Lisa Hedman - Academia.edu (original) (raw)

Papers by Lisa Hedman

BMC Medicine, Sep 29, 2016

Shortages of medicines and vaccines have been reported in countries of all income levels in recen... more Shortages of medicines and vaccines have been reported in countries of all income levels in recent years. Shortages can result from one or multiple causes, including shortages of raw materials, manufacturing capacity problems, industry consolidation, marketing practices, and procurement and supply chain management. Existing approaches to mitigate shortages include advance notice systems managed through medicine regulatory authorities, special programmes that track medicines, and interventions to improve efficiency of the medicine supply chain. Redistribution of supplies at the national level can mitigate some shortages in the short term. International redistribution and exceptional regulatory approvals may be used in limited circumstances, with the understanding that such approaches are complex and may introduce cost and quality risks. If it is necessary to prioritise patients to receive a medicine that is in shortage, evidence-based practice should be used to ensure optimal allocation. Important steps in reducing medicine shortages and their impact include identifying medicines that are most at risk, developing reporting systems to share information on current and emerging shortages, and improving data from medicine supply chains.

Journal of Pharmaceutical Policy and Practice, Dec 1, 2014

PLOS ONE, Jul 19, 2016

Background Congenital syphilis continues to be a preventable cause of global stillbirth and neona... more Background Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis.

Reproductive and maternal health commodity policy and systems indicators for a subset of countrie... more Reproductive and maternal health commodity policy and systems indicators for a subset of countries (countries arranged in order of increasing gap with CD 2015 targets). (PDF 94â kb)

Indicators and data sources. (PDF 70â kb)

Measuring determinants of access to lifesaving commoditiesâ not just availability. (PDF 541â kb)

Journal of Pharmaceutical Policy and Practice, 2014

Optimizing Treatment for Children in the Developing World, 2015

Availability and affordability of medicines are crucial to delivery of health services in any com... more Availability and affordability of medicines are crucial to delivery of health services in any community. In many countries, public sector institutions play a significant role in providing health services but when public health facilities lack medicines they risk losing trust of the population. Children and families will go elsewhere or be forced into the private sector where care and medicines are often unaffordable. Child-specific issues complicate the pre-existing challenges of adequate financing, timely procurement and distribution of quality-assured medicines in many low and middle income countries. Progress has been made in recent years with renewed efforts at the global, regional and national level to improve access to paediatric medicines. Effort has been focused to reduce stock-outs and to ensure availability of appropriate dosage forms. Emphasis has also been placed on increasing demand for evidence-based prescribing, supporting quality use by health providers. Further research is needed in critical facets, including preclinical and clinical studies and incentivization of the private sector.

Inledningen till studien tar sin utgangspunkt i ett perspektiv av Arbetsintegrerat larande genom ... more Inledningen till studien tar sin utgangspunkt i ett perspektiv av Arbetsintegrerat larande genom det socialpedagogiska programmet som har varit forlagt till norra Kalmar lans region sedan 2003. Med ...

BackgroundIn 2000, the Millennium Development Goals set targets for social achievements by 2015 i... more BackgroundIn 2000, the Millennium Development Goals set targets for social achievements by 2015 including goals related to maternal and child health, with mixed success. Several initiatives supported these goals including assuring availability of appropriate medicines and commodities to meet health service targets. To reach the new Sustainable Development Goals by 2030, information is needed to address policy and systems factors to improve access to lifesaving commodities.MethodsWe compiled indicator data on 15 commodities related to reproductive, maternal, newborn, and child health (RMNCH) and analyzed them across 75 Countdown to 2015 countries from eight regions to identify problems with specific commodities and determinants of access. The determinants related to policy, regulatory environment, financing, pharmaceutical procurement and supply chain, and information systems. We mapped commodity information from four datasets from the World Health Organization and the United Nation’...

