Boosting distribution of medical supplies at health facilities

SHORTAGE of medicine, medical supplies and equipment as well as laboratory reagents at health facilities, especially those in rural areas, are among thorny issues that puzzle the government and health stakeholders.

Sometimes people suffer due to lack of health services in their villages, while few hospitals in urban areas experience patient overcrowding, a situation that also affects health service providers as they get overwhelmed due to absence of doctor/ patient ratio.

There are many reasons behind shortage of medical equipment, including poor infrastructure, financial constraints and shortage of reliable and qualified personnel for equipment supply, who adhere to effectiveness, safety and good quality. 

The Swiss Agency for Development and Cooperation (SDC) through its Health Promotion and System Strengthening (HPSS) project has come up with a solution.

HPSS which is also known as ‘Tuimarishe Afya Project’ is part of the development cooperation between Tanzania and Switzerland which was launched in 2011, supporting Dodoma region in areas of health insurance, pharmaceuticals management, community health promotion and management of maintenance and repair services for a period of 10 years.

Through HPSS, the Agency introduced Premier Vendor System (PVS) idea, which is also known as ‘Jazia-PVS’, aimed at availability of professional and committed medicine suppliers. Jazia is a Public-Private partnership (PPP) that supplements Medical Store Department (MSD) with supplies from a single vendor in a pooled regional approach.

The project runners say that, PVS is important because access to health care is determined by availability of medical supplies. Clinicians depend on effective, safety and good quality medicines to provide adequate health care and patients equate quality of care with availability of medicines. If medicines are out of stock, patients suffer, lose confidence in health services and decline to enroll in health insurance funds. 

In 2015, the project was expanded to Morogoro and Shinyanga regions, funded by SDC and implemented by Swiss Tropical and Public Health Institute (Swiss TPH) in collaboration with the President’s office of Regional Administration and Local government (PORALG).

HPSS Advisor on Medicine Supply and Management, Ms Fiona Chilunda told the ‘Daily News’ during the just ended Tanzania Health Summit 2018, held in Dar es Salaam that in 2017, the government requested to roll-out the successful Jazia pilot project from three to all 26 regions of Tanzania Mainland, covering 185 councils, 5381 health facilities and a total population of 51,400,000. The mission was accomplished after the cascade training from national to facility level was conducted. All selected private vendors signed a contract with respective regional authorities. 

According to HPSS runners, MSD is and will continue to be the backbone for public medicines supply in the country but has been facing challenges in filling orders of health facilities. The supply gap has been growing and reached over 40 percent.

Healthy facilities may procure missing medicines from private sector through the districts but the procedure is uneconomic, bureaucratic, in transparent and lengthy, supplies are of questionable quality and it prolongs lead-time for delivery.

It was stressed that Jazia-PVS which was developed under the bilateral governmental agreement between the two countries, signed by the relevant Ministry for heath issues and PORALG will not replace MSD but serves as a complementary source for medicines and supplies out of stock at MSD without compromising quality or price.

According to the project advisor, the system provided convincing results in the sense that medicines availability at heath facilities has been well monitored. Operational indicators measure the performance of the system and prime vendor as a supplier.

“Due to innovative Jazia and other measures such as auditing and coaching, mean medicine availability in the region increased by over 40 percent between 2011 to date. Procurement of additional medical supplies when MSD is out of stock now operates within a culture of transparency and accountability, simplified and standardized procedures in partnership with private sector,” she said. 

While MSD will remain the backbone for medical supply, Jazia-PVS will stick on ensuring that health facilities have medical supplies to meet the need of people.

It was further stressed that, the system suppliers are of assured efficacy, safety and quality in accordance with the Ministry of health, Community Development, Gender, Elderly and Children as well as Tanzania Food and Drug Authority (TFDA).

HPSS operators believed that Jazia-PVS will serve as an impetus for most Tanzanians to join various health insurance funds, including the imminent Improved Community Health Fund (CHF), also known as ‘CHF Iliyoboreshwa’ after the challenge on the lack or shortage medicines at health facilities has been resolved.

CHF is also sponsored by SDC through the same HPSS project wherein it currently offers training to potential (CHF) registrars. Registration exercise is set to take off soon, probably next month, after completion of training in Dodoma, Morogoro, Shinyanga, Dar es Salaam Mwanza, Geita, Simiyu, Tabora and Kagera regions.

HPSS Financing Advisor, Mr Elizeusi Rwezaura, confirmed that majority of Tanzanians are now to breathe a sigh of relief following improvements in the Fund, wherein Insurance Cover for a-house hold with six family members will be paying only 30,000/- for a-12 month- health service.

He clarified that, the amount (30,000/-) is for all Tanzanians county-wide, except those in Dar es Salaam who should pay 40,000/- per individual and 150,000/-for a-house hold with six family members.

“There are so many reasons behind the amount difference between Dar es Salaam and other regions, including the fact that any kind of health service is available in Dar es Salaam and at any time, compared to rural areas. Again, source of incomes for urban and rural dwellers are quite different,” he said, stressing:

“CHF members will have access to health services at any health facility county-wide, unlike in the past when the patient was forced to have treated at only one health center. Patients will have any kind of treatments, including surgical operations wherever she/he is.” 

Jazia-PVS was officially launched last month in Dar es Salaam with PORALG Minister, Mr Seleman Jafo revealing that the system won’t affect the central government budget for health issues. Instead, health centers will be footing the vendors’ bills, from their domestic source of incomes, including Basket Funds and health insurances.

Again, vendors should abide by prices set by MSD throughout validity of their medicines supply contracts, stressing: “They will not be allowed to go beyond, but maintain MSD prices, or go below. I also remind vendors that quality control of medicines is of most importance for betterment of our people,” he said.

The minister said that, the government does and will continue doing whatever possible to improve the health sector, saying: ‘’No healthy people, no healthy national economy’. 

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