Assessing national governance of medicine promotion: an exploratory study in Ghana to trial a structured set of indicators
Bibliographic record
Abstract
BACKGROUND: Two billion people worldwide, predominantly in low- and middle-income countries, cannot consistently access required essential medications, thus affecting their ability to attain optimal health outcomes. Access to appropriate medicines may be compromised due to issues involving cost, availability, quality, and prescribing practices, and system-wide factors such as a lack of transparency and accountability. Pharmaceutical promotional practices impact many of these issues, thus influencing the use of appropriate medicines,. Good governance is ultimately the responsibility of national governments through strong health systems with transparent and accountable practices that facilitate appropriate medicine use. We designed a structured set of indicators, based on existing tools, to assess the strength of the national governance of pharmaceutical promotion. In this exploratory study, we trialed the indicators in Ghana. METHODS: were adapted to examine the governance of pharmaceutical promotion, resulting in a hybrid framework of 45 indicators of system strength, grouped into four categories: a) Governance of prescription medicines, b) Health care professional codes and regulations, c) Anti-corruption governance, and d) Indexes. Evidence was gathered via desk-based research to establish whether indicator requirements were met. RESULTS: Our desk-based research discovered the following: a) 21 of 45 indicators for the governance of prescription medicines were met in Ghana, including the existence of a national medicines policy, national medicines list, medicines regulatory authority and a national guide for the promotion of prescription pharmaceuticals; b) pharmacists have a code of conduct specific to ethical promotion though co-development with the pharmaceutical industry should be further examined; and c) anti-corruption indicators were met for 10 of 12 criteria; and d) two indexes were available that were relevant to Ghana. CONCLUSION: Our set of indicators identified gaps and opportunities for the governance of medicines promotion in Ghana. These indicators have the potential to highlight areas requiring improved governance and could therefore form a useful diagnostic tool for identifying key discussion points for policy strengthening within low- and middle-income countries.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".