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Assessing public–private procurement practices for medical commodities in Dar Es Salaam: a situation analysis
BACKGROUND: In Tanzania, the Medical Stores Department is the principal pharmaceutical provider to public health facilities throughout the country. However, growing demand from health facilities has proved difficult to satisfy and stock-outs at health facilities are frequent. The aim of the current...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749154/ https://www.ncbi.nlm.nih.gov/pubmed/36517787 http://dx.doi.org/10.1186/s12913-022-08923-1 |
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author | Mbwasi, Romuald Mbepera, Denis Mfuko, William Makanzo, Jason Kikwale, Martha Canavan, Robert Stoermer, Manfred Wiedenmayer, Karin |
author_facet | Mbwasi, Romuald Mbepera, Denis Mfuko, William Makanzo, Jason Kikwale, Martha Canavan, Robert Stoermer, Manfred Wiedenmayer, Karin |
author_sort | Mbwasi, Romuald |
collection | PubMed |
description | BACKGROUND: In Tanzania, the Medical Stores Department is the principal pharmaceutical provider to public health facilities throughout the country. However, growing demand from health facilities has proved difficult to satisfy and stock-outs at health facilities are frequent. The aim of the current study was to conduct a situation analysis of the procedures and practices of procuring medicines and medical supplies from private suppliers in the Dar es Salaam region when those commodities are unavailable at the Medical Stores Department. METHODS: A mixed-method approach including qualitative and quantitative methods was applied to understand procurement procedures and practices and private suppliers’ performance at district level. Qualitative interviews with suppliers and district authorities, and a review of inventory documents at store level was conducted between February and March 2018. The quantitative approach included a review and analyses of relevant procurement documents from the 2016/2017 financial year to explore the funds used to procure health commodities from the private sector. The ten most frequently mandated private suppliers were assessed in more detail focusing on cost, quality and availability of medicines and lead times and delivery. RESULTS: A lack of consistency and written guidelines for procuring medicines and medical supplies from the private sector was observed. The procurement process was bureaucratic and lengthy requiring multiple steps between health facilities, suppliers and district authorities. A significant number of people were involved requiring a minimum of 13 signatures and 16 steps from order preparation to approval. Only 17 of 77 prequalified private suppliers received orders from public health facilities. The criteria for choosing which supplier to use were unclear. Completed orders amounted to USD 663,491. The bureaucratic process drove councils and healthcare facilities towards alternative ways to procure health commodities when Medical Stores Department stock-outs occurred. CONCLUSION: The procurement procedure outside the Medical Stores Department is inefficient and cumbersome, often circumventing government regulations. General lack of accountability renders the process susceptible to leakage of funds and medicines. Increasing the transparency and efficiency of procurement procedures from the private sector with a prime vendor system would help to better manage Medical Stores Department stock-outs and help improve health care services overall. |
format | Online Article Text |
id | pubmed-9749154 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-97491542022-12-15 Assessing public–private procurement practices for medical commodities in Dar Es Salaam: a situation analysis Mbwasi, Romuald Mbepera, Denis Mfuko, William Makanzo, Jason Kikwale, Martha Canavan, Robert Stoermer, Manfred Wiedenmayer, Karin BMC Health Serv Res Research BACKGROUND: In Tanzania, the Medical Stores Department is the principal pharmaceutical provider to public health facilities throughout the country. However, growing demand from health facilities has proved difficult to satisfy and stock-outs at health facilities are frequent. The aim of the current study was to conduct a situation analysis of the procedures and practices of procuring medicines and medical supplies from private suppliers in the Dar es Salaam region when those commodities are unavailable at the Medical Stores Department. METHODS: A mixed-method approach including qualitative and quantitative methods was applied to understand procurement procedures and practices and private suppliers’ performance at district level. Qualitative interviews with suppliers and district authorities, and a review of inventory documents at store level was conducted between February and March 2018. The quantitative approach included a review and analyses of relevant procurement documents from the 2016/2017 financial year to explore the funds used to procure health commodities from the private sector. The ten most frequently mandated private suppliers were assessed in more detail focusing on cost, quality and availability of medicines and lead times and delivery. RESULTS: A lack of consistency and written guidelines for procuring medicines and medical supplies from the private sector was observed. The procurement process was bureaucratic and lengthy requiring multiple steps between health facilities, suppliers and district authorities. A significant number of people were involved requiring a minimum of 13 signatures and 16 steps from order preparation to approval. Only 17 of 77 prequalified private suppliers received orders from public health facilities. The criteria for choosing which supplier to use were unclear. Completed orders amounted to USD 663,491. The bureaucratic process drove councils and healthcare facilities towards alternative ways to procure health commodities when Medical Stores Department stock-outs occurred. CONCLUSION: The procurement procedure outside the Medical Stores Department is inefficient and cumbersome, often circumventing government regulations. General lack of accountability renders the process susceptible to leakage of funds and medicines. Increasing the transparency and efficiency of procurement procedures from the private sector with a prime vendor system would help to better manage Medical Stores Department stock-outs and help improve health care services overall. BioMed Central 2022-12-14 /pmc/articles/PMC9749154/ /pubmed/36517787 http://dx.doi.org/10.1186/s12913-022-08923-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Mbwasi, Romuald Mbepera, Denis Mfuko, William Makanzo, Jason Kikwale, Martha Canavan, Robert Stoermer, Manfred Wiedenmayer, Karin Assessing public–private procurement practices for medical commodities in Dar Es Salaam: a situation analysis |
title | Assessing public–private procurement practices for medical commodities in Dar Es Salaam: a situation analysis |
title_full | Assessing public–private procurement practices for medical commodities in Dar Es Salaam: a situation analysis |
title_fullStr | Assessing public–private procurement practices for medical commodities in Dar Es Salaam: a situation analysis |
title_full_unstemmed | Assessing public–private procurement practices for medical commodities in Dar Es Salaam: a situation analysis |
title_short | Assessing public–private procurement practices for medical commodities in Dar Es Salaam: a situation analysis |
title_sort | assessing public–private procurement practices for medical commodities in dar es salaam: a situation analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749154/ https://www.ncbi.nlm.nih.gov/pubmed/36517787 http://dx.doi.org/10.1186/s12913-022-08923-1 |
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