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Impact of pharmacy worker training and deployment on access to essential medicines and health outcomes in Malawi: protocol for a cluster quasi-experimental evaluation.

Lubinga SJ, Jenny AM, Larsen-Cooper E, Crawford J, Matemba C, Stergachis A, Babigumira JB - Implement Sci (2014)

Bottom Line: Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes.This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five.The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

View Article: PubMed Central - PubMed

Affiliation: Global Medicines Program, Department of Global Health, University of Washington, Harris Hydraulics Building, 1510 NE San Juan Road, Seattle 98195-7965, WA, USA. slubinga@uw.edu.

ABSTRACT

Background: Access to essential medicines is core to saving lives and improving health outcomes of people worldwide, particularly in the low- and middle-income countries. Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes.

Methods/design: This study measures the impact of an innovative pharmacy assistant training program in the low-income country of Malawi on access to medicines and health outcomes. We employ a cluster quasi-experimental design with pre-and post-samples and decision analytic modeling to examine access to and the use of medicines for malaria, pneumonia, and diarrhea for children less than 5 years of age. Two intervention districts, with newly trained and deployed pharmacy assistants, and two usual care comparison districts, matched on socio-economic, geographic, and health-care utilization indicators, were selected for the study. A baseline household survey was conducted in March 2014, prior to the deployment of pharmacy assistants to the intervention district health centers. Follow-up surveys are planned at 12- and 24-months post-deployment. In addition, interviews are planned with caregivers, and time-motion studies will be conducted with health-care providers at the health centers to estimate costs and resources use.

Discussion: This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five. The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

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Related in: MedlinePlus

Map of Malawi indicating study districts. Ntchisi and Machinga marked in pink are the intervention sites and Chikwawa and Dedza marked in yellow are the comparison sites.
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Fig2: Map of Malawi indicating study districts. Ntchisi and Machinga marked in pink are the intervention sites and Chikwawa and Dedza marked in yellow are the comparison sites.

Mentions: Malawi has 28 districts across three regions—North, Central, and South (Figure 2). Administratively, the districts are subdivided into traditional authorities (TAs). Each TA is composed of villages, which are the smallest administrative units. There are three levels of health care: (1) the primary level, which operates at the village level, consists of village clinics operating community-based Integrated Management of Childhood Illness (cIMCI), health posts, dispensaries, maternities, health centers, and community and rural hospitals; (2) the secondary level, which operates at the district level, consists of district hospitals; and (3) the tertiary level which consists of four specialist referral central hospitals [11]. The PAs are deployed to health centers, one of the seven different types of health facilities at the primary level.Figure 2


Impact of pharmacy worker training and deployment on access to essential medicines and health outcomes in Malawi: protocol for a cluster quasi-experimental evaluation.

Lubinga SJ, Jenny AM, Larsen-Cooper E, Crawford J, Matemba C, Stergachis A, Babigumira JB - Implement Sci (2014)

Map of Malawi indicating study districts. Ntchisi and Machinga marked in pink are the intervention sites and Chikwawa and Dedza marked in yellow are the comparison sites.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4196014&req=5

Fig2: Map of Malawi indicating study districts. Ntchisi and Machinga marked in pink are the intervention sites and Chikwawa and Dedza marked in yellow are the comparison sites.
Mentions: Malawi has 28 districts across three regions—North, Central, and South (Figure 2). Administratively, the districts are subdivided into traditional authorities (TAs). Each TA is composed of villages, which are the smallest administrative units. There are three levels of health care: (1) the primary level, which operates at the village level, consists of village clinics operating community-based Integrated Management of Childhood Illness (cIMCI), health posts, dispensaries, maternities, health centers, and community and rural hospitals; (2) the secondary level, which operates at the district level, consists of district hospitals; and (3) the tertiary level which consists of four specialist referral central hospitals [11]. The PAs are deployed to health centers, one of the seven different types of health facilities at the primary level.Figure 2

Bottom Line: Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes.This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five.The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

View Article: PubMed Central - PubMed

Affiliation: Global Medicines Program, Department of Global Health, University of Washington, Harris Hydraulics Building, 1510 NE San Juan Road, Seattle 98195-7965, WA, USA. slubinga@uw.edu.

ABSTRACT

Background: Access to essential medicines is core to saving lives and improving health outcomes of people worldwide, particularly in the low- and middle-income countries. Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes.

Methods/design: This study measures the impact of an innovative pharmacy assistant training program in the low-income country of Malawi on access to medicines and health outcomes. We employ a cluster quasi-experimental design with pre-and post-samples and decision analytic modeling to examine access to and the use of medicines for malaria, pneumonia, and diarrhea for children less than 5 years of age. Two intervention districts, with newly trained and deployed pharmacy assistants, and two usual care comparison districts, matched on socio-economic, geographic, and health-care utilization indicators, were selected for the study. A baseline household survey was conducted in March 2014, prior to the deployment of pharmacy assistants to the intervention district health centers. Follow-up surveys are planned at 12- and 24-months post-deployment. In addition, interviews are planned with caregivers, and time-motion studies will be conducted with health-care providers at the health centers to estimate costs and resources use.

Discussion: This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five. The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

Show MeSH
Related in: MedlinePlus