Management of Pharmaceutical Information in Vertical Program
Session 12:Management of Pharmaceutical Information in
Vertical Program
Learning Tasks
By the end of this session, students are expected to be able to:
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Introduction
Health services (curative and preventive) can be provided using two modes of delivery:
o horizontal and vertical programmes.
By horizontal delivery, services are delivered through public financed health systems
and are commonly referred as comprehensive primary care (WHO 1978).
Vertical delivery of health services implies a selective targeting of specific interventions
not fully integrated in health systems
o This focus on one particular disease or group of diseases e.g. HIV or TB.
Horizontal programs are the oldest of the two modes of delivery – they were derived
from Primary Health Care (PHC), originated as part of the WHO/UNICEF declaration
in Alma Ata in 1978 (WHO 1978).
In the 80s, the concepts behind the design of PHC systems in most countries focused on
the health crisis that a country faced at a particular time.
With emergence of communicable diseases such as drug-resistant Tuberculosis (TB),
Ebola, drug-resistant Malaria, HIV/AIDS, challenges facing most health systems in
developing countries have been paramount.
Selectivity and prioritization of interventions, particularly in resource limited settings
are important issues for consideration for health planners.
As most of the diseases are global public goods, selectivity is done at the country and
global levels – with the latter increasingly packaged in international initiatives with
specific goals – such as “Health for All by 2000”, and “Millennium Development
Goals”.
Country-specific health crises were prioritized in PHC systems, but cost and efficiency
in delivering health services drove the nature of the PHC design (WHO 1978).
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Efficiency and effectiveness of delivering health services are important contributors to
the attainment of international health goals at all levels.
In most settings, this implies the ability 3 to identify and to reach poor people. In
addition, this requires a multi-sectoral approach in delivering health services.
At the launch of the World Health Organization initiative of ‘Health for All by 2000’, the
strategy to attain the set goals was a comprehensive primary health care based on a
horizontal mode of delivery of abasic services (WHO 1978).
A few years of implementation of the initiative proved to be too difficult to attain the set
goals (Banerji, 1984).
Failure to control malaria in India during the early 80s is one example. This recognition
led to a change in the strategy of delivery of services from horizontal to vertical
programs.
In short Horizontal Programme is the Programme thus designed to deal with more than one
disease. It can be program for eradicating a couple of Disease as Millenium Targets as (Long
Term Plan)
Example
o A horizontal program might focus on all tropical diseases, or in fact all diseases.
o A horizontal approach might consist of equipping a clinic to treat every kind of disease
and health problem in the region.
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Vertical programme
leave and go on up to the level where planners, evaluators and decision makers making
decision of a particular case.
houses where the people live, educating people about how to avoid malaria, establishing
clinics where malaria can be diagnosed and treated, and finally, finding medications to cure
the disease, and so on.
the level where the doctors and scientists try to develop new cures.
The Vertical Programmes Existing in the Country
Tanzania vertical health programmes:
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The Importance of Pharmaceutical Information Management in Vertical Programmes
o The integration strengthened Vertical Programs services likewise lowered the
operations costs of programs and resulted into increase the availability of VP
Medicines, Medical Supplies and Laboratory Reagents to the health facilities.
o A good PMIS provides the necessary information to make sound decisions in the
pharmaceutical sector.
o Effective pharmaceutical management requires policymakers, program managers, and
health care providers to monitor information related to patient adherence, drug
resistance, availability of medicines and laboratory supplies, patient safety, post-market
intelligence, product registration, product quality, financing and program management,
among other issues.
o Coordinating the elements of a pharmaceutical supply system requires
relevant, accurate, and timely information.
o Increased funding for HIV/AIDS, tuberculosis, and immunization programs has
contributed to the need for accurate and timely information on a variety of parameters
that affect the ability to conduct accurate quantification, procurement planning,
budgeting, resource mobilization and program management.
The perceived advantage of a vertical programme are:
o strong central technical and financial control.
o Better ability to monitor restricted output
o Operational planning is focused & easy to deliver
o Efficient & effective delivery
o the ability to respond to changing circumstances and the identification of new
strategies.
o focused objectives, achievable in a limited time-frame; and the appeal to external
donors.
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Enlist The integration functions of MSD to Vertical Prrogramming
o Coordination of procurement, Storage and Distribution of program medicines, Medical
Supplies and Laboratory Reagents.
o Managing receipts of all Medicines, Medical Supplies and Laboratory Reagents
supplied by different programs and development Partners (Global Fund, UNICEF,
World Health Organization and USAID).
o Give timely report to the programs on stock status to programs and development
Evaluation Questions
o A vertical programme is a programme which targets one particular disease.
o A vertical program might focus on malaria from the bottom where members of
community leave and go on up to the level where planners, evaluators and decision
makers making decision of a particular case.
Tanzania vertical health programmes:
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