Ongoing Initiatives to Improve the Quality and Efficiency of Medicine Use within the Public Healthcare System in South Africa; A Preliminary Study

Frontiers in Pharmacology

Jacobus Stokes¹  Ruth Lancaster³  Brian Godman⁴  Helecine Zeeman⁵  Douglas Defty⁶  Natalie Schellack⁷  Johanna C. Meyer⁷  Gavin Steel⁸ 

[1] Contract Management, South Africa Directorate: Affordable Medicines, Sector Wide Procurement, National Department of Health, Pretoria, South Africa;Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden;Essential Drugs Programme, South Africa Directorate: Affordable Medicines, Sector Wide Procurement, National Department of Health, Pretoria, South Africa;Health Economics Centre, Management School, University of Liverpool, Liverpool, United Kingdom;Health Systems Trust, Pretoria, South Africa;Mediclinic Southern Africa, Stellenbosch, South Africa;School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa;Sector Wide Procurement, National Department of Health, Pretoria, South Africa;Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom;

关键词: essential medicines;    health care reforms;    pharmacovigilance;    procurement;    South Africa;    supply chain;   

DOI  :  10.3389/fphar.2017.00751

来源: DOAJ

【 摘 要 】

Introduction: South Africa has an appreciable burden of both communicable and non-communicable diseases as well as high maternal, neonatal, and child morbidity. In recent years there have been significant strides with improving the public health system, and addressing current inequalities, with the right to health a constitutional provision in South Africa. Initiatives include the introduction of National Health Insurance, programmes to enhance access to medicines for patients with chronic diseases, as well as activities to improve care in hospitals, including improving pharmacovigilance. Consequently, the objective of this paper is to review ongoing initiatives within the public healthcare sector in South Africa and their influence to provide future direction.Method: Principally a structured review of current and planned activities.Results: There have been a number of major activities and initiatives surrounding the availability and access to medicines in the public system in recent years in South Africa. This includes a National Surveillance Centre and an innovative early warning system for the supply of medicines as well as the development of a National Health Care Pricing Authority and initiatives to improve contracting. There have also been developments to improve the supply chain including instigating Medicine Procurement Units in the provinces and enhancing forecasting capabilities. Access to medicines is improving though the instigation of stable chronic disease management initiatives to increase the number of external pick-up points for medicines. There are also ongoing programmes to enhance adherence to medicines as well as enhance adherence to the Standard Treatment Guidelines and the Essential Medicines List with their increasing availability. In addition, there is a movement to enhance the role of health technology assessment in future decision making. Hospital initiatives include increased focus on reducing antimicrobial resistance through instigating stewardship programmes as well as improving adverse drug reaction reporting and associated activities.Conclusion: Overall, there are an appreciable number of ongoing activities within the public healthcare system in South Africa attempting to ensure and sustain universal healthcare. It is too early to assess their impact, which will be the subject of future research.

【 授权许可】

Unknown