Where There Are No Pharmacists
Pharmacists are an essential component of a successful drug management system. What happens when there are no pharmacists? Scarce resources and lack of trained personnel caused staff shortages in health facilities throughout South Africa. Rietvlei Hospital was one of those places. Nozodwa Jonginamba, pharmacist assistant and supervisor of the pharmacy store room at Rietvlei, recalls how difficult circumstances were prior to help coming form USAID and the South African Department of Health: “Staff used to order everything. No stock taking took place and there was little, if any, stock control. We had many expired drugs on the shelves.” Patients had to wait interminably as staff searched for medicines; drugs were ordered and packed onto shelves with no categorization. Many drugs—often essential—were overlooked and not ordered at all. Lack of systems and training placed patients’ lives at risk.
USAID spends one-third of its budget helping to remedy South Africa’s basic health program. The project is called “EQUITY” because it aims to balance health care for all South Africans by reversing the systematic segregation by race that apartheid had entrenched.
The EQUITY approach improves drug supply management in several ways: pharmacist assistant training (now accredited by South Africa’s Pharmacy Council), recruiting district and community pharmacists, automating inventory management, helping establish and train drug coordinators to manage and supervise drug supply, and reinforcing inventory management and prescribing patterns at clinics. As a result, staff now routinely order from an official Essential Drug List (EDL) and the use of resources has improved substantially, including prescription levels and prices.
Rietvlei Pharmacy personnel have already noticed a difference: expired drugs no longer appear on the shelves and regular stock counts are helping ensure that medicines and supplies are not over-ordered. Nozodwa grins as she switches on her computer to demonstrate the recently installed RX Store program. This inventory management program is a welcome addition to the pharmacy storeroom. Nozodwa swiftly shows how the program works as she generates requisition sheets for ordering in a short space of time, followed by lists of stock specific to the facility. Additional drugs can be added or deleted as requirements change. This careful tracking of drugs is important for Nozodwa: “The nurse-in-charge will know how to control medicines because she can see the expenses using the [RX Store] program.” USAID’s support for the Drug Management Program enables wards to see if items are out of stock using the computer. Wards can also receive printouts pertaining to their individual expenditure and ascertain how much they are spending. The new inventory system, coupled with training and reinforcement of key practices, is going a long way to improving drug management in Rietvlei Hospital and around the country.
