Table 5 Patterns of interactions and pharmacogovernance codebook

Autonomy

Self-governing or acting independently.

So that’s the thing with devolution. You can make the decision. You don’t have to wait for somebody to tell you what you do if this or that.

Advocacy

Motivates change in policies, priorities and/or resource allocation to advance pharmacovigilance

The country can identify it [pharmacovigilance] as a priority but if it had not been an important focus area from Washington, then it becomes difficult for the local region to get sufficient resources for it.

Collaborative

Formal or non-structured partnerships for the joint development of programs, policies, and pharmacovigilance resources that strengthen pharmacovigilance.

[We developed a] Master’s in pharmacy, pharmacoepi, and pharmacovigilance. And we collaborated with the University of Nairobi and the University of Washington. I got it up and running now.

Consultative

Engages external advisors in pharmacovigilance decision-making.

So you want to work closely with the County Directors of Health, the County pharmacists so that you can get more information from them. And share with them what you are seeing in other counties because they will only see what is available in the county.

[T]hey send you their comments. …Cause we cannot do a guideline without the input from the stakeholders. We even require that in our constitution. Anything that is going to affect your stakeholders, it is important that you get input from them.

Cooperative

Agreement made between federal, state, county, or global actors to work together or jointly support a specific issue.

[B]ilateral cooperation is agreed among the countries. We may or may not take part. We may suggest some field for cooperation among two countries.

Delegate

Give oversight of pharmacovigilance activities to another entity or group (e.g., national regulatory authority to county/state dept. of health; MoH to NGO; nurses to pharmacists).

The staff in the county, they’re mostly drug inspectors; there are no pharmacovigilance case [workers]. So in case the [regulatory authority] wants to conduct pharmacovigilance they will contact me to coordinate the activities in Coast region.

Fragmented

Interrelated PV responsibilities and overlapping functions with limited integration of PV activities and accountability.

Yeah, It’s quite complicated for faith-based organizations, at least for the Catholic church. They have their own system.

Hierarchical

Organized according to a series of levels with different importance or status, each subordinate to the one above it.

[B]ecause as a global group I don’t report here. My director is based in headquarters. I have a dotted line to the country manager but my group reports directly to headquarters.