To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H... more To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) to resource-constrained countries with otherwise very little access to the A(H1N1)pdm09 vaccine, the World Health Organization (WHO) coordinated distribution of donated vaccine to selected countries worldwide, including those in Africa. From February through November 2010, 32.2 million doses were delivered to 34 countries in Africa. Of the 19.2 million doses delivered to countries that reported their vaccination activities to WHO, 12.2 million doses (64%) were administered. Population coverage in these countries varied from 0.4% to 11%, with a median coverage of 4%. All countries targeted pregnant women (median proportion of all vaccine doses administered [mpv], 21% [range, 4%-72%]) and healthcare workers (mpv, 9% [range, 1%-73%]). Fourteen of 19 countries targeted persons with chronic conditions (mpv, 26% [range, 5%-66%]) and 10 of 19 countries vaccinated children (mpv, 54% [...

BMC Health Services Research

Background: In 2000, the Millennium Development Goals set targets for social achievements by 2015... more Background: In 2000, the Millennium Development Goals set targets for social achievements by 2015 including goals related to maternal and child health, with mixed success. Several initiatives supported these goals including assuring availability of appropriate medicines and commodities to meet health service targets. To reach the new Sustainable Development Goals by 2030, information is needed to address policy and systems factors to improve access to lifesaving commodities. Methods: We compiled indicator data on 15 commodities related to reproductive, maternal, newborn, and child health (RMNCH) and analyzed them across 75 Countdown to 2015 countries from eight regions to identify problems with specific commodities and determinants of access. The determinants related to policy, regulatory environment, financing, pharmaceutical procurement and supply chain, and information systems. We mapped commodity information from four datasets from the World Health Organization and the United Nation's Commission on Life Saving Commodities creating a stoplight dashboard to illustrate countries' environment to assure access. We also developed a dashboard for policy and systems indicators for select countries. Results: The commodities we identified as having the fewest barriers to access had been in use longer, including oral rehydration solution and oxytocin injection. Looking across the different systems and policy determinants of access, only Zimbabwe had all 15 commodities on both its essential medicines list and in its standard treatment guidelines, and only Cameroon and Zambia had at least one product registered for each commodity. Senegal alone procured all tracer commodities centrally in the previous year, and 70% of responding countries had costed plans for maternal, newborn, and child health. No country reported recent stock-outs of all the 15 commodities at the central level-countries always had some of the 15 commodities available; however, products with frequent stock-outs included misoprostol, calcium gluconate, penicillin injections, ceftriaxone, and amoxicillin dispersible tablets. Conclusions: This analysis highlights country deficiencies in policies and systems, such as incoherent policy guidelines, problems in product registration, lack of logistics data, and central-level stock-outs that may affect access to essential RMNCH commodities. To tackle these deficiencies, countries need to integrate commodity-related indicators into other health monitoring activities to improve service quality.

BMC medicine, Jan 29, 2016

Shortages of medicines and vaccines have been reported in countries of all income levels in recen... more Shortages of medicines and vaccines have been reported in countries of all income levels in recent years. Shortages can result from one or multiple causes, including shortages of raw materials, manufacturing capacity problems, industry consolidation, marketing practices, and procurement and supply chain management. Existing approaches to mitigate shortages include advance notice systems managed through medicine regulatory authorities, special programmes that track medicines, and interventions to improve efficiency of the medicine supply chain. Redistribution of supplies at the national level can mitigate some shortages in the short term. International redistribution and exceptional regulatory approvals may be used in limited circumstances, with the understanding that such approaches are complex and may introduce cost and quality risks. If it is necessary to prioritise patients to receive a medicine that is in shortage, evidence-based practice should be used to ensure optimal allocat...

PloS one, 2016

Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidi... more Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis. Proportions of antenatal care attendance, syphilis screening coverage in pregnancy, syphilis prevalence among pregnant women, and adverse pregnancy outcomes due to untreated maternal syphilis reported to WHO were applied to 2012 birth estimates for 30 high syphilis burden countries to estimate current and projected benzathine penicillin need for prevention of congenital syphilis. Using current antenatal care syphilis screening coverage and seroprevalence, we estimated the total number of women ...

