In Uganda, the use of alternative drug distribution models has been identified as a key way to help the 1.3 million people living with HIV access their chronic medication more easily, increase antiretroviral therapy (ART) adherence, and decongest health facilities.
The Ministry of Health’s (MoH) AIDS Control Programme (ACP) has been working with its partners for the past several years to develop and implement alternative drug distribution models that will achieve these outcomes.
In 2018, the ACP approached the Africa Resource Centre (ARC) to explore possible alternative drug distribution models that would be suitable for the Ugandan context.
After an intensive feasibility process, ARC developed and proposed two differentiated channel delivery models – one for rural recipients of care and the other for urban recipients of care.
Pilots of both the urban community retail pharmacy drug distribution (CRPDDP) model and the rural community led drug distribution point (CLDDP) were then initiated.
The initial phase of the CRPDDP pilot was so well received that it was extended to run until the end of September 2022. During this time, the project was scaled to include over 27 000 recipients of care. There was consistent growth in enrolment over the course of the pilot. Additionally, 85% of the targeted number of pharmacies and 92% of the targeted number of facilities were connected to and reporting through the digital platforms created for the initiative.
Preparation is also underway for the CLDDP pilot. ARC worked with the ACP to develop guidelines, identify areas of implementation and train stakeholders. The Department of Community Health has been brought into leadership of the model development and strategy to support its roll out.
Outcomes and impact
ARC’s support to ministries of health focuses on strengthening six supply chain elements. The rollout phase of work on alternative drug distribution models in Uganda strengthens five of these six areas: strategy, improvement roadmap, governance, policies and research and solutions proposals.
Patient-centric distribution strategies
Key element: strategy and policies and research
For both CRPDDP and CLDDP, ARC is working with the MoH to adapt, strengthen and scale up the alternative drug distribution models in order to increase the availability of medicines to chronic patients in Uganda.
IMPACT: ARC has formed a research team and is guiding the research project to incorporate questions about CRPDDP service outcomes and scale.
Overseeing planning and execution for scaling up
Key element: governance
ARC is supporting the MoH and its implementing partners in the effective rolling out of the CRPDDP pilot. This includes:
- monitoring and reporting on implementation progress through dashboards,
- supporting the use of the digital tools developed for the pilot, and
- supporting supervision trips and reporting to identify gaps and best practices in the pilot locations.
IMPACT: This oversight work supports the development of an implementation plan and guidelines for scaling up CRPDDP to the national level.
Assessing outsourcing potential for commodity distribution
Key elements: improvement roadmap and solutions proposals
The team in Uganda has been using ARC’s Outsourcing Toolkit to assess the potential for outsourcing at the Joint Medical Stores (JMS). JMS is the main distributor for private-not-for-profit facilities in Uganda.
IMPACT: A data sharing agreement has been forwarded to JMS for review and signing.