How to establish a successful revolving drug fund: the experience of Khartoum state in the Sudan

Ali, Gamal Khalafalla Mohamed

doi:10.2471/blt.07.048561

Cited by 18 publications

(14 citation statements)

References 5 publications

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Level 1—Individuals, households and communities. Compared with a baseline situation of medicines shortage, RDF increase availability of medicines (Ali 2009) and affordability, through a closer control over price (Carasso et al 2009). Communities’ satisfaction and trust in health services may increase (Ali 2009) and out-of-pocket expenses (OOPE) may decrease.

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Section: Resultsmentioning

confidence: 99%

“…Absence of reliable procurement sources impacts on medicine quality (Ali 2009) and prices, thus affecting their affordability. Health financing : Establishment of RDF may increase available domestic funding for other health priorities (Audibert and Mathonnat 2000), improve cash availability and management flexibility at facility level although RDF revenues may simply fill a budget gap without solving funding shortage; OOPE is increased. Human resources : Health staff may feel confident to perform their work as medicines are available. There is a risk, however, that they focus on revenue generation activities at the expense of delivering preventive services (Uzochukwu and Onwujekwe 2005).…”

Section: Resultsmentioning

confidence: 99%

“…Absence of reliable procurement sources impacts on medicine quality (Ali 2009) and prices, thus affecting their affordability.…”

Section: Resultsmentioning

confidence: 99%

“…Although RDF establishment requires a ‘business-oriented management’ (Ali 2009) or ‘market-oriented thinking’ (Murakami 2001), a strong governance, regular supervision, monitoring and evaluation need to be in place to keep the focus on public health goals.…”

Section: Resultsmentioning

confidence: 99%

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Access to medicines from a health system perspective

Bigdeli

Jacobs

Tomson

et al. 2012

Health Policy and Planning

240

237

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Most health system strengthening interventions ignore interconnections between systems components. In particular, complex relationships between medicines and health financing, human resources, health information and service delivery are not given sufficient consideration. As a consequence, populations' access to medicines (ATM) is addressed mainly through fragmented, often vertical approaches usually focusing on supply, unrelated to the wider issue of access to health services and interventions. The objective of this article is to embed ATM in a health system perspective. For this purpose, we perform a structured literature review: we examine existing ATM frameworks, review determinants of ATM and define at which level of the health system they are likely to occur; we analyse to which extent existing ATM frameworks take into account access constraints at different levels of the health system. Our findings suggest that ATM barriers are complex and interconnected as they occur at multiple levels of the health system. Existing ATM frameworks only partially address the full range of ATM barriers. We propose three essential paradigm shifts that take into account complex and dynamic relationships between medicines and other components of the health system. A holistic view of demand-side constraints in tandem with consideration of multiple and dynamic relationships between medicines and other health system resources should be applied; it should be recognized that determinants of ATM are rooted in national, regional and international contexts. These are schematized in a new framework proposing a health system perspective on ATM.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Absence of reliable procurement sources impacts on medicine quality (Ali 2009) and prices, thus affecting their affordability.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Access to medicines from a health system perspective

Bigdeli

Jacobs

Tomson

et al. 2012

Health Policy and Planning

240

237

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“…In order to stem the flow of pharmacists to the private-sector and increase their performance, the Ministry of Health needs to pay incentives to its pharmacy staff on a semi-private basis. Introduction of the employment contract and the application of the incentive budget line opposite performance proved to be effective in Khartoum State experience [23]. The obligations of each part (employer and employee) should be written in non-ambiguous language and transparent reward system should be in place.…”

Section: Recommendationsmentioning

confidence: 99%

Personnel Policy and Practice: Sustainable Management of Pharmacy, Pharmacists and Pharmaceuticals and How to Bridge the Gap in Human Resources for Health

Omer

2019

Medical &Amp; Clinical Research

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Worldwide there are different systems for providing pharmacy services. Most countries have some element of state assistance, either for all patients or selected groups such as children, and some private provisions. Medicines are financed either through cost sharing or full private. The role of the private services is therefore much more significant. Nationally, there is a mismatch between the numbers of pharmacists and where are they worked, and the demand for pharmacy services. The position is exacerbated locally where in some areas of poor; there is a real need for pharmacy services, which is not being met and where pharmacists have little spare capacity. Various changes within the health-care system require serious attention be given to the pharmacy human resources need. In order to stem the brain drain of pharmacists, it is, however, necessary to have accurate information regarding the reasons that make the pharmacists emigrate to the private sector. Such knowledge is an essential in making of informed decisions regarding the retention of qualified, skilled pharmacists in the public sector for long time. There are currently 3000 pharmacists registered with the Sudan Medical Council of whom only 10% are working with the government. The pharmacist: population ratio indicates there is one pharmacist for every 11,433 inhabitants in Sudan, compared to the World Health Organisation (WHO) average for industrialised countries of one pharmacist for 2,300 inhabitants. The situation is particularly problematic in the Southern states where there is no pharmacist at all. The distribution of pharmacists indicates the majority are concentrated in Khartoum state. When population figures are taken into consideration all states except Khartoum and Gezira states are under served compared to the WHO average. This mal-distribution requires serious action as majority of the population is served in the public sector. This study reveals the low incentives, poor working conditions, job dissatisfaction and lack of professional development programmes as main reasons for the immigration to the private-sector. The objective of this communication is to highlight and provide an overview of the reasons that lead to the immigration of the public sector pharmacists to the private-sector in Sudan. The survey has been carried out in September 2014. Data gathered by the questionnaires were analysed using Statistical Package for Social Sciences (SPSS) version 12.0 for windows. The result have been evaluated and tabulated in this study. The data presented in this theme can be considered as nucleus information for executing research and development for pharmacists and pharmacy. More measures must be introduced to attract pharmacists into the public sector. The emerging crisis in pharmacy human resources requires significant additional effort to gather knowledge and dependable data that can inform reasonable, effective, and coordinated responses from government, industry, and professional associations.

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