Bulletin of the World Health Organization, 2016

Journal of pharmaceutical policy and practice, 2014

Approximately a third of the world populationand about half in the most underdeveloped settingsha... more Approximately a third of the world populationand about half in the most underdeveloped settingshave been estimated to lack access to essential medicines and diagnostics . Effective supply chains are vital to deliver essential health commodities. In high-income countries the availability of medicines in the public and private sector is taken as a given: quality assurance is managed by robust national regulatory agencies; supply and distribution are increasingly privatized, with performance measured against timeliness and cost. Conversely, in many low-and middle-income countries, stock-outs of essential commodities are commonplace, with a mean availability of core medicines in the public sector ranging from 38.2% in sub-Saharan Africa to 57.7 % in Latin America and the Caribbean [2]. Vulnerability of supply chain functions also increases the potential for the entry of counterfeit and substandard products .

Journal of Infectious Diseases, 2012

To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H... more To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H1N1] pdm09) to resource-constrained countries with otherwise very little access to the A(H1N1)pdm09 vaccine, the World Health Organization (WHO) coordinated distribution of donated vaccine to selected countries worldwide, including those in Africa. From February through November 2010, 32.2 million doses were delivered to 34 countries in Africa. Of the 19.2 million doses delivered to countries that reported their vaccination activities to WHO, 12.2 million doses (64%) were administered. Population coverage in these countries varied from 0.4% to 11%, with a median coverage of 4%. All countries targeted pregnant women (median proportion of all vaccine doses administered [mpv], 21% [range, 4%-72%]) and healthcare workers (mpv, 9% [range, 1%-73%]). Fourteen of 19 countries targeted persons with chronic conditions (mpv, 26% [range, 5%-66%]) and 10 of 19 countries vaccinated children (mpv, 54% [range, 17%-75%]). Most vaccine was distributed after peak A(H1N1)pdm09 transmission in the region. The frequency and severity of adverse events were consistent with those recorded after other inactivated influenza vaccines. Pandemic preparedness plans will need to include strategies to ensure more-rapid procedures to identify vaccine supplies and distribute and import vaccines to countries that may bear the brunt of a future pandemic.

BMC Medicine, Sep 29, 2016

Shortages of medicines and vaccines have been reported in countries of all income levels in recen... more Shortages of medicines and vaccines have been reported in countries of all income levels in recent years. Shortages can result from one or multiple causes, including shortages of raw materials, manufacturing capacity problems, industry consolidation, marketing practices, and procurement and supply chain management. Existing approaches to mitigate shortages include advance notice systems managed through medicine regulatory authorities, special programmes that track medicines, and interventions to improve efficiency of the medicine supply chain. Redistribution of supplies at the national level can mitigate some shortages in the short term. International redistribution and exceptional regulatory approvals may be used in limited circumstances, with the understanding that such approaches are complex and may introduce cost and quality risks. If it is necessary to prioritise patients to receive a medicine that is in shortage, evidence-based practice should be used to ensure optimal allocation. Important steps in reducing medicine shortages and their impact include identifying medicines that are most at risk, developing reporting systems to share information on current and emerging shortages, and improving data from medicine supply chains.

Journal of Pharmaceutical Policy and Practice, Dec 1, 2014

PLOS ONE, Jul 19, 2016

Background Congenital syphilis continues to be a preventable cause of global stillbirth and neona... more Background Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis.

Reproductive and maternal health commodity policy and systems indicators for a subset of countrie... more Reproductive and maternal health commodity policy and systems indicators for a subset of countries (countries arranged in order of increasing gap with CD 2015 targets). (PDF 94â kb)

Indicators and data sources. (PDF 70â kb)

Measuring determinants of access to lifesaving commoditiesâ not just availability. (PDF 541â kb)

Journal of Pharmaceutical Policy and Practice, 2014

Optimizing Treatment for Children in the Developing World, 2015

Availability and affordability of medicines are crucial to delivery of health services in any com... more Availability and affordability of medicines are crucial to delivery of health services in any community. In many countries, public sector institutions play a significant role in providing health services but when public health facilities lack medicines they risk losing trust of the population. Children and families will go elsewhere or be forced into the private sector where care and medicines are often unaffordable. Child-specific issues complicate the pre-existing challenges of adequate financing, timely procurement and distribution of quality-assured medicines in many low and middle income countries. Progress has been made in recent years with renewed efforts at the global, regional and national level to improve access to paediatric medicines. Effort has been focused to reduce stock-outs and to ensure availability of appropriate dosage forms. Emphasis has also been placed on increasing demand for evidence-based prescribing, supporting quality use by health providers. Further research is needed in critical facets, including preclinical and clinical studies and incentivization of the private sector.

