Abstract

PSS Insight v2.0 – a framework and indicators for measuring pharmaceutical systems strengthening

Maura Soucy Brown, MPH¹, Tamara Hafner¹, Lauren Herzog¹, Jebun Rahman¹, MHM Mahmudul Hassan¹, S.M. Abu Zahid¹, Birna Trapp¹, Samrat Balal¹, Edgar Lusaya¹, Reuben Kiggundu¹, Marion Murungi¹, Dr. Morries Seru² (1)Management Sciences for Health, (2)Ministry of Health, Uganda

APHA 2022 Annual Meeting and Expo

Context
Sustainable access to and appropriate use of safe, effective, quality-assured, and affordable essential medicines and pharmaceutical services are critical to health system strengthening efforts and improved health outcomes. Without a standardized approach for measuring pharmaceutical systems it will be difficult for low- and middle- income countries to set strategic priorities to guide their pharmaceutical system strengthening (PSS) efforts. PSS Insight is an indicator-based measurement tool that combines 38 indicators to provide a holistic view of system performance and progress in PSS. Seven critical system components for measuring PSS comprise the tool: pharmaceutical products and related services; policy, laws, and governance; regulatory systems; innovation, research and development, manufacturing, and trade; financing; human resources; and information. Performance and resilience are key system attributes, and access and use are the primary system outcomes.

Methods
The USAID-funded Medicines, Technologies, and Pharmaceutical Services program piloted PSS Insight v2.0 in Bangladesh, Nepal, Tanzania, and Uganda to test the feasibility of deploying the tool at the central level and determine the relevance of the indicators to national PSS priorities and information needs. The pilot consisted of desk review of publicly available information, key informant interviews, and a series of validation workshops.

Results
Public availability of indicator data varied by country and PSS component. Indicators pertaining to access, use, and affordability of pharmaceutical products and services pose the greatest challenges to data collection due to resource constraints, complexities in data collection processes, and patient confidentiality. In many cases, these data were available as a result of single-implementation studies that were funded externally and not incorporated into routine national data capture systems.

Conclusion and Discussion
Changing priorities both at national and global levels have shifted emphasis on the importance of certain indicators since v2.0 was conceived. Commodity security, domestic manufacturing, pharmacovigilance, and patient-centered care have all emerged as priorities for PSS as countries move toward Universal Health Coverage. PSS Insight v2.0 is a powerful tool to prioritize and streamline data collection efforts to demonstrate how a holistic view of pharmaceutical systems over time can support informed decision making and investment in PSS.