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Problem Area4 FDC registration neededFDCs not on on EDLSTGs need to be updated

Benin, Congo Brazzaville, DRC, Nigeria, and Uganda ... Selection committee needed: NTP manager, NDA, clinical specialist (TB physician, nurse, pharmacist) (Uganda) ...

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Problem Area4 FDC registration neededFDCs not on on EDLSTGs need to be updated

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    Development of Country-Specific Plans for TB Drug Selection and Use Benin, Congo Brazzaville, DRC, Nigeria, and Uganda Selection

    2. Problem Area 4 FDC registration needed FDCs not on on EDL STGs need to be updated

    Selected Activity Register drugs (Uganda, Nigeria, CB) Add to EDL (Nigeria, Uganda, DRC) Committee in place, currently in process (Nigeria). (CB, DRC)

    Selection, continued

    3. Problem Area Blister pack configuration and implementation Poor distribution of drugs to sub-county health workers

    Selected Activity Selection committee needed: NTP manager, NDA, clinical specialist (TB physician, nurse, pharmacist) (Uganda) Bicycles and small motorcycles needed to access remote areas

    Use

    4. Problem Area Default rate too high related to adherence to drug treatment

    Selected Activity Open more centers closer to patients (Nigeria, CB) Health workers training, education campaigns (CB) Research to understand the problem (Benin)

    Use, continued

    5. Problem Area Prescribers not following STGs

    Selected Activity Train health personnel (CB, Nigeria) Train medical students (Nigeria) Introduce new STGs to prescribers and monitor their use (DRC)

    Use, continued

    6. Problem Area Poor use in private sector Community capacity strengthening and team building needed

    Selected Activity Train prescriber in rational drug use, have patient go to public sector for drugs (meeting, training, registration) (DRC)

    Procurement: Quantification

    7. Problem Area NTP not involved in quantification Staff poorly trained in quantification Different groups ordering TB drugs

    Selected Activity Meet w/ DM committee (DRC) Train existing NTP staff at all levels (Nigeria, CB) Hold quantification meeting with all key government agencies (Nigeria, Uganda) Nigeria Existing NTP staff trained in quantification- funds needed Ensure quality and accuracy of data- train staff at all levels Have quantification meeting to know what is being brought into country the following yearNigeria Existing NTP staff trained in quantification- funds needed Ensure quality and accuracy of data- train staff at all levels Have quantification meeting to know what is being brought into country the following year

    Quantification, continued

    8. Problem Area Forms needed for participation Slow importation process Value of data uncertain

    Selected Activity Sensitizing and training TB personnel (Benin) Meeting with all branches of the government (Nigeria) Conduct study to compare consumption and morbidity data (Uganda, DRC) Nigeria Existing NTP staff trained in quantification- funds needed Ensure quality and accuracy of data- train staff at all levels Have quantification meeting to know what is being brought into country the following yearNigeria Existing NTP staff trained in quantification- funds needed Ensure quality and accuracy of data- train staff at all levels Have quantification meeting to know what is being brought into country the following year

    Procurement

    9. Problem Area No government funds for Procurement No line item in budget for TB drugs NTP lacks experience in TB drug procurement

    Selected Activity Advocacy at the highest level (MOH, President) (DRC, Nigeria, Benin) Establish pooled mechanisms (Uganda) Advocacy (CB, Benin) Secure funds and technical assistance to train staff (CB) Funds and technical assistance needed (CB) Nigeria Carry out meetings to simplify Nigeria Carry out meetings to simplify

    Distribution

    10. Problem Area Poor storage in drug warehouses Lack of storage space Poor distribution of drugs to peripheral areas No distribution system with community DOTS

    Selected Activity Upgrade facilities (e.g., add air conditioning) (Benin, CB, DRC) Currently building a new storage facility (DRC) Using advocacy, secure funds from the MOH to deliver drugs by air/train (CB, DRC, Benin, Nigeria) Secure bicycles and motorcycles (Uganda)

    Distribution, continued

    11. Problem Area No information on drugs in periphery No information on storage facilities

    Selected Activity Drug information management system (Uganda, DRC) Assessment (Nigeria)

    Management Support

    12. Problem Area Data from management systems not being used

    Selected Activity System rationalization and training

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