Inledningen till studien tar sin utgangspunkt i ett perspektiv av Arbetsintegrerat larande genom ... more Inledningen till studien tar sin utgangspunkt i ett perspektiv av Arbetsintegrerat larande genom det socialpedagogiska programmet som har varit forlagt till norra Kalmar lans region sedan 2003. Med ...

BackgroundIn 2000, the Millennium Development Goals set targets for social achievements by 2015 i... more BackgroundIn 2000, the Millennium Development Goals set targets for social achievements by 2015 including goals related to maternal and child health, with mixed success. Several initiatives supported these goals including assuring availability of appropriate medicines and commodities to meet health service targets. To reach the new Sustainable Development Goals by 2030, information is needed to address policy and systems factors to improve access to lifesaving commodities.MethodsWe compiled indicator data on 15 commodities related to reproductive, maternal, newborn, and child health (RMNCH) and analyzed them across 75 Countdown to 2015 countries from eight regions to identify problems with specific commodities and determinants of access. The determinants related to policy, regulatory environment, financing, pharmaceutical procurement and supply chain, and information systems. We mapped commodity information from four datasets from the World Health Organization and the United Nation’...

To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H... more To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) to resource-constrained countries with otherwise very little access to the A(H1N1)pdm09 vaccine, the World Health Organization (WHO) coordinated distribution of donated vaccine to selected countries worldwide, including those in Africa. From February through November 2010, 32.2 million doses were delivered to 34 countries in Africa. Of the 19.2 million doses delivered to countries that reported their vaccination activities to WHO, 12.2 million doses (64%) were administered. Population coverage in these countries varied from 0.4% to 11%, with a median coverage of 4%. All countries targeted pregnant women (median proportion of all vaccine doses administered [mpv], 21% [range, 4%-72%]) and healthcare workers (mpv, 9% [range, 1%-73%]). Fourteen of 19 countries targeted persons with chronic conditions (mpv, 26% [range, 5%-66%]) and 10 of 19 countries vaccinated children (mpv, 54% [...

BMC Health Services Research

Background: In 2000, the Millennium Development Goals set targets for social achievements by 2015... more Background: In 2000, the Millennium Development Goals set targets for social achievements by 2015 including goals related to maternal and child health, with mixed success. Several initiatives supported these goals including assuring availability of appropriate medicines and commodities to meet health service targets. To reach the new Sustainable Development Goals by 2030, information is needed to address policy and systems factors to improve access to lifesaving commodities. Methods: We compiled indicator data on 15 commodities related to reproductive, maternal, newborn, and child health (RMNCH) and analyzed them across 75 Countdown to 2015 countries from eight regions to identify problems with specific commodities and determinants of access. The determinants related to policy, regulatory environment, financing, pharmaceutical procurement and supply chain, and information systems. We mapped commodity information from four datasets from the World Health Organization and the United Nation's Commission on Life Saving Commodities creating a stoplight dashboard to illustrate countries' environment to assure access. We also developed a dashboard for policy and systems indicators for select countries. Results: The commodities we identified as having the fewest barriers to access had been in use longer, including oral rehydration solution and oxytocin injection. Looking across the different systems and policy determinants of access, only Zimbabwe had all 15 commodities on both its essential medicines list and in its standard treatment guidelines, and only Cameroon and Zambia had at least one product registered for each commodity. Senegal alone procured all tracer commodities centrally in the previous year, and 70% of responding countries had costed plans for maternal, newborn, and child health. No country reported recent stock-outs of all the 15 commodities at the central level-countries always had some of the 15 commodities available; however, products with frequent stock-outs included misoprostol, calcium gluconate, penicillin injections, ceftriaxone, and amoxicillin dispersible tablets. Conclusions: This analysis highlights country deficiencies in policies and systems, such as incoherent policy guidelines, problems in product registration, lack of logistics data, and central-level stock-outs that may affect access to essential RMNCH commodities. To tackle these deficiencies, countries need to integrate commodity-related indicators into other health monitoring activities to improve service quality.

