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    Drug delivery systems for primary health care in Latin America.

    Perez CE; Fefer E; Pena J; Katatsky M; Ortiz J; Marchan E

    Bulletin of the Pan American Health Organization. 1983; 17(2):201-3.

    A field study to ascertain the status of drug delivery systems for primary health care centers in Latin America was conducted by the Pan American Health Organization (PAHO) in 1980-81. Countries studied included Bolivia, Ecuador, Peru, Honduras, Panama, and the Dominican Republic. The planning and purchasing functions of the drug distribution systems were found to be highly centralized, failing to take local morbidity patterns or drug demand levels into account. Storage areas lacked adequate equipment and were poorly designed. Personnel were insufficiently trained and were found to ignore procedures regarding the handling of damaged or expired drugs. Also noted was a lack of adequate equipment for transporting medicines to rural clinics. A widespread characteristic was the lack of formal supervision and control (excluding fiscal) at national, regional, and local levels. Many essential drugs were unavailable at the local level, and formulations with unjustified associations and products for which there are more advantagous substitutes were found. These results were presented at the PAHO-sponsored Regional Workshop on Administration and Supply of Essential Drugs held in 1981. The workshop made 5 recommendations to governments: 1) every national health plan should include a national drug policy; 2) the drug policy should encompass a registry of all drugs sold, a list of essential drugs by level of care, quality control measures, educational activities for personnel, proper financing, and an evaluation methodology; 3) an integrated system for managing drug distribution should be designed; 4) information on essential drugs, legislation, pricing, and quality control should be exchanged among regions; and 5) centers should participate in the WHO-developed quality certification system. In addition, it was recommended that PAHO should: 1) participate in developing a system of regional cooperation, 2) identify regional centers for training personnel in the management of drug distribution systems, 3) stimulate development of training programs, and 4) support operational research on drug distribution systems.
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