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BOTSWANA
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Background
• Medicines are key to the success of any Health Care Strategy.
For this reason, the Botswana National Drug (Medicine) Policy
(BNDP) was established with the aim “to make medicines of
acceptable safety, efficacy and quality available and affordable to
all those who need them and to promote their rational use by
prescribers, dispensers and consumers”.
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Background… contd.
• The Ministry of Health and Wellness, through the BNDP,
encourages the key health personnel, both in public and private
sector, to participate in collaborative management of medicines
in their facilities so as to promote rational, efficient and cost-
effective use of medicines.
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Key Definition
• A collaborative management committee, generally referred to
as Drugs (Medicines) and Therapeutics Committee
(DTC).
• The DTC is a multi-disciplinary committee that advises the
medical staff, administration, pharmacy and other
departments in the health facility on matters relating to the
therapeutic use of medicines. 12/30/2017 4
..Definition contd..
• DTC is a forum to bring together all stakeholders involved in decisions
about medicine use. It may exist at any level within the health-care
system, i.e. at district level (overseeing primary health-care facilities, be
it in hospital or clinic) or at national level.
• This is a committee within a health facility which is responsible for the
evaluation of medicines, as well as ensuring proper management, use
and administration of all pharmaceuticals in that facility.
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..Definition contd..
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GOALS AND OBJECTIVES
Goals
• The aim of a DTC is to ensure that patients are provided with the best
possible cost-effective and quality care.
• In addition, the DTC has to oversee the safe, effective and economic use
of medicines within the facility.
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GOALS AND OBJECTIVES … contd.
Objectives
In order to achieve the above goals, the DTC has the following specific objectives:
• To ensure that only efficacious, safe, cost effective and good quality
medicines are used
• To ensure the best possible medicine safety through monitoring, evaluating and
thereby preventing adverse drug reactions (ADRs) and medication errors.
• To develop and implement interventions to improve medicine use by
prescribers, dispensers and patients.
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COMPOSITION / MEMBERSHIP OF A DTC
Referral hospitals
• Hospital Superintendent departments: Infection Control
• Pharmacist in charge Medicine Administration
• Nursing Officer in charge IDCC
• Pathologist Surgery
• Laboratory Officer in charge Paediatrics
• Radiologist or Radiographer Obstetrics and
Gynaecology
• Nursing Superintendent
Oncology
• Specialist / Medical Officer in
charge of the following Dentistry
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COMPOSITION / MEMBERSHIP OF A DTC
District Health Management Teams
• DTC promotes and monitors safe, cost effective and rational use of
medicines.
Standard Treatment guidelines/protocols are a proven way to
promote the rational use of medicines. The DTC is responsible for
monitoring and ensuring adherence to national treatment
guidelines/protocols and policies as a way to achieve the above
objective.
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PRIMARY FUNCTIONS OF A DTC… CONTD.
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PRIMARY FUNCTIONS OF A DTC… CONTD.
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PRIMARY FUNCTIONS OF A DTC… CONTD.
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PRIMARY FUNCTIONS OF A DTC… CONTD.
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PRIMARY FUNCTIONS OF A DTC… CONTD.
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BENEFITS OF AN ACTIVE AND
FUNCTIONING DTC
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BENEFITS OF AN ACTIVE AND FUNCTIONING DTC
contd…
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CHALLENGES TO HAVING FULLY
FUNCTIONAL FACILITY DTCs
Scarcity of Professionals
• Transfer of officers-Other facilities go down because some officers who have been active get transferred, resulting in the
slowdown of the committee.
• Active officers going on end of contract leaves and not coming back.
• Resignation of officers who have been active or ensuring the running of the committee.
• Officers not able to honour scheduled meetings due to other commitments or clashes.
-DTC members are generally Heads of Departments in most cases, who sit in other important committees, hence have
to postpone some of the scheduled meetings at times due to business or conflicting responsibilities.
• Shortage of staff- Some facilities do not have Pharmacists to mobilise the existence and functioning of the committee.
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CHALLENGES NOT TO HAVING FULLY FUNCTIONAL
FACILITY DTC…………… contd.
• Lack of Monitoring
-Due to shortage of staff in the monitoring unit at the Ministry (BEDAP), facilities have not been
closely monitored effectively in the past.
Role of pharmacy therefore very crucial in the functioning of a facility DTC.
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STRATEGIES PUT IN PLACE TO APPROACH,
ENCOURAGE AND MONITOR FACILITIES
Increase Monitoring
• Ensuring facilities submit schedule of meetings at the beginning of financial year.
• Submission of minutes for meetings held.
• Facility visits once a year. Priority given to those facilities with no DTCs.
Improved Communication
• Monthly email communication, followed by telephone, reminding facilities to submit minutes of
the meetings held.
• Feedback from minutes given to facilities.
Benchmarking
• For facilities not doing well, suggestions made to that facility to liaise with another that is active. 25
12/30/2017
CURRENT STATUS OF DTCs IN HEALTH FACILITIES
COUNTRYWIDE
BASELINE INFORMATION -AS AT END OF 1st Quarter 2016/2017
Number of Percentage (%)
facilities out of Out of 31
the total 31 facilities
Number of facilities with existing DTC 20 64.5%
Number of facilities with non-existing DTC 11 35.5 %
Number of facilities with existing, functional DTC 11 35.5%
Number of facilities with existing, non-functional 9 29 %
DTC
Number of facilities with up-to-date DTC 6 30% (subjective)
minutes(out of those with DTCs)
Number of facilities without DTC minutes (out of 14 70% (subjective)
those with DTCs)
Number of facilities with no response 0 0%
Total number of facilities 31 100% 26
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PROGRESS–AS AT END OF 4th QUARTER 2016/2017
COUNTRYWIDE Number of Percentage (%)
facilities out of out of 35
the total 35 facilities
QUESTIONS/COMMENTS
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