By Roma Ramphal, CCMDD Provincial Co-ordinator: KZN
A very exciting medicine parcel collection-point model has been pioneered by Health Systems Trust (HST) in order to increase the number of Central Chronic Medicine Dispensing and Distribution (CCMDD) external pick-up points available in under-serviced areas.
Providing the public with more options for convenient collection of their chronic medication allows for the decongestion of high-burden facilities and in thus the provision of quality health services to those requiring care, and supports patients' treatment adherence by ensuring that they have stocks of their medication as and when they need it.
The number of external CCMDD pick-up in eThekwini District has increased by 79 over the last year; however, there are still communities that are underserviced. To reach these patients, HST's mobile pick-up point vehicle will enable them to collect their medicines until a fixed pick-up point can be established in their area. The van can also service any area as the need arises.
In preparing to launch this initiative, numerous potential 'park and issue' sites recommended by public health facilities were assessed for suitability. Multiple challenges were noted, among which was the requirement for individual permissions and rental fees for parking the vehicle. In order to roll out a stronger model that would be expandable and sustainable, HST embarked on gaining approval from selected Municipal Libraries across eThekwini to park the mobile pick-up point vans in their outdoor spaces. Six library sites were chosen, based on the volumes of CCMDD-registered patients currently collecting in the clinics' Spaced Fast-Lane Appointment System queues in under-serviced locations.
eThekwini Municipality's Head of Health and Head of Libraries for eThekwini granted approval for use of the requested spaces and supported the implementation team's planning with useful recommendations.
Three 2019 Mercedes Sprinters were purchased and modified to facilitate this medicine parcel distribution plan. Each van will be used at two libraries, alternating mornings and afternoons, to ensure that every site has full cover for every day. Site evaluations of the libraries' grounds were conducted to ensure that safe spaces are available for the vehicles to park.
Identifiable by eye-catching branding, each van is insulated and clad to maintain an even temperature inside the vehicle, and are fitted with supplementary air-conditioners that maintain a regulated temperature while the vehicle is parked. The vehicles are fitted with pull-out awnings to protect patients from sun and rain. The medicine parcels are stored in lockable aluminium cages for transportation, and the vans are equipped with a tablet for use of the CCMDD electronic record system, SyNCH.
HST concurrently identified a space at the Durban Head Office in Westville in which to operate the CCMDD Receipt and Dispatch Office. Once it was equipped, the space underwent a pre-qualification assessment by the eThekwini Municipality.
To register this site and the vans as external pick-up points, HST signed a Non-remunerated Service Provider Service-level Agreement with the Department of Health. The required Project Plan, Risk Management Plan and proof of comprehensive insurance cover for the vehicles were submitted as Addenda to the Agreement.
Post-Basic Pharmacist Assistants with Code 10 driver's licences have been recruited as Drivers and Issuers for the vans.
This pilot project will begin in eThekwini as soon as approval from National Department of Health has been confirmed. The project will be piloted for six months and evaluated before replication in other districts is considered.
How does the Mobile Van Project work?
Community engagement and marketing:
To promote the use of the vehicles, and to inform patients when they can collect, their medication from the mobile pick-up points, HST has designed a CCMDD Van Schedule flyer that will be given to every patient who chooses to collect medicine parcels at any of the six participating Libraries. HST has also re-designed the eThekwini CCMDD Pick-up Point List and segregated pick-up points into suburbs to allow for convenient access.
The mobile pick-up vans feature CCMDD branding
Pharmacists in the tempreture controlled van
Medication parcels will be locked in these cabinets while they await collection