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Progress made but still a lot more to do–understanding the nuances and final hurdles of Decentralized Drug Distribution (DDD) - Shared screen with speaker view
Sarah Dixon (she/her)
11:32
Welcome and thank you for joining us. Please let us know your name and where you are joining us from.
Pauline Kibe
12:00
Pauline Kibe, Solthis Sierra Leone
Michael Odo
12:01
Michael Odo.....Monrovia- Liberia
Precious Andifasi
12:30
Precious Andifasi, MOH Zimbabwe
catherine michel
12:57
Cathy Michel EpiC MZ
MAHOUDO Bonou
13:06
Jules Bonou, EGPAF, Mozambique
MAHOUDO Bonou
13:22
Jules Bonou, EGPAF, Mozambique
Alexandre Nguimfack
13:24
Alexandre Nguimfack,CDC Mozambique
Joseph Ng'weshemi
13:51
Joseph L Ng'weshemi, EpiC Tanzania
Annamore Mutisi
13:53
Annamore Mutisi, FHI360 Zimbabwe
Harriet Blest
14:41
Harriet Blest, FHI 360, London
Chel Sarim
14:59
Chel Sarim from Cambodia, FHI 360.
Jean Claude Nkezabahizi
15:09
Jean Claude Nkezabahizi, Program Officer, FHI 360, Burundi
Moses Bateganya
15:55
Moses Bateganya, EpiC/FHI 360
Willibrord Shasha
16:15
Willibrord Shasha, USAID Cote d'Ivoire
Andrew Maranga
16:23
Andrew Maranga, EpiC/DDD Mozambique
Dercio Filimão
16:28
Dercio Filimao, USAID, Mozambique
lathe- assoumou jeannine
17:37
Hi all, Jeannine Lathe, EpiC/DDD, CDI
Felix Nwajiani
19:31
Felix Nwajiani, Chemonics SharpTo1
Khan Kankomba
25:39
Khan kankomba, Epic/DDD DRC
Thomas Minior
30:18
I find these statistics fascinating - particularly that Saturday availability of private sector pharmacies... For those attending, please feel free to put any questions you may have in the chat.
Denise Harrison
33:42
Can we get a copy of the slides?
Diah Nyanplu
34:17
I following from Liberia (National AIDS & STI Control Program)
Nidze Guilovica
34:26
Interesting to hear that clients still prefer facility based models. Do you think that it is related to community stigma or perhaps to the need of payment in some of the community models?
Lirica Nishimoto
35:50
Hi Denise, yes, we will be sending out the slides after the webinar to all attendees!
Thomas Minior
36:28
Others are better placed to answer that, Nidze, though interestingly in Uganda, there were some clients I met who LIKED coming to the facilities because of the social element...(they got to meet and talk with other recipients of care). It surprised me a little at first, but highlights that our clients have different needs - there probably will be no 'one size fits all' approach.
Nicholas Kisyeri
40:26
Clients prefer facility based: Some of the reasons are that many facilities can be reached easily, some people fear stigma, lack of other essential chronic medicines, lack of lab services. Also the fact that DDD is mainly on dispensing not clinical care
Bona Chitah
01:21:46
To Tom, is this cross country experience being documented as part of a critical, systematic assessment of the process vis-à-vis DDD/DSD as a sub-system within the health system....This may be necessary to begin to transform it from a "model" (ad-hoc or standalone) to a system.....
Bona Chitah
01:22:09
Tom that was Bona
Bona Chitah
01:22:30
In reference to the immediate question above of course
Thomas Minior
01:25:31
Hi Bona - Good question. The organizers from EPIC may be best placed to answer, but I don't know if we've systematically analyzed and written everything up, probably because different countries are in different phases of implementation.
Nidze Guilovica
01:27:05
Thanks for the presentation. I would like to confirm if the e pharmacies were also dispensing other chronic diseases medications
Nidze Guilovica
01:28:10
what about the CSO offices? Are they also dispensing other drugs such as INH for TPT or just ARVs ?
Samretta Caldwell
01:30:06
Currently in Liberia, all outlets are only dispensing ARVs. As we have just started, we want to see the outcomes of ARVs dispensing and impact on retention and adherence before moving to integrating other commodities such as TOT.
Michael Odo
01:32:01
Slow enrolments has been noticed in the Estwatini, Malawi and Liberia presentation- contrary to appetite observed in most pre-implementation assessment. This is not unexpected, and is mainly behavioral; established ``comfort`` within the discomfort of repeated clinic visits despite absence of ill health, and very commonly the fear of potential breaches in confidentiality. Moving forward, the beauty and objective of DDD needs to be moved beyond the confine sof the ART clinics- as Malawi seems to be doing.
Michael Odo
01:34:40
Putting the MOH in the active lead is key to sustainability. The Liberia model ensures the hub Pharmacist maintains the case holding at the peripheral PUP points, and is supported for random stock cross check for quality assurance.
Moses Bateganya
01:37:44
Hi Michael good comments. One of the points to consider is also that many patients are on MMD so changing where they get their next refill has to take into account the fact that appoints will be 3 or 6 months ahead. So in most countries people accept but wait until their next refill 3 or 6 months later
Samretta Caldwell
01:41:33
I strongly agree the "marketing to clients and care givers". This is key to getting through the challenges of fears from both the clients and the clinicians. In Liberia, advocacy and awareness for clinicians to alleviate their fears of losing their clients and losing the drug supplies was key to the devolvement process.
Sarah Dixon (she/her)
01:42:32
To register for the next session, click here: https://bit.ly/2UKYsA9
Samretta Caldwell
01:43:06
A key lesson is that demonstrating to and engaging with stakeholders from the onset is essential to ensure buyin.