Study On Monitoring And Evaluation Indicators System Of National Essential Medicines System For Primary Health Care Institutions

ObjectivesTo analyze key problems in implementation processes ofnational essential medicines system. On the basis of this, the research intends to establish a indicator-based monitoring system of essential medicines system for primary health care institutions, which evaluates implementation processes and progress, and indentify problems of essential medicines system.Research contentThe research is consisted of three parts. The first part studies the implementation processes of essential medicines system in primary health care institutions. In the second part, we analyze key processes in implementing national essential medicines system, problems and their influencing factors. In part three, a monitoring and evaluation indicator system is developed on the basis of part two. Delphi and fuzzy comprehensive evaluation were used to scan and adjust indictors.MethodsLiterature review and expert interview were carried out to collect information on the processes, problems and their influencing factors in implementing essential medicine system in primary health care institutions.Delphi method is used to scan and adjust indicators and fuzzy comprehensive evaluation is used to weight indictors.Results(1) The key processes in implementing essential medicines system include the storage and use of essential medicines. The storage process was influenced by the absence of some essential medicines, low quantity, limited medicine storage situation and low willingness to distribute essential medicines. The use of essential medicines was influenced by the low usage rate of essential medicines and irrational use of medicines. A lack of effective surveillance, limited knowledge of rational use of medicines among prescribers and irrational requires of patients were accountable.(2)Three levels of indicators were designed initially on basis of the research on key process problems of implementing national essential medicines system in grass root health facilities. There are 3 level 1 indicators, 18 level two and 61 level three. After two round of Delphi expert consultancy, we indentified 3 level 1 indicator which include structure, process and outcome indicators,15 level two indicators which include essential medicines storage, use, government structures, structures of distribution companies, distribution of essential medicines, medicines use, financial situation of health facilities, medical fees, quantity of medical service, the accessibility of essential medicines, the affordability of essential medicines, the quality of essential medicines, rational use of medicines, satisfaction rate of patients and satisfaction rate of health staff. There are 42 level 3 indicators.(3)Fuzzy comprehensive evaluation method was used to identify the weight of each indicator. The weight of the three level 1 indicators are 0.32418,0.32601 and 0.34982. The weight of the 15 level 2 indicators are0.08648,0.09064,0.08278,0.06428,0.07224,0.07564,0.06127,0.06013。0.05673,0.06372,0.06177,0.05429,0.06242,0.05429 and 0.05332. DiscussionThe study has discussed 3 issues: firstly, we discussed canceled indicators. Secondly, we discussed the importance of monitoring and evaluation system.Lastly we discussed the similarity and discrepancy of this system and other monitoring and evaluation systemRecommendationFirstly, a scientific and reasonable monitoring and evaluation indicator system for essential medicines system which includes full range indicator based monitoring and evaluation system should be established. The system should be improved while implementing. Secondly, a monitoring and evaluation system for essential medicines system should be formed which include fixed term and external monitoring and evaluation system.