Supervision, performance assessment, and recognition strategy (SPARS) – a multipronged strategy to strengthen medicines management in Nepal: pilot study methods and baseline results
Background: Nepal piloted a multipronged supervision, performance assessment, and recognition strategy (SPARS), to improve medicines management (MM) in public health facilities. This paper describes the SPARS pilot intervention and reports on MM performance at baseline.Methods: To build MM capacity...
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Taylor & Francis Group
2025-12-01
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| Series: | Journal of Pharmaceutical Policy and Practice |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20523211.2024.2449043 |
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| author | Nirajan Bhusal Anup Bastola Reekesh Shrestha Narendra Kumar Khanal Birna Trap |
| author_facet | Nirajan Bhusal Anup Bastola Reekesh Shrestha Narendra Kumar Khanal Birna Trap |
| author_sort | Nirajan Bhusal |
| collection | DOAJ |
| description | Background: Nepal piloted a multipronged supervision, performance assessment, and recognition strategy (SPARS), to improve medicines management (MM) in public health facilities. This paper describes the SPARS pilot intervention and reports on MM performance at baseline.Methods: To build MM capacity at public sector health facilities, health workers were trained as MM supervisors to visit and supervise government health facilities, assess MM performance, and use the findings to provide support in MM practices. Performance was assessed using a SPARS indicator-based tool containing 25 indicators covering five MM domains: dispensing quality, prescribing quality, stock management, storage management, and ordering and reporting. From the middle of 2022, we trained 60 MM supervisors who began conducting supervisory visits at 284 health facilities in 12 randomly selected pilot districts located in three provinces. The intent, pending funding, is to continue supervision and expand SPARS to achieve national coverage.Results: The overall MM baseline median score was 8.5 (34%) (maximum 25) with an inter-quartile range (IQR) of 6.4–10.7. Median facility domain scores (maximum 5) were: storage management, 2.0 (IQR 1.4–2.6); stock management 0.3 (IQR 0.0–1.0); ordering and reporting 2.5 (IQR 1.7–3.5); dispensing quality 1.3 (IQR 0.9–1.6); and prescribing quality 2.3 (IQR 1.3–3.3). The overall score did not differ significantly by level of care; however, hospitals had the lowest overall baseline score and individual domain scores.Conclusion: The baseline assessment using the SPARS tool provides valuable information on the current state of MM in Nepal, which was poor, assessed by the 25 SPARS indicators covering stock and storage management, ordering and reporting, prescribing, and dispensing. Assessing and building national capacity in MM is needed at health facilities at all levels of care. |
| format | Article |
| id | doaj-art-51210e418c424bbda519fcccab91efcb |
| institution | Kabale University |
| issn | 2052-3211 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Pharmaceutical Policy and Practice |
| spelling | doaj-art-51210e418c424bbda519fcccab91efcb2025-01-20T15:08:53ZengTaylor & Francis GroupJournal of Pharmaceutical Policy and Practice2052-32112025-12-0118110.1080/20523211.2024.2449043Supervision, performance assessment, and recognition strategy (SPARS) – a multipronged strategy to strengthen medicines management in Nepal: pilot study methods and baseline resultsNirajan Bhusal0Anup Bastola1Reekesh Shrestha2Narendra Kumar Khanal3Birna Trap4USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program Nepal, Management Sciences for Health, Kathmandu, NepalCurative Service Division, Department of Health Services, Ministry of Health and Population, Kathmandu, NepalUSAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program Nepal, Management Sciences for Health, Kathmandu, NepalCurative Service Division, Department of Health Services, Ministry of Health and Population, Kathmandu, NepalUSAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program Nepal, Management Sciences for Health, Kathmandu, NepalBackground: Nepal piloted a multipronged supervision, performance assessment, and recognition strategy (SPARS), to improve medicines management (MM) in public health facilities. This paper describes the SPARS pilot intervention and reports on MM performance at baseline.Methods: To build MM capacity at public sector health facilities, health workers were trained as MM supervisors to visit and supervise government health facilities, assess MM performance, and use the findings to provide support in MM practices. Performance was assessed using a SPARS indicator-based tool containing 25 indicators covering five MM domains: dispensing quality, prescribing quality, stock management, storage management, and ordering and reporting. From the middle of 2022, we trained 60 MM supervisors who began conducting supervisory visits at 284 health facilities in 12 randomly selected pilot districts located in three provinces. The intent, pending funding, is to continue supervision and expand SPARS to achieve national coverage.Results: The overall MM baseline median score was 8.5 (34%) (maximum 25) with an inter-quartile range (IQR) of 6.4–10.7. Median facility domain scores (maximum 5) were: storage management, 2.0 (IQR 1.4–2.6); stock management 0.3 (IQR 0.0–1.0); ordering and reporting 2.5 (IQR 1.7–3.5); dispensing quality 1.3 (IQR 0.9–1.6); and prescribing quality 2.3 (IQR 1.3–3.3). The overall score did not differ significantly by level of care; however, hospitals had the lowest overall baseline score and individual domain scores.Conclusion: The baseline assessment using the SPARS tool provides valuable information on the current state of MM in Nepal, which was poor, assessed by the 25 SPARS indicators covering stock and storage management, ordering and reporting, prescribing, and dispensing. Assessing and building national capacity in MM is needed at health facilities at all levels of care.https://www.tandfonline.com/doi/10.1080/20523211.2024.2449043Medicines managementsupervisionperformance assessment and recognition strategySPARSpharmacy indicatorsmedicines management indicators |
| spellingShingle | Nirajan Bhusal Anup Bastola Reekesh Shrestha Narendra Kumar Khanal Birna Trap Supervision, performance assessment, and recognition strategy (SPARS) – a multipronged strategy to strengthen medicines management in Nepal: pilot study methods and baseline results Journal of Pharmaceutical Policy and Practice Medicines management supervision performance assessment and recognition strategy SPARS pharmacy indicators medicines management indicators |
| title | Supervision, performance assessment, and recognition strategy (SPARS) – a multipronged strategy to strengthen medicines management in Nepal: pilot study methods and baseline results |
| title_full | Supervision, performance assessment, and recognition strategy (SPARS) – a multipronged strategy to strengthen medicines management in Nepal: pilot study methods and baseline results |
| title_fullStr | Supervision, performance assessment, and recognition strategy (SPARS) – a multipronged strategy to strengthen medicines management in Nepal: pilot study methods and baseline results |
| title_full_unstemmed | Supervision, performance assessment, and recognition strategy (SPARS) – a multipronged strategy to strengthen medicines management in Nepal: pilot study methods and baseline results |
| title_short | Supervision, performance assessment, and recognition strategy (SPARS) – a multipronged strategy to strengthen medicines management in Nepal: pilot study methods and baseline results |
| title_sort | supervision performance assessment and recognition strategy spars a multipronged strategy to strengthen medicines management in nepal pilot study methods and baseline results |
| topic | Medicines management supervision performance assessment and recognition strategy SPARS pharmacy indicators medicines management indicators |
| url | https://www.tandfonline.com/doi/10.1080/20523211.2024.2449043 |
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