021 Multi country study supply

Slide1: 

Multi-country study on drug supply and distribution activities of faith-based supply organizations in sub-Saharan African countries, 2003 Sophie Logez / Marthe Everard EDM/PAR Promoting use of effective medicines supply strategies in Africa

Outline: 

Outline Objectives Methodology Results Next step

Objectives of the MC Study: 

Objectives of the MC Study Document experiences and practices of FB DSOs Strengthen EPN’s technical capacity by evaluating drug supply systems existing in the Network Strengthen collaboration between WHO/EDM and EPN

Outline: 

Outline Objectives Methodology Results Next step

Methodology: 

Methodology Sample: 16 DSOs in 11 African countries reviewed (Feb-Dec 2003) Data collection tool: structured questionnaires (4) Data collection: Paired country assessments by FB DSO staff Data management: WHO database Joint analysis of results with all participants (EPN/WHO feedback meeting, June 2004)

Slide6: 

Ghana Nigeria Tanzania Kenya Uganda Malawi Zambia S Africa Cameroon Rwanda DR Congo Methodology Selected countries

Issues Investigated: 

Issues Investigated Role, functions and perspectives of DSOs Procurement management Founding Bodies's opinion Government’s view Customer's view Methodology

Outline: 

Outline Objectives Methodology Results Next step

Governance and Administration: 

Governance and Administration Founding bodies expectations Providing medicines to FB facilities Generating funding to support other projects Type of boards 44% elected (7DSOs) 38% nominated (6DSOs) 13% committees (2DSOs) 1 DSO with no board Board meeting: 4times a year (10DSOs) Twice a year (4DSOs) Once a year (1DSO) Results

Infrastructure : 

Infrastructure 13 DSOs have storage capacity 13 DSOs have cold storage capacity 5 DSOs have regional stores 16 DSOs have necessary utilities 2 DSOs do not have regular email Results

Services provided by the 16 DSOs : 

Services provided by the 16 DSOs Results

Customers Served : 

Customers Served Results

Procurement: Drug Selection: 

Procurement: Drug Selection By whom? Drug committees: 7 DSOs (44%) DSO's procurement team: 5 DSOs (31%) Individual decision by DSO: 2 DSOs (13%) Customers themselves: 2 DSOs (13%) Selection principles 14 DSOs select medicines based on EDL 5 DSOs also supply medicines out of EDL 3 DSOs use kit systems Drug donations 5 DSOs (38%) received donations for free distribution Results

Drug Procurement Methods: 

Drug Procurement Methods 3 DSOs buy exclusively locally, 1 DSO exclusively internationally Results

Price information : 

Price information Results

Criteria for prequalification of suppliers : 

Criteria for prequalification of suppliers Results

Quality Assurance: SOPs for 7 DSOs: 

Quality Assurance: SOPs for 7 DSOs Results

Human Resources: 

Human Resources 13 DSOs employed at least one pharmacist (up to 6) 13 DSOs have staff policy All 16 DSOs use selection committees for recruitment 15 DSOs have staff wages higher than public sector Wide range of pharmacist annual wages in EPN (from US$2,400 to US$13,450) Results

Donor Support: 

Donor Support 12 DSOs reported receiving donor support 9 DSOs received support from FBOs in Europe and the USA and some from bilateral agencies (USAID, KfW and DfID) Results

Factors Affecting DSOs Operations: 

Factors Affecting DSOs Operations External factors economic situation political situation poverty of population no tax exemption for imported medicines Internal factors inadequate financing drug donations lack of qualified staff for management and activities reluctance to change mentality Results

Governments’ view: 

Governments’ view Acknowledge great contribution of FB DSOs to national drug supply system Lack of formal reporting/communication Lack of formal collaboration Perception of governments: quality of medicines supplied by FB DSOs questioned distribution of donated medicines not always found appropriate Results

Customers’ view: 

Customers’ view Good quality of medicines Medicines supplied quantities (50 - 75% of needs met) range of items (to be increased) Need for technical assistance regular supervision training (drug management/RDU) Better communication/relation Results

Future Perspectives (1): 

Future Perspectives (1) Objectives for 15 DSOs: Increase number of customers: 12DSOs (80%) Improve delivery services for customers: 7DSOs (47%) Collaborate with other DSOs: 7DSOs (47%) Results

Future Perspectives (2): 

Future Perspectives (2) 15 DSOs (94%) planning to scale up of their activities Results

Outline: 

Outline Objectives Methodology Results Next step

Next step: Feedback meeting June 2004: 

Next step: Feedback meeting June 2004 Recommendations drafted Quality assurance (SOPs) Sustainability of DSOs (financial/organizational) Training (sharing tools) Procurement and storage capacity Collaboration (DSOs/EPN) Distribution service (feasibility study) Activities identified for DSOs/EPN/wider sector

EPN/WHO Feedback meeting, Nairobi, Kenya, June 2004: 

EPN/WHO Feedback meeting, Nairobi, Kenya, June 2004