USAID in Africa>Success Stories: Where there are no Pharmacists

Nozodwa Jonginamba, pharmacist assistant and supervisor of the pharmacy store room at Rietvlei Hospital in South Africa, recalls how difficult circumstances were prior to help coming from USAID and the South African Department of Health. "Staff used to order everything. No stocktaking took place and there was little, if any, stock control. We had many expired drugs on the shelves."

The absence of systems to track drugs and medicines and lack of training on the use of drugs places patients' lives at risk. When there are no systems in place, patients have to wait interminably as staff search for medicines. Drugs are ordered and packed onto shelves with no categorization. Many drugs, often essential drugs, are overlooked and not ordered at all.

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: training pharmacist assistants (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 and resource use 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. Jonginamba happily shows what she has learned to manage drug stocks, how to order drugs when needed. Additional drugs can be added or deleted as requirements change. Careful tracking of drugs is important for Jonginamba. "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. Wards can also receive printouts of individual expenditures to determine 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.