Health Policy Issues and Health Programmes in ... - Amazon S3

Streamlining the Drug Procurement and Supply System in Uttaranchalcost-effectiveness of health care through economic and efficient drug use. Strategies toimprove the rational use of drugs can be characterized as educational, managerial, andregulatory. Educational strategies cover training of prescribers through formal andcontinuing education, seminars, and workshops. In addition, they could be supplied withprinted material such as newsletters, treatment guidelines, drug formulations, and so forth.Professional associations could be approached for this purpose. The managerial strategiesinclude selection, procurement, and distribution of drugs; cost information; review of drugutilization patterns; and formation of drug and therapeutic committees in hospitals.Regulatory approaches include drug registration, prescribing restrictions, dispensingrestrictions, and so forth.4. Constitution of a Drug Procurement Agency There should be a state-level procurementcommittee to support and advise the total procurement system at all levels in the publichealth department. Various functions and responsibilities could be further delegated byconstituting different committees to look after specific activities. A list of suggestedcommittees is as follows.l Drug and Therapeutic Committee: consists of experts, users, pharmacists, and clericalsupport for selection of drugs, determination of quantities, and formular managementl Specifications Committee: consists of concerned experts and administrators to set downclear, unambiguous specifications for each productl Tender Committee: consists of administrators, pharmacists, and the finance and auditdepartment for preselection of suppliers and adjudication of tendersl Procurement and Distribution Committee: consists of administrators and pharmacists forpooled procurement and distributionl Finance Committee: consists of senior administrators and the finance and auditdepartment to facilitate payments in timel Quality Assurance Committee: consists of pharmacists, clinical pharmacology/pharmacology and user departments for ensuring quality of products at all steps of theprocurement cycle.5. Procurement Office Staffing and Management There is need for adequate staff that is welltrained, highly motivated, and capable of making the procurement system effective. Oftenpeople are transferred as they become competent and a new cycle of training begins.Salaries of the staff are too low to support an individual with a family, leading to amplescope for corruption and negligence in duties. The procurement office should beindependent and autonomous as in the state of Tamil Nadu. The agency should havepermanent office and secretarial staff to manage and monitor the procurement process.There should also be a procurement manual. A reliable management information system isan essential step. Market intelligence and communication are an integral part ofprocurement management. A reliable payment mechanism and financial support areequally important.6. Development of a Logistics and Supply System Some of the states, such as Assam andRajasthan, have central warehouses along with district-level warehouses promoted undervarious area development projects. Serious consideration needs to be given toappropriateness, design, and utilization of these warehouses. This should be in consonance221