Costs of the Supervision, Performance Assessment and Recognition Strategy (SPARS) for improving medicines management in Nepal

J Pharm Policy Pract. 2024 Nov 18;17(1):2421258. doi: 10.1080/20523211.2024.2421258. eCollection 2024.

Abstract

Background: Nepal implemented a pilot of the Supervision, Performance Assessment, and Recognition Strategy (SPARS) program aimed to increase health workers' ability to manage medicines through on- the-job training and support from a new cadre of Medicines Management Supervisors (MMS). This study aims to assess the implementation costs.

Methods: Data from the SPARS central database and facilities was analysed to assess the total cost of the SPARS pilot including 293 public health facilities from 12 districts of 3 provinces, from May 2022 until July 2023. We estimated the number of health facilities to achieve a successful performance status, defined as a SPARS score ≥ 18.75 out of 25 (75%) and estimated the cost per facility to reach a successful score.

Results: In total, 293 facilities received 838 visits, performed by 48 MMS for an estimated total cost of $226,531. 124 facilities (44.3%) reached a score of 18.75 points after two or more visits. On average, it costs $1827 USD per facility to reach a successful SPARS score.

Conclusion: This study assesses the costs of implementing SPARS in 12 districts in Nepal. These findings can provide insights into further scaling up SPARS in Nepal or in other countries.

Keywords: Cost; Nepal; essential medicines and health supplies; medicine management; performance assessment; public sector.

Grants and funding

This study was funded by the US Agency for International Development (USAID) under contract number 7200AA18C00074. USAID did not have any role in the study design, data analysis, or writing of this paper or in the decision to submit the paper for publication. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the US Government.