An Assessment of the implementation of the East African pooled procurement mechanism among faith-based medicines supply organizations
Jaguga, Collins Davies Pambo
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The East African region has a significant burden of communicable and noncommunicable diseases, yet patients have low access to essential medicines and medical supplies. Some of the barriers to accessing medicines are high prices and stock-outs. Pooled procurement of health products is an innovative approach to obtaining large volumes of products at competitive prices, thus promoting affordability and availability. A number of factors influence the success of pooled procurement mechanisms. These include sustainable financing, harmonization of processes and political support. The East African Pooled Procurement Mechanism had been in operation for over three years but significant benefits were not being realized. This study sought to understand how this pooled procurement intervention was implemented, challenges encountered and key strategies for the realization of intended outcomes. A census survey was conducted among members of the pooled procurement steering committee. Data was collected through questionnaires, a focus group discussion and individual interviews. Collected data was analyzed using content and thematic analysis approaches. The results revealed that implementation of the East African pooled procurement intervention involved, for the most part, elements of successful implementation of pooled procurement mechanisms. These were stakeholder engagement; situation analysis; consensus building and implementation planning; setting up of a central procurement agency and managing and organizing procurement. However, a myriad of challenges were faced in the implementation of this intervention. The major ones were conflicting legislations and regulations for health products across the East African countries and limited financial resources for procuring health products and meeting administrative costs. As a result, there were marginal cost savings and delays in delivering or non-delivery of health products to medicine supply organizations. In view of the major challenges, it is recommended that the initiative adopts the third or fourth model of pooled procurement, to navigate country legislations and regulations for health products; a revolving drug fund for sustainable financing is implemented for organizations that are not financially stable and a continuous quality improvement system through reporting, monitoring and evaluation system is established.