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03/10/2005
Findings on "Back Office" Services Reported in the British Medical Journal
Paris France (3rd October 2005) - An article published today in the British Medical Journal highlights the need for more attention to broad-based and balanced strengthening of health care facilities in Africa. The importance of coordinated investment in the often disregarded "back office" services, such as management capacity, financial and supply management, procurement and distribution, hygiene and waste management, is essential to improving the quality of treatment and care. This is particularly critical as African governments and the international community have mobilized unprecedented resources to provide treatment and care to patients with HIV/AIDS and other chronic diseases.
"For development in health care, there must be cohesive and well-performing back office services at the health facility," said Dr. Lola Dare, author of the article. "The delivery of quality treatment and care requires improved collaboration between the functions of management, human resources, finance, procurement and distribution, and government and partners. The strengthening and integration of such functions must be promoted."
The difficulty of providing access to drugs in developing countries such as anti-retrovirals for treatment of HIV/AIDS, is highlighting the large impact that back office services have on the provision of treatment and care. The inability of institutions to organize centralized procurement and to report consumption and forecasting is a significant barrier to drug resupply, restricting the continuous availability of ARVs and other drugs such as those for treatment of opportunistic infections. With strengthened institutional capacity in this area, it is possible to increase the number of people who have access to the drugs necessary for their treatment and survival.
"The international community has mobilized billions of dollars to provide anti-retroviral treatments for people with HIV/AIDS. Most countries now have money and drugs, but less than 5 percent of patients in need of ARVs in Africa have access to them," said Anne Reeler, Chief Operating Officer of Axios and co-author of the article. "The major obstacle now is the insufficient capability of health care institutions to provide quality care and drugs to the patients. Through the Axios Institutional Network in 81 countries, our experience shows that current institutional capacity in Africa can only serve up to 10 percent of patients in need of HIV care and treatment."
One of the programs described as demonstrating the successful implementation of high-performing back office services and state-of-the-art infrastructure is the rehabilitation of Muhimbili National Hospital, currently being undertaken by a partnership between the Government of Tanzania and the Abbott Fund, implemented by Axios. Key areas of intervention address hospital and patient management, human resources and staff training, renovating and equipping the central pathology laboratory, a newly built three-story outpatient department, financial sustainability and information technology. These activities serve to strengthen the ability of Muhimbili Hospital to provide high quality care to patients, to set the standard for other hospitals in Tanzania, and to serve as a national referral hospital. As more international funding becomes available, it is hoped that Muhimbili Hospital will provide a regional model for informing other efforts where adequate back office services are not in place
Another innovative program focusing on health system development in the context of the back office is being implemented in Ondo State, Nigeria. The initiative presents a bold approach that balances financial options to invest in human resources as a central basis to achieving improvements in health system performance, resulting in the identification of modifications required to improve efficiency, effectiveness and cost-effectiveness of the health services in the state. Partnerships are formed with key stakeholders, the state, community, private sector and development agencies, using evidence-based research to inform official policy.
Highlighted in the article are issues relating to efficient procurement and distribution systems, as health facilities frequently fail to obtain value for money for their investments and there are often undefined supply chain processes. A lack of internal information and feedback systems leads to inadequate drug forecasting and uninformed decision-making. Financial management remains difficult and fragmented, requiring the central administration of resources to ensure long term sustainable funding. Improved policy-making and leadership development protects public interest by making social services accessible to the population and by establishing the best and fairest health system possible.
Media Contact
Lisa Menning, Communications and Advocacy Manager
Contact: lisa.menning@axiosint.com or +33 1 44 860 760 (Paris, France)