Figure F2
Accredited Drug Dispensing Outlet Program Outline Pharmacy Board (Leadership, licensing, quality assurance) Regional Authority (Leadership, technical supervision, problem solving, audit, inspection) District Authority (Leadership, monitoring, problem solving, reporting, inspection) Health care providers (Prescribing) Ward Committees (Leadership, reporting, problem solving) Owner (Attitude, investments, incentives)
Care
Seller (Attitude, competence)
takers
ADDO SHOP
Clients with illness
Other products & services
Drug + advice No drug + advice
Assess
Clients served
Plan Refer
Clinical symptoms Functional problems Expectations Costs
Decision to Access: Cutural belief re Rx system Distance Seriousness of Illness Wealth/cash Availability of drugs in public PHC Other Rx failure Shop "quality" Referral
Clinical outcomes Functional outcomes Satisfaction Costs
Promotion/Prevention
Drug supply
Training, retraining
Inspection, problem solving
Accreditation, promotion
CHF, NHIF
Source: CPM 2003, 74. Reproduced with permission from Management Sciences for Health. Note: CHF = Community Health Fund; NHIF = National Health Insurance Fund; PHC = primary health care.
MSH provided technical support and funding through SEAM and enlisted other partners, such as the Mennonite Economic Development Associates, for their specific expertise. (After the pilot project was completed in 2005, other donors, including USAID [U.S. Agency for International Development] and the Global Fund, also provided support, as described below.) With the assistance of SEAM, the Tanzanian Federal Drug Administration developed legally enforceable standards for the ADDOs, including the following: • Application and approvals procedures • Building location, design, and layout • Staffing, training, and continuing education • Sanitation and hygiene • Drug list • Drug quality Converting Basic Drug Shops to Accredited Drug Dispensing Outlets in Tanzania
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