IMPLEMENTATION PLAN FOR SCALLING PHARMACY SERVICES IN GHAIN NEW ART SITES IN GHAIN-SUPPORTED STATES.

Background Information

Mission

Pharmacy and Continuing Education (PACE) mission is to expand and strengthen the roles of pharmacists and pharmacy in the public and private sectors of the international community in health care delivery.

The Center strives to achieve this mission through:

- the provision of innovative skills enhancement courses for pharmacy practitioners and students;

- collaborative projects with partner institutions to refine and complement existing pharmacy programs and curricula; and

- the introduction of methods that utilize the maximum resource potential of pharmacists in delivery of health care including care for PLWAs.

The vision of HUCE/PACE under GHAIN project is to ensure high quality, pharmacy-based services, information and activities that support individuals, families and communities in the target states in the treatment, care, support and prevention of HIV/AIDS and TB.

Over 1200 pharmacists from 18 countries have so far been trained by HUCE/PACE. Trainings have been conducted in-country, Washington DC , USA , and through distance learning and Customized Continuing Education. In the GHAIN project, so far about 202 facility pharmacists have received onsite training on pharmacy best practices, and 204 community pharmacists in 6 GHAIN-supported states have undertaken skills certification training on ART support services.

Plan to Implement Pharmacy Services Programs in the new ART sites

Basically, HUCE/PACE will continue to be involved in two program elements, viz. (1) Basic health care and support (HBHC), and (2) HIV/AIDS treatment/ARV services (HTXS). As we scaled up into the new sites, we will build upon our collaboration with FHI/other IPs, the previous work in strengthening pharmacy system and with pharmacy profession network, to support the scaling up of comprehensive HIV/AIDS treatment, care and support for PLWHA. This will be done through the following:

•  Capacity building of site pharmacists. This will be accomplished through:

•  Didactic training on HIV/AIDS care and Pharmaco-therapeutics . A 3-day training workshop would be organized to train an average of five (5) pharmacists per site. The training will improved knowledge and increase the skills of the pharmacists to offer quality care services within the comprehensive ART program. This training besides increasing the knowledge of pharmacists, would also act as an orientation for pharmacists in the new sites on ART.

•  Pharmacy Best Practices (PBP) training: All pharmacists in the new ART sites would be exposed to on-site training on PBP. The PBP training would focus on 9 key pharmacy elements, viz. (i) Quality dispensing; (ii) Patient Counseling; (iii) Refilling; (iv) Monitoring Therapy & Patient Adherence; (v) Referring; (vi) Education Programs; (vii) Interacting with other health team members; (viii) Data production and collection; and (ix) Control of Drugs. This would be done through the Pharmacy experts (consultant), and the GHAIN State (pharmacy) Coordinators (SCs), supported by the State M&E pharmacists. This training would create an avenue for hands-on learning experience by the pharmacists with supportive supervision by the pharmacy experts/consultants. This would facilitate the installation and enhancement of best practices in the pharmacies. The duration of the on-site training in each site is one to 4 weeks.

•  Technical assistance/mentoring and support

HUCE/PACE will provide technical assistance (TA) and mentoring support to the point of service (POS) pharmacy staff in all new sites through the State Coordinators and the M&E Pharmacists stationed at each state . This would involve information sharing on best practices, and hand-on assistance on ART services to cushion the work load in pharmacies. The technical assistance with the on-site training would not only enable the pharmacists to provide quality pharmacy services to patients, but would also help them to contribute immensely to the ART program and treatment services in the facilities.

•  Provision of dispensing aids and other resources

In order to improve the provision of pharmaceutical care services, the needed dispensing aids and resources would be provided in the pharmacies. We would continue to provide the following materials as they have need of them:

•  Dispensing labels (regular and auxillary labels)

•  Dispensing trays and spatulae (a set of 3 per site)

•  Medication dispensing posters ( 4 per sites)

•  Auxillary label charts for adults and paed dosage forms ( 4 sets per site)

•  Reference materials, including pharmacy reference book, guidelines, etc

•  PBP Guide, 4 copies to be provided per site.

•  Physical Upgrade

HUCE/PACE will collaborate with FHI and other partners and the facility management to ensure a smooth execution of the provisions of the respective site implementation plans and the sub-agreements. Physical upgrade would be pursued so as to ensure good environment for the provision of ART services

•  Monitoring and evaluation

HUCE/PACE M&E pharmacists will routinely undertake monitoring visits to POS. The HUCE/PACE team (as a member of GHAIN M&E team) will continue to support GHAIN global M&E system, and participate in data collation and reporting for GHAIN. Quality management would be highly considered, and quality improvement materials developed such as SOPs, Checklists, dispensing aids, would be provided for use in the facilities.

In addition, we would work to:

•  build on work with members of the Pharmaceutical Society of Nigeria to enhance the use of the pharmacies at the community level as a resource center in the fight against HIV/AIDS;

•  meet training and support needs as the come, and may involve re-training; continuous mentoring, TA/support services, and on-site training.

Note:

The implementation plans are however, limited by the need to:

•  ensure that the required number of pharmacists are employed;

•  obtain the PCN or PSN curriculum detail on the training of pharmacy technicians or  the need to develop this curriculum in detail (we have a proposed outline);

•  have agreement with FHI and AXIOS on the upgrades, computers, and other supports;

•  itemization of budgetary impact of this plan for each site; and

•  State Coordinators' input


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