Project 1-89 Indonesia

Integrated Management of Childhood Illnesses (IMCI) developed by WHO has been adopted by Indonesia as a method used by non-physician health providers to manage childhood illnesses. Appropriate management of childhood illnesses will also depend on availability and quality of essential drugs. Currently, the quality of drugs in primary health centers and district hospitals in Indonesia are rarely monitored due to the complexity and high cost of drug quality testing. PharmaCheck, developed by the NIH collaborator at Boston University, is the only user-friendly, reliable, cost effective technology that screens for substandard drugs using active pharmaceutical ingredient concentration and drug dissolution tests. The technology is of significant value in Indonesia as an affordable, effective tool for local and central health authorities to better safeguard the efficacy of their pharmacopeia. The goal of this study is to assess the implementation of PharmaCheck for testing the quality of selected IMCI drugs in Indonesia. We have chosen 2 most frequently used IMCI antibiotics, Cotrimoxazole and Amoxicillin. The study will be implemented in 4 phases. In the first phase, probes for testing these 2 antibiotics will be developed at Boston University. The second phase will be a comparison between PharmaCheck and standard drug quality testing to test accuracy. If PharmaCheck shows reliable accuracy, the third phase will commence, in which PharmaCheck will be field tested to investigate the correct amount of active ingredients present in cotrimoxazole and amoxicillin in 80 primary health care centers (PHCs) and 10 district hospitals in 10 districts in West Java. The 80 PHCs chosen have been trained in implementing IMCI and the 10 hospitals are referral sites for the 80 PHCs. During the implementation, a cost study will be done to understand the cost of implementing PharmaCheck in Indonesia. In the fourth phase, analysis will be done to understand the potential application of PharmaCheck in Indonesia.