BMC medicine, Jan 29, 2016

Shortages of medicines and vaccines have been reported in countries of all income levels in recen... more Shortages of medicines and vaccines have been reported in countries of all income levels in recent years. Shortages can result from one or multiple causes, including shortages of raw materials, manufacturing capacity problems, industry consolidation, marketing practices, and procurement and supply chain management. Existing approaches to mitigate shortages include advance notice systems managed through medicine regulatory authorities, special programmes that track medicines, and interventions to improve efficiency of the medicine supply chain. Redistribution of supplies at the national level can mitigate some shortages in the short term. International redistribution and exceptional regulatory approvals may be used in limited circumstances, with the understanding that such approaches are complex and may introduce cost and quality risks. If it is necessary to prioritise patients to receive a medicine that is in shortage, evidence-based practice should be used to ensure optimal allocat...

PloS one, 2016

Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidi... more Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis. Proportions of antenatal care attendance, syphilis screening coverage in pregnancy, syphilis prevalence among pregnant women, and adverse pregnancy outcomes due to untreated maternal syphilis reported to WHO were applied to 2012 birth estimates for 30 high syphilis burden countries to estimate current and projected benzathine penicillin need for prevention of congenital syphilis. Using current antenatal care syphilis screening coverage and seroprevalence, we estimated the total number of women ...

Bulletin of the World Health Organization, 2016

Journal of pharmaceutical policy and practice, 2014

Approximately a third of the world populationand about half in the most underdeveloped settingsha... more Approximately a third of the world populationand about half in the most underdeveloped settingshave been estimated to lack access to essential medicines and diagnostics . Effective supply chains are vital to deliver essential health commodities. In high-income countries the availability of medicines in the public and private sector is taken as a given: quality assurance is managed by robust national regulatory agencies; supply and distribution are increasingly privatized, with performance measured against timeliness and cost. Conversely, in many low-and middle-income countries, stock-outs of essential commodities are commonplace, with a mean availability of core medicines in the public sector ranging from 38.2% in sub-Saharan Africa to 57.7 % in Latin America and the Caribbean [2]. Vulnerability of supply chain functions also increases the potential for the entry of counterfeit and substandard products .

Journal of Infectious Diseases, 2012

To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H... more To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H1N1] pdm09) to resource-constrained countries with otherwise very little access to the A(H1N1)pdm09 vaccine, the World Health Organization (WHO) coordinated distribution of donated vaccine to selected countries worldwide, including those in Africa. From February through November 2010, 32.2 million doses were delivered to 34 countries in Africa. Of the 19.2 million doses delivered to countries that reported their vaccination activities to WHO, 12.2 million doses (64%) were administered. Population coverage in these countries varied from 0.4% to 11%, with a median coverage of 4%. All countries targeted pregnant women (median proportion of all vaccine doses administered [mpv], 21% [range, 4%-72%]) and healthcare workers (mpv, 9% [range, 1%-73%]). Fourteen of 19 countries targeted persons with chronic conditions (mpv, 26% [range, 5%-66%]) and 10 of 19 countries vaccinated children (mpv, 54% [range, 17%-75%]). Most vaccine was distributed after peak A(H1N1)pdm09 transmission in the region. The frequency and severity of adverse events were consistent with those recorded after other inactivated influenza vaccines. Pandemic preparedness plans will need to include strategies to ensure more-rapid procedures to identify vaccine supplies and distribute and import vaccines to countries that may bear the brunt of a future pandemic.