This DCD programme demonstrates how the private sector can work with government on a public service initiative that results in securing and improving the health and well-being of recipients of care. It is a demonstrable, measurable contribution that the private sector can make and shows another way it can have a positive social impact besides being a provider of traditional retail services.
The private sector often finds it difficult to demonstrate how it can have a positive long-term impact on the well-being of the communities or societies it serves, beyond providing ‘paid-for’ goods and services and certainly beyond traditional social corporate responsibility initiatives.
In most societies, the private sector is the driver of development, innovation, job creation and wealth for citizens. The private sector does this in partnership with the government, facilitating these realities and creating a conducive environment for success. In fact, the private sector and government are looking for a ‘healthy, wealthy and productive’ society. This aspiration is expressed in many government manifestos across Africa, and many development agencies are aligned with it too.
The Africa Resource Centre (ARC) is currently supporting Uganda’s Ministry of Health in setting up differentiated delivery channels that patients can use to access their regular medicines. This initiative involves the private sector in the form of retail pharmacies that are medicine collection points for patients referred from the public health sector. This partnership provides a good example of how the private sector can work with government to create a service and contribute to public healthcare.
In Uganda, the Ministry of Health’s AIDS Control Programme (ACP) has been the driving force for setting up different models of providing clinical and treatment services to patients at health facilities and in communities. Several patient-centred care and treatment models are applied at the health facility level to enable stable patients on long-term treatment to be served rapidly without creating a management burden on the facility. Significantly, this also reduces the inconvenience and cost burden for the patient collecting their monthly treatment. In addition, these solutions aim to decrease congestion that accompanies diagnostic, care and treatment programmes at health facilities and which results in the images we often see at our public health facilities of large queues, over-burdened healthcare workers and unhappy patients.
Reaching communities
The ACP has led the development of differentiated service delivery models, where clinical care and treatment programmes are extended into the community. The ACP added differentiated channel distribution (DCD) solutions to these models to provide medicines to stable patients who do not need to collect their medication at health facilities. As outlined above, the idea of a DCD is to decongest a health facility and provide convenience to the many stable patients that do not need to travel to a health facility to collect their treatments.
To further address the issue of convenience, reduce congestion at health facilities, and enable recipients of care to lead as normal lives as possible, the ACP has worked with stakeholders to set up a DCD that applies to retail pharmacies. In this DCD model, the medicines prescribed to a stable patient on long-term treatment can be collected from a partner retail pharmacy that works closely with the health facility managing that patient. This service, covered under a patient management agreement between the government health facility and the retail pharmacy, allows patients to routinely collect their medicines from their selected retail pharmacy, without paying for that service. At this early stage, the service from the retail pharmacy is paid for by development partners supporting the Ministry of Health.
This DCD initiative working through retail pharmacies in Uganda is a major achievement by a government. Uganda’s Ministry of Health has put in place a secure, organised and managed transfer of public health medicines to retail pharmacies, which secures those medicines only for named patients referred from their respective district health facility. In this process, the retail pharmacy works closely with the health facility and can report to that health facility using ICT tools developed locally for the service. This system provides transparency and visibility in the supply chain and takes care of record keeping and communication between the retail pharmacy and the health facility.
In ARC’s view, this DCD programme demonstrates how the private sector can work with government on a public service initiative that results in securing and improving the health and well-being of recipients of care. It is a demonstrable, measurable contribution that the private sector can make and shows another way it can have a positive social impact besides being a provider of traditional retail services. A recipient of care empowered to remain on treatment through this initiative is a healthier citizen who can have a normal work/life balance and contribute to society.
