Mobilization of Resources for Improving the Storage and Transport of Medicines and Medical Supplies in the Dominican Republic

This initiative was launched in 2010, following a baseline assessment that revealed a shortage of critical medicines and medical supplies, as well as losses caused by expired products, due to poor scheduling, a fragmented procurement system, and inadequate storage and transport conditions. The SUGEMI system was designed to provide a comprehensive approach for addressing problems common to all MSP programs, including the National Tuberculosis Control Program and the national HIV and AIDS care program. The system aims to ensure the uninterrupted supply of medicines and medical commodities of guaranteed quality, and to improve storage practices and conditions, infrastructure, and equipment for product handling. A technical team conducted an assessment of the state of regional warehouses in 2010 and 2011, using as points of reference MSP outfitting standards, good storage practices (GSPs) as recommended by the World Health Organization, and the technical construction standards in effect in the Dominican Republic. The assessment revealed that despite the existence of motivated human resources and regional initiatives for improving conditions for the storage of medicines and medical supplies, these conditions continue to reflect deficiencies, including poor infrastructure and equipment, lack of a national standard for GSPs, lack of training, absence of systematized procedures, and lack of appropriate equipment for handling medicines and supplies. The assessment also revealed that more than half of the GSP criteria evaluated were not being observed in any of the warehouses, and that the balance of these criteria were most frequently in "major noncompliance." Based on these findings, a proposal was developed to improve practices involving warehouse storage, infrastructure, and outfitting, including improving infrastructure, equipment, and equipment for product handling, drafting a GSP manual, drafting a manual of operating procedures for proper storage, training in GSP for pharmaceutical staff, agreeing on and developing a work plan for implementing GSPs, and scheduling quarterly supervisory activities to assess progress. In addition to the assessment of regional warehouses, an assessment was also made of the state of medicine and medical supply transport within the MSP's Health Network in 2011. The assessment revealed that the state of transportation resources varies considerably among the nine SRSs, and that the number of units is insufficient to properly satisfy the needs of the Primary Care Centers and those CEASs that operate Special Programs. At the time of the study, the nine SRSs had a combined transport fleet consisting of a total of eight units, with six of these units requiring repairs and improvements to achieve a standard of operation that meets best practices for the distribution of medicines and medical supplies.