutical

Procurement Unit; and the Pharmacy Board of Sierra Leone (PBSL).

The project objectives are to strengthen:

Governance and leadership of the DDMS and district health management teams to

effectively support health facilities in overall pharmaceutical management systems

Supply chain management at districts and health facilities to ensure product availability and

rational use

Pharmaceutical management information systems to increase the use of information for

supply chain decision making

Key Technical Assistance Provided to Date

Governance and Leadership

Assisted in reviewing and revising the organogram/structure of the DDMS and drafting the

terms of references of the different units

Initiated capacity building of directorate personnel in leadership/management/governance

Assisted with developing the Antimicrobial Resistance National Strategic Plan

Supported the launch of hospital Drug and Therapeutics Committees (DTCs) in four

hospitals, with five more soon to launch and plans under way to work with all 24 hospitals in

Sierra Leone. All DTCs will be provided with computers, projectors, printers, office

equipment, and furniture as part of capacity building efforts.

Provided up-to-date reference books to the DDMS, district/hospital pharmacists, PBSL, and

the School of Pharmacy

Supply Chain Management

Developed and introduced checklists for conducting a bimonthly, indicator-based continuous

results monitoring and support system (CRMS) as part of a dynamic supportive supervision

process. The CRMS tracks pharmaceutical management system performance at all health

facilities to improve the transparency and accountability of pharmaceutical management

systems. It has been implemented in nearly 1,000 of the 1,300 PHUs in the country.

SIERRA LEONE PROJECT OVERVIEW 2

Systems for Improved Access to Pharmaceuticals and Services │Sierra Leone

Supplied PHUs with urgently needed shelves, pallets, and cupboards to improve storage

based on CRMS recommendations

Collaborated with partners on a plan for reverse logistics of expired products from PHUs to

alleviate congestion of storage space and ensure proper disposal at the central level

Information for Decision Making

Supported the revision of a manual logistics management information system tool (report,

request, and issue voucher)

Supported the establishment of long-term quantification practices, including forming a

quantification committee and building its capacity. Supported a multi-year forecasting and

supply exercise for essential medicines and consumables. Conducted training in electronic

data management tools (e.g., Quantimed, Pipeline, and QuanTB).

Introduced a four-part daily and monthly treatment/pharmacy register to be used at the

health facility, district, and central levels. The register captures patient uptake, priority

disease (11 conditions), consumption, and stock status data of tracer/key pharmaceuticals,

including 13 essential products and selected Ebola-related commodities, from 21 hospitals

and approximately 1,200 PHUs. It is a key tool and source of actual consumption data to

monitor inventory and promote the rational use of pharmaceutical products.

Developed the Sierra Leone Pharmaceutical Dashboard, a web-based early warning

system that provides visual data on real-time patient and product information. Initially

developed for monitoring stock status/uptake of antiretrovirals, it is now being scaled up to

include priority health programs and other essential medicines.

Supported the revision of the National Essential Medicines List to inform the selection of

products for quantification and use at different levels of the health system

CHALLENGES AND CONSTRAINTS

Weak governance and management infrastructure, leadership, and structures/mechanisms

Outdated regulations/guidelines

Severe Ebola-related shortage of trained/skilled pharmaceutical staff at PHUs

Storage and handling at all levels in dire need of improvement; unusable Ebola supplies

and other expired products congesting the storage system

Cost recovery system not functioning as designed/planned, potentially impacting resources

for Free Health Care Initiative

Weak information system: data quality and recording tools; data not used for decision

making; irregular reporting

NEXT STEPS

Build on successes to date

Continue to fine tune interventions and provide capacity building/mentorship

Quickly transition ownership to counterparts by escalating the involvement of the DDMS,

DHMTS, health programs, and DTCs

Advocate with the Ministry of Health and Social Services, USAID, and other partners for

resources to continue activities

Country Program Director: Murtada M. Sesay (msesay@msh.org)