Page 22 - UNAM Virtual Graduation e-Book (April2021)

FACULTY OF HEALTH SCIENCES
SCHOOL OF PUBLIC HEALTH

DOCTOR OF PHILOSOPHY IN PUBLIC HEALTH

CANDIDATE: KAGOYA Harriet R

CURRICULUM VITAE

Harriet Rachel Kagoya was born in Uganda. Her qualifications include
Bachelor of Science with Education (Hons), Master of Business Administration
(MBA), and Master of Public Health (MPH), all three from Makerere University,
Kampala, Uganda. Her professional career includes working as a public
health and system strengthening specialist in the positions of Consultant, Senior Monitoring and Evaluation (M&E)
Advisor, M&E Manager, M&E National Coordinator, M&E Specialist, Project Manager, Programme Coordinator,
Community Development Facilitator, gender specialist and secondary school teacher in Uganda, Namibia
and Tanzania. She has indispensable expertise in public health; health system strengthening; programmes’
design, management, implementation, monitoring, evaluation and research; M&E quality assurance; reporting,
documentation, dissemination and rational end-use of information; and capacity building.

CANDIDATE’S DISSERTATION

OPTIMIZING THE QUALITY AND UTILITY OF INDICATORS FOR PHARMACEUTICAL MANAGEMENT IN PUBLIC
HEALTHCARE IN NAMIBIA

The doctoral study was undertaken and completed under the supervision of Professor Honoré Kabwebwe
Mitonga (University of Namibia) as Main-Supervisor and Professor Timothy William Rennie (University of Namibia)
as Co-Supervisor.

Pharmaceutical management information systems (PMIS) are a pillar of global healthcare systems for monitoring
pharmaceutical services and commodities. The World Health Organisation (WHO) has promoted health systems
strengthening such as through implementation of Standard Treatment Guidelines (STGs) and PMIS to promote
access to medicines, their management and appropriate use. Despite the initiatives, the WHO still estimates
that globally, 50% of essential medicines are prescribed, dispensed and used inappropriately. This contributes
to the global threat of antimicrobial resistance, suboptimal outcomes and high cost of healthcare. Namibia
implemented PMIS from 2007 and first comprehensive STGs from 2011.

The study assessed quality of data in Namibia’s PMIS database using population-level analysis; modelled
impact of STGs on three medicines use indicators through longitudinal population-based interrupted time-series
modeling; determined alignment of Namibia’s STGs with WHO medicines use indicators using descriptive policy
analysis; and determined extent and predictors of utility of PMIS data using mixed methods. The study found
that data quality of PMIS in Namibia’s public healthcare is suboptimal and widely varies by reporting period,
level of health facility and region. Namibia’s STGs did not improve medicine use indicators over time. The STGs
have high indication of antibiotics and a number of medicines indicated per disease/condition commonly
managed at primary healthcare level. Use of PMIS data in public healthcare needs augmentation. A model was
developed. It describes concepts to access, management, dissemination and utility of PMIS data to improve
pharmaceutical management in healthcare. The model integrates a real-time automated pharmaceutical
intelligence system to collect, consolidate and monitor data. Guidelines for operationalising the model are
included to guide managers to implement proposed activities among healthcare professionals. While quality
and utility of PMIS data in Namibia needs enhancement, implementation of the proposed model with the
guidelines is promising, towards building resilient pharmaceutical intelligence systems at grass-root levels, not
only in Namibia but globally as many countries battle with weak health systems, high disease burden and limited
resources.

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