Monday March 10 2014

Drug monitoring alone not enough

Reports of health units across the country regularly operating without basic drugs are common. The constant debate on who is responsible for the recurrent drug stock-outs aside, the government has now announced a plan that, if implemented, will greatly improve healthcare delivery.

Under the new scheme using revised tools in the Health Management Information System, the Ministry of Health will now be able to monitor and track drug stock-outs in all public health facilities. The scheme, aimed at achieving zero stock-outs of drugs at all points, rightly singles out tracking of maternal deaths using data generated from all districts to inform policy makers on areas that deserve attention.

Uganda’s maternal mortality rate being unacceptably high, standing at 438 per 100,000 live births, safe motherhood should be one of our topmost priorities.

The tracking system is, on paper, a comprehensive method that is designed to automatically generate daily alerts on how much of a specific drug is left and how frequently that particular drug runs out of stock.

This information also helps the ministry to understand disease patterns in different parts of the country, which will ease management of diseases.
Whereas the tracking system is a positive development, reforms to improve access to medicines should be far-reaching. On Friday, this newspaper reported that security personnel in Ntungamo District in western Uganda were following reports that drugs delivered to health centres in the area are sold in neighbouring Rwanda.

Cases of health workers stealing drugs from public facilities for sale in their private clinics are also common.
Many Ugandans depend on public health service providers. Very few have employer-based insurance, which is often limited to very few individuals per family and, in case of loss of employment, they will have to either buy their own policy or resort to the country’s appalling public healthcare. Ugandans, therefore, expect broader reforms that will improve overall access to health services.

Over time, the tracking system could bring about extensive changes in the way healthcare is delivered to Ugandans. But that can only be successfully done if other factors, especially theft of drugs, is firmly dealt with. The Ministry of Health last week made a commitment to deliver drugs to all health centres in time. That promise should be kept.