Poster 14

Bottom-up Innovations: System of auditable pharmaceutical transactions, and services for supply chain, proper use of medicines, and delivering health services in Ethiopia. (79)

One-third of the global population does not have regular access to medicines; this number is even greater in many low-income countries, such as Ethiopia. Ethiopia’s challenges with health care access can be attributed to gaps in the health system and supply chain such as poor deployment of human resources; poor management of and planning for commodities, leading to high wastage rates and low availability of medicines; lack of transparency of transactions preventing the tracking of medicine theft; and under resourced service delivery systems to give proper care to patients. To address these gaps, the Ministry of Health (MOH) in collaboration with the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC- PSM) project in Ethiopia, and with support from the US President’s Malaria Initiative (PMI) has designed and implemented an innovative system, Auditable Pharmaceutical Transaction and Services (APTS). APTS is a data-driven package of interventions focused on five “result areas” that will improve access to medicines: efficient budget utilization, transparent and accountable transactions, effective workforce development and deployment, reliable information for decision making (on product, financial value, and dispensary service delivery) and improved customer satisfaction. To fully implement APTS, GHSC-PSM worked with MOH and partners from January 2017 to October 2020 to enact legislation; develop guides, training materials and recording tools; deploy pharmacy staff and accountants; renovate pharmacy premises; support stock transfer; and monitor implementation. Due to Ethiopia’s extraordinarily diverse topography and climatic conditions, epidemiology of diseases (such as malaria) varies by geographical region and months, adding a layer of nuance to APTS implementation. GHSC-PSM has supported 263 hospitals (238 general and 25 specialized) from FY17 to FY22 to implement APTS. By taking qualitative and quantitative information from over four years of implementation, GHSC-PSM evaluated the impact of APTS.

Ayalew Adinew¹, Habtamu Tesfaye¹, Fikreslassie Alemu¹, Elias Geremew¹, Mahlet T Gabre¹, Edmealem Ejigu¹, Tesfaye Seifu1, Mahdi Abdella², Tigist Abebe²

¹USAID GHSC-PSM project in Ethiopia, 2Ministry of Health Ethiopia