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Tanzania: Improving Access to Health Commodities Through a Stronger Health System
A mantra for low- and middle-income countries is greater self-reliance, which includes taking on greater responsibility for the financing and delivery of health services and products to citizens. This requires countries to strengthen their health commodity supply chains by mobilizing sufficient resources and managing them efficiently for urgent needs such as the COVID-19 response. At the same time, countries must transform their supply chains to be more reliable, provide better quality services, and reach more people in the long-term by adopting new policies, financing solutions, technologies, and partnerships.
Like many countries, a priority of the government of Tanzania (at the national and sub-national level) is to develop an efficient, sustainable system to procure, pay for, and deliver health commodities. USAID is helping the Tanzanian government meet these goals through projects like Global Health Supply Chain Program Technical Assistance-Tanzania (GHSC TA-TZ) and Public Sector Systems Strengthening Activity Plus (PS3+). Both projects tackle immediate challenges—such as stock outs or poor-quality medicines—to deliver essential health services and products to people who need them, highlighting the interdependency of supply chain management with other public sector systems, such as those used in planning, financing, governance, and reporting. They also support initiatives to strengthen Tanzania’s health system, including its supply chain, for the future. This includes raising adequate, sustainable financing and delivering better value for money.
Enhancing Supply Chain Reporting
For example, to improve current supply chain performance, under the GHSC TA-TZ project, Abt Associates, in partnership with Guidehouse, supported the establishment of more interoperable financial and procurement systems. Reliable, real-time data on available funds and orders give managers a better idea of how to procure and manage the commodities they need. Abt also helped streamline the process for “out-of-stock” notifications from the government’s Medical Stores Department (MSD). These notifications trigger more timely and accurate re-ordering from other vendors to reduce stock outs.
Through GHSC TA-TZ, Abt also helped streamline the reporting process and indicators used to monitor the availability of commodities from the MSD among health providers participating in a results-based financing program in eight regions. The program aims to improve the quality and utilization of services in primary healthcare facilities as well as strengthen the MSD supply chain through financial incentives to improve results in areas such as inventory accuracy, fleet utilization, and order lead times.
Supporting Commodities Funding
Under PS3+ (and before that, PS3), Abt and its partners helped Tanzania strengthen systems to manage public monies, including those used for health commodities, down to the local level. This broader support, coupled with greater autonomy of local facilities to decide how to spend funds for health, benefits Tanzania’s health system, including its supply chain.
Through GHSC-TA-TZ, Abt also is helping the government more accurately estimate funds needed to procure health commodities across the health system, and evaluate potential sources of funds, such as the growing National Health Insurance Fund.
We’re also advancing Tanzania’s plans to launch a Health Commodities Revolving Fund that aims to promote sustained procurement of health commodities. The fund will start with an initial capital investment from the government and subsequently be replenished with proceeds from the sale of commodities. Abt supported the government’s efforts to solicit input from stakeholders on the design of the Fund and develop operating guidelines for health facilities who will access the Fund when it becomes operational.
This support is enabling Tanzania to provide the health commodities people need today – while building the systems and self reliance the country will need tomorrow.