Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects

Mwencha, Marasi; Rosen, James E.; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

doi:10.9745/ghsp-d-16-00395

Cited by 26 publications

(22 citation statements)

References 1 publication

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“… 44 A study conducted in a different setting in Tanzania showed that staff training on the web-based electronic logistics management information system (eLMIS) intervention accounted for >50% of the investment costs, however, there were enormous cost savings after upgrading the eLMIS. 45 …”

Section: Discussionmentioning

confidence: 99%

Cost and cost drivers associated with setting-up a prime vendor system to complement the national medicines supply chain in Tanzania

et al. 2020

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IntroductionEconomic analysis of supply chain management interventions to improve the availability of healthcare commodities at healthcare facilities is important in generating evidence for decision-makers. The current study assesses the cost and cost drivers for setting-up a public-private partnership programme in Tanzania in which all public healthcare facility orders for complementary medicines are pooled at the district level, and then purchased from one contracted supplier, the prime vendor (referred to as ‘Jazia Prime Vendor System’ (Jazia PVS)).MethodsFinancial and economic costs of Jazia PVS were collected retrospectively and using the ingredients approach. The financial costs were spread over the implementation period of January 2014–July 2019. In addition, we estimated the financial rollout costs of Jazia PVS to the other 23 regions in the country over 2 years (2018–2019). A multivariate sensitivity analysis was conducted on the estimates.ResultsJazia PVS start-up and recurrent financial costs amounted to US$2 170 989.74 and US$709 302.32, respectively. The main cost drivers were costs for short-term experts, training of staff and healthcare workers and the Jazia PVS technical and board management activities. The start-up financial cost per facility was US$2819.47 and cost per capita was US$0.37.ConclusionIn conclusion, the study provides useful information on the cost and cost drivers for setting-up a complementary pharmaceutical supply system to complement an existing system in low-income settings. Despite the substantial costs incurred in the initial investment and operations of the Jazia PVS, the new framework is effective in achieving the desired purpose of improving availability of healthcare commodities.

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Section: Discussionmentioning

confidence: 99%

Cost and cost drivers associated with setting-up a prime vendor system to complement the national medicines supply chain in Tanzania

et al. 2020

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“…Investment in technology over time allows the system to keep pace with innovative ways to collect, manage, and analyze data. 7,12 Early cost-bene t analysis of some Tanzania upgrades to the HIS have shown a nancial bene t, though additional bene ts may not be seen for several years [33].…”

Section: Discussionmentioning

confidence: 99%

“…In 2005, the MOHCDGEC began working with the USAID | DELIVER Project and other partners to improve national health information logistics and strengthen human capacity and systems design. This work led to implementation of the Integrated Logistic System Gateway, a mobile reporting system designed to increase the visibility of logistics data and improve product availability, and subsequently the electronic Logistics Management Information System (eLMIS), which increases supply chain visibility at all system levels [31][32][33]. Other routine and non-routine health information were collected through household surveys (such as the Demographic and Health Surveys), health facility and administrative databases, census and vital events registration data, the Integrated Disease Surveillance and Response framework for communicable disease surveillance, and mobile technology for data collection on immunizations and neglected tropical diseases [35][36][37][38].…”

Section: Building Tanzania's Health Information Systemmentioning

confidence: 99%

One country's journey to interoperability: Tanzania's experience developing a national health information exchange

Nsaghurwe¹,

Dwivedi²,

Ndesanjo³

et al. 2020

Preprint

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Background and purpose: Robust, flexible, and integrated health information (HIS) systems are essential to achieving national and international goals in health and development. Such systems are still uncommon in most low and middle income countries. This article describes a first-phase activity in Tanzania to integrate the country’s vertical health management information system with the help of an interoperability layer that enables cross-program data exchange. Methods: From 2014 to 2019, the Tanzanian government and partners implemented a five-step procedure based on the “Mind the GAPS” (governance, architecture, program management, and standards) framework and using both proprietary and open-source tools. In collaboration with multiple stakeholders, the team developed the system to address major data challenges via four fully documented “use case scenarios” addressing data exchange among hospitals, between services and the supply chain, across digital data systems, and within the supply chain reporting system. This work included developing the architecture for health system data exchange, putting a middleware interoperability layer in place to facilitate the exchange, and training to support use of the system and the data it generates. Results: Tanzania successfully completed the five-step procedure for all four use cases. Data exchange is currently enabled among 15 separate information systems, and has resulted in improved data availability and significant time savings. The government has adopted the health information exchange within the national strategy for health care information, and the system is being operated and managed by Tanzanian officials. Conclusion: Developing an integrated HIS requires a significant time investment; but ultimately benefit both programs and patients. Tanzania’s experience may interest countries that are developing their HIS programs.

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“…Tanzania's public health supply chain system serves the MOHCDGEC-operated facilities, including 20 regional vaccine stores, 137 district stores, and 6.821 service delivery points (hospitals, health centres, and dispensaries). The value of medicines and other commodities moving through the public health supply chain each year is roughly 300 billion Tanzanian shillings (TSh) (14).…”

Section: Study Settingmentioning

confidence: 99%

“…The MOHCDGEC has overall responsibility for ensuring the system remains functional. System logistics are run by the MSD, a semi-autonomous organisation in MOHCDGEC (14,15). At the district level, the forecast and ordering of commodities is done by district pharmacists, whose supervision lies under the President's O ce Regional Administration and Local Government (PORALG), as part of Tanzania's decentralized system (16).…”

Section: Study Settingmentioning

confidence: 99%

The complexity of scaling up an mHealth intervention. SMS for Life: A Case Study from a Health Systems Integration Perspective

Fruchtman

Mbuyita

Mwanyika‐Sando

et al. 2020

Preprint

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Background The objective of this study was to apply systems thinking to examine the opportunities and challenges of scaling up and integrating a new electronic health technology into a complex health system. We used the implementation cycle of the supply chain management solution (SMS for Life 1.0) in Tanzania as a case study. SMS for Life was one of the earliest large-scale implementations of mHealth innovations worldwide. It aimed to bring visibility to antimalarial stock-outs through the use of SMS technology.Methods A qualitative case-study approach was used. This included a literature review, a document review of 61 project documents, a timeline of key events and the collection and analysis of 28 interviews with key stakeholders involved in or affected by the SMS for Life programme. Using the WHO mHealth Assessment and Planning for Scale (MAPS) Toolkit as a framework, we carried out a joint thematic analysis and identified the key reasons for the discontinuation of the programme.Results SMS for Life was reliable at scale and raised awareness of stock-outs with real-time monitoring. However, it was discontinued in 2015 after four years of a national rollout. The main reasons identified for the discontinuation were the programme’s failure to adapt to the continuous changes in Tanzania’s health system, the focus on stock-outs rather than ensuring appropriate stock management, and that it was perceived as costly by policy-makers.

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Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects

Cited by 26 publications

References 1 publication

Cost and cost drivers associated with setting-up a prime vendor system to complement the national medicines supply chain in Tanzania

Cost and cost drivers associated with setting-up a prime vendor system to complement the national medicines supply chain in Tanzania

One country's journey to interoperability: Tanzania's experience developing a national health information exchange

The complexity of scaling up an mHealth intervention. SMS for Life: A Case Study from a Health Systems Integration Perspective

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