Measuring Country Medicines Situations
For many years, DPM faculty members have provided technical assistance to the World Health Organization, the UK Department for International Development (DFID)-supported Medicines Transparency Alliance, the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, the Gates Foundation-funded Sustainable Drug Seller Initiatives (SDSI), and others in the development of standardized tools to measure important aspects of country pharmaceutical situations.
WHO pharmaceutical sector country profiles are a practical indicator-based tool that measures the existence and performance of key national pharmaceutical sector structures and processes. Its standardized methodology has been developed and refined through several waves of implementation: 2003 WHO Level I surveys, 2008 Medicines Transparency Alliance (MeTA) pharmaceutical sector scans, 2011 WHO Pharmaceutical Sector Country Profiles.
WHO Level II systematic surveys of health facilities measure key pharmaceutical sector aspects related to medicines availability, quality, prices/affordability, and components of medicines price. They have been used by governments as well as international agencies in many low- and middle-income countries to gather baseline data, and help determine the impacts of interventions aimed at improving access to medicines.
Dr. Dennis Ross-Degnan has led DPM’s involvement in developing tools and strategies to measure country medicines situations in low and middle income countries since 1985. Dr. Anita Wagner contributed to the analysis and reporting of the 2003 WHO Level I and 2002-2004 Level II surveys. Dr. Catherine Vialle-Valentin developed the pharmaceutical sector scan tools, contributed to the development of the 2011 and 2015 WHO pharmaceutical country profile instruments, and in collaboration with Management Sciences for Health, is supporting work to measure the community impact of Accredited Drug Dispensing Outlets (ADDOs) in Tanzania.
- Holloway KA, Ivanovska V, Wagner AK, Vialle-Valentin C, Ross-Degnan D. Have we improved use of medicines in developing and transitional countries and do we know how to? Two decades of evidence. Trop Med Int Health 2013;18(6):656–64. PMID: 23648177.
- Pharmaceutical Situation in Barbados. WHO Assessment of Level II – Health Facilities and Household Survey. (ISBN 978-92-75-13158-9) Washington; Pan-American Health Organization. 2011.
- Medicines Use in Primary Care in Developing and Transitional Countries. A fact book summarizing results from studies reported between 1990 and 2006. (WHO/EMP/MAR/2009.3) Geneva; World Health Organization: 2009.
- WHO Operational package for assessing, monitoring and evaluating country pharmaceutical situations. Guide for coordinators and data collectors. (WHO/TCM/2007.2) Geneva; World Health Organization: 2007.
- World Health Organization, Harvard Medical School & Harvard Pilgrim Health Care. Using indicators to measure country pharmaceutical situations. Fact book on WHO Level I and Level II monitoring indicators. (WHO/TCM2006.2) Geneva; World Health Organization: 2006.
- Laing R, Hogerzeil H, Ross-Degnan D. Ten recommendations to improve use of medicines in developing countries. Health Policy Plan 2001;16(1):13–20. PMID: 11238425.
- Laing RO, Ross-Degnan DG. National drug policies. Lancet 1995;346(8989):1561–2. PMID: 7491072.
- Hogerzeil HV, Bimo, Ross-Degnan D, et al. Field tests for rational drug use in twelve developing countries. Lancet 1993;342(8884):1408–10. PMID: 7901689.
- Ross-Degnan D, Laing R, Quick J, et al. A strategy for promoting improved pharmaceutical use: the International Network for Rational Use of Drugs. Soc Sci Med 1992;35(11):1329–41. PMID: 1462173.
- Quick JD, Laing RO, Ross-Degnan DG. Intervention research to promote clinically effective and economically efficient use of pharmaceuticals: the International Network for Rational Use of Drugs. J Clin Epidemiol 1991;44 Suppl 2:57S–65S. PMID: 2045843.
Methodologies and associated tools:
Principal Investigator: Dennis Ross-Degnan
Funders have included: European Community, UK Department for International Development (DFID), World Health Organization, Pan-American Health Organization, USAID through the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Project, and Gates Foundation through the Sustainable Drug Seller Initiatives (SDSI)