Expansion of the successful complementary supply system to Shinyanga and Morogoro region in Tanzania- filling the medicines gap with a Prime Vendor system

Health facilities in Tanzania depend on the Medical Stores Department (MSD) for their medicines supply. Due to performance challenges at the MSD, availability of medicines in the health faci­lities in the region is insufficient, with a supply gap of up to 50%. While MSD will remain the backbone for medici­nes supply to the public sector, Dodoma Region with support from the SDC funded Health Promotion and System Strengthening project developed this public private partnership to tackle the problem of medicine stock-outs.

The Prime Vendor System has the objective to ensure that health facilities have the medicines and medical supplies to meet the needs of the people, by supplementing regular gover­nment supplies with additional supplies- filling the MSD gap. These are financed with complementary funds from national sources such as the Community Health Fund, National Health Insurance Fund, user fees and bas­ket funds. Districts pool their demand for supplementary medicine at the regional level, benefitting from lower prices (economies of scale). Prices from the contracted private Prime Vendor are fixed and comparable to MSD prices. The region operates a Prime Vendor office with a coordinator, a dedicated pharmacist and support staff. The system is closely managed and supported by manda­ted administrative structures such as a technical committee and a board appointed by the regional authorities. The PVS allows health facilities to manage their own funds, enhancing fiscal decentralization. This is in line with the government policy of empo­wering health facilities to respond to community needs.

After two years of successful implementation in Dodoma region, the Jazia PVS has been rolled out and formally launched with contract signing in the presence of national and regional authorities of Shinyanga and Morogoro region in December 2016.

Operations of the PV system are managed and driven by Standard Operating Procedures. A comprehensive but user-friendly handbook with Standard Operating Proceduress for health facilities and districts covers the key PVS operational areas. The performance of the Prime Vendor (supplier) and the Prime Vendor System is mo­nitored on a quarterly basis, using a limited number of indicators.

While Shinyanga and Morogoro region are starting operations and have placed first orders with the PV, Dodoma region can boast of good results and overall satisfaction with the Jazia PVS. Tracer medicines availability in the region has in­creased from 54% in 2011 to over 80% in 2016. All districts place orders with the prime vendor. The PV utilization rate in 2016 reached 50% as compared to the value of orders from MSD. Satisfaction of districts and health facilities with the PV performance as a com­plementary supplier is high. Most importantly though improved availability of medicines and supplies is greatly appreciated by health care workers and patients.