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Arnold C 1 , Audureau E 2 , Kurzinger ML 1 , Besson MH 1 , Sembatya Y 3 , Ladner J 2 , Saba J 1

Evaluation of Drug Forecasting and Drug Consumption Capacity of African Institutions. Arnold C 1 , Audureau E 2 , Kurzinger ML 1 , Besson MH 1 , Sembatya Y 3 , Ladner J 2 , Saba J 1 1 Axios International, Paris, France

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Arnold C 1 , Audureau E 2 , Kurzinger ML 1 , Besson MH 1 , Sembatya Y 3 , Ladner J 2 , Saba J 1

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  1. Evaluation of Drug Forecasting and Drug Consumption Capacity of African Institutions Arnold C1, Audureau E2, Kurzinger ML1, Besson MH1, Sembatya Y3, Ladner J2, Saba J1 1 Axios International, Paris, France 2 Faculty of Medicine - University of Rouen, University Hospital, Rouen, France 3 Axios International, Kampala, Uganda

  2. Introduction and Objectives • Program activities • Managing drug access initiatives and assessing drug supply management • Identifying gaps in drug management capacity • Objectives • Evaluate the performance of drug forecasting in a PMTCT drug access initiative • Describe the characteristics of under-performing programs

  3. Design and Study Sample • Retrospective July 2000 to November 2005, from routine reporting data • 101 programs distributing Nevirapine or Determine HIV rapid test for PMTCT in 27 African countries

  4. Drug Ordering Process Initial Application Review ProgressReports M0 M6-M64 Quantities Requested Quantities Shipped Quantities Used

  5. # Used IFR = # Requested Performance Indicator of Drug Forecasting Institutional Forecasting Ratio (IFR)

  6. Results (1)Characteristics of the Programs Number/Mean % Total number of programs 101 - Mean number of months since application 33.0 - Mean number of re-supply requests 2.5 - Type of programs Governments 52 51.5 NGOs, Private Providers 49 48.5 Number of health facilities ≤ 5 37 36.6 ]5-20] 28 27.7 ]20-100] 18 17.8 >100 18 17.8

  7. Results (2)Baseline characteristics of the Institutional Forecasting Ratio (IFR) Mean IFR 0.46 Median IFR 0.38 N=101

  8. Results (3)Forecasting Method Challenges N=32

  9. Coefficient p IFR- Age of the program 0.25 <0.01 IFR- Number of health facilities 0.14 <0.05 Results (4)Factors associated with value of the Institutional Forecasting Ratio (IFR) Mean IFR p Type of programs Governments 0.39 0.06 NGOs, Private Providers 0.52 Areas of programs implementation Mixed 0.49 0.24 Rural 0.42 Urban 0.34

  10. Results (5)Evolution of Drug Forecasting Performance Over Time in Program

  11. Conclusion and Recommendations • Drug forecasting in a PMTCT program in 27 countries had substantial inaccuracies • Forecasts improved over time with increased use of clinical capacity (consumption) data • Scaling up distribution of ARVs will require capacity building in sophisticated drug forecasting and reporting to maximize therapy uptake and avoid stock-outs

  12. www.AccessToTreatment.org Thank you Celine.Arnold@axiosint.com

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