A study by a team of researchers from the University of Ghana Business School (UGBS), has exposed various challenges within the health commodity security and its supply system, particularly in public facilities.
The study, which was a recommendation by stakeholders during the 2008 health summit, was to review health commodities supply and security systems in Ghana to determine the level of performance of the procurement, supply
and distribution systems in relation to policies, procedures and statutory arrangements.
It was also aimed at determining the financial position of the supply system and identify opportunities for future strengthening of its financing and functioning process.
Professor Joshua Abor, Head of Department, UGBS, who presented the findings at a workshop in Accra on Tuesday, said the study explored
governance institutions, procurement and supply chain issues, general human resource needs of institutions, availability of tracer drugs and the information and communication systems in place.
Others were level of indebtedness throughout the supply chain, revolving fund of institutions, mark-ups at the various levels, projections for
commodities and financing gaps for the next two years.
Participants who were health experts and development partners of the Ministry of Health (MOH) were expected to discuss the findings of the study, make inputs and forward the draft report to the Minister of Health to be presented at the next Health Summit in the country.
Prof. Abor said the findings indicated that though increased autonomy for the Central Medical Stores (CMS) had been recommended since the early
1990's, no significant progress had been made to implement it.
"It appeared that the decentralisation and the division of labour between the MOH and the Ghana Health Service did not help the enforcement of the flow of consumption and forecasting of data up the system."
He noted that all health facilities with the exception of health centres, are increasingly procuring from the private sector directly because the Procurement Act allowed each facility to constitute an entity tender committee and operate within their thresholds.
Prof. Abor said the Regional Medical Stores, resorted to sourcing up to 90 per cent of their envisaged needs from the open market, adding that the procurement units of the regions, unlike the teaching hospitals were weak as a result of a "one man-unit," sometimes supported by service personnel.
He said it was noticed that there was no well articulated quality assurance system in place for the management of procurement and supplies to ensure health commodity security at all levels and facilities, while faith-based health organisations did not receive any external monitoring and supervision at all.
Prof. Abor said some recommendations made included improvement in human resource capacity, a clear policy on debt collection periods, automation of accounting processes of the medical stores and facilities, as well as the revision of the National Health Insurance Scheme price list to take into consideration the mark-ups that were desirable.
He pointed out that the CMS should be revamped so that it could procure drugs on a larger scale to achieve the benefits of economies of scale, while pursuing a rigorous enforcement of the policy of making pharmacists mandatory signatories of Revolving Drug Fun Accounts at all levels.
Dr Sylvester Anemana, Acting Chief Director, MOH, in a speech read on his behalf, assured stakeholders of the Ministry's commitment to implement the recommendations of the study and said a steering committee had been instituted to supervise the implementation.
He urged participants to provide the needed support by developing very useful and innovative approaches to ensure realistic and implementable
recommendations that would feed into the overall sector development to ensure beneficial health outcomes from an efficient health supply chain
system.