1. TBS 2008-H. Tata & M. Babaley 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

2. TBS 2008-H. Tata & M. Babaley Outline of Presentation 1.Background 2.Objectives 3.Methods, tools and steps to follow - Mapping - In-depth assessment 4.The way forward

3. TBS 2008-H. Tata & M. Babaley 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

4. TBS 2008-H. Tata & M. Babaley 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.

5. TBS 2008-H. Tata & M. Babaley 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

6. TBS 2008-H. Tata & M. Babaley 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

7. TBS 2008-H. Tata & M. Babaley 1 st 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

8. TBS 2008-H. Tata & M. Babaley 2 nd 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

9. TBS 2008-H. Tata & M. Babaley Questionnaires for Mapping and Assessment –No 1 Partners –No 2Ministry of Health –No 3Programs –No 4Central medical stores –No 5Regional Stores –No 6 Health facilities

10. TBS 2008-H. Tata & M. Babaley Stage 2: In-depth assessment (1) Steps to follow 1.Selecting the geographical areas 2.Selecting health facilities 3.Selecting data collectors 4.Training data collectors/pre-testing tool 5.Data collection 6.Data entry, processing, analysis and reporting 7.Presentation of findings 8.Printing and disseminating the report

11. TBS 2008-H. Tata & M. Babaley 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

12. TBS 2008-H. Tata & M. Babaley 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

13. TBS 2008-H. Tata & M. Babaley 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 collaboration and 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