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Mapping and In-depth Assessment of Medicines Procurement and Supply Systems. WHO Technical Briefing Seminar 17 th -21 st November 2008 Helen Tata/Magali Babaley Essential Drugs and Pharmaceutical Policies World Health Organization. Outline of Presentation. 1. Background
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Mapping and In-depth Assessment of Medicines Procurement and Supply Systems WHO Technical Briefing Seminar 17th -21st November 2008 Helen Tata/Magali Babaley Essential Drugs and Pharmaceutical Policies World Health Organization
Outline of Presentation 1. Background 2. Objectives 3. Methods, tools and steps to follow - Mapping - In-depth assessment 4. The way forward
Background • Evidence based selection and rational use are critical in ensuring access to medicines • Adequate resources (human and financial) • Inadequate • Affordable prices • Medicine prices are high and are burden to households and governments • Supply systems inadequately functioning • About 50% of the population in Sub-Saharan Africa lack regular access to affordable essential medicines
The Procurement Process • Many steps, efficient procedures should be put in place: • to select the most cost-effective essential drugs to treat commonly encountered diseases; • to quantify the needs; • to pre-select potential suppliers; • to manage procurement and delivery; • to ensure good product quality; and • to monitor the performance of suppliers and the procurement system. • Failure in any of these areas leads to lack of access to appropriate medicines and to waste. • In many public supply systems, breakdowns regularly occur at multiple points in this process.
Mapping and in-depth assessment Aim • Strengthen the procurement and supply management systems to improve access to essential medicines Specific Objectives • Map all partners and financial flows • Review strengths and weaknesses of existing procurement and supply systems • Assist national authorities to develop appropriate procurement and supply strategies and plans
Methods Two Stages: • Stage 1. Mapping • Identifying all partners • Describing the procurement and distribution circuits • Describing the financial flows • Stage 2. In-depth assessment - Procurement and supply systems
1st Stage:Mapping Procurement systems • Aim to establish a list of Partners involved in procurement of medicines and medical supplies • The following information is collected from each partner: • Category of products supported • Financial value of support • Procurement agents for partners • Distribution channel of products • Final recipients/beneficiaries of each product supported etc
2nd Stage: In-depth Assessment of Medicines Procurement systems • Structured questionnaire: quantitative and more qualitative • Five Questionnaire: MOH, CMS, programs, regional & district and health facility levels involved in procurement and supply management • Questions cover issues around the medicines management cycle: • Selection • Quantification • Procurement • Storage/stock management • Distribution • Quality Assurance • Rational Use • Financing • Monitoring & Evaluation • Human Resource • Policy framework
Questionnaires for Mapping and Assessment • No 1 Partners • No 2 Ministry of Health • No 3 Programs • No 4 Central medical stores • No 5 Regional Stores • No 6 Health facilities
Stage 2: In-depth assessment (1) • Steps to follow • Selecting the geographical areas • Selecting health facilities • Selecting data collectors • Training data collectors/pre-testing tool • Data collection • Data entry, processing, analysis and reporting • Presentation of findings • Printing and disseminating the report
Significance for MOH • To have an advocacy tool, an information link and feed back to support national planning/strategy for a coordinated, coherent and efficient national medicines supply system. • To mobilize resources for under served programme areas within the macro frame of the sector needs • To schedule procurement priorities, facilitate forecasting and maintain an un-interrupted supply chain • To ensure full supply and security for essential medicines
Significance for Partners • Provide advocacy tool to prioritize investments in procurement. • Targeted support to address gaps identified towards strengthening capacity of the Procurement and supply management systems • Provide information to monitor progress and plan for future support. • Enable strengthening of procurement processes and sharing procurement information • Keep program managers informed on gaps in respective procurement plans and monitor implementation • Have a platform to coordinate procurement and distribution of medicines among partners
The way forward • Maximize benefits from donors and partners • Functional Country working group lead by MOH with all Partners • Identifying cross-cutting areas for greater collaborationand improving the system • Developing tools for quantifying and forecasting • Assisting the preparation of national procurement and distribution plans • On the job training of personnel on effective supply chain management • Strengthening management information system