Evaluation of the integration of health supply chain management in Rwanda

Abstract

Introduction: Well-functioning supply chain ensures quality healthcare system through continuous availability of affordable, high-quality medicines, vaccines and health products at all health service delivery points. The integrated supply chain system ensures the optimization in delivering products from the point where they are manufactured to the end user in a cost-effective way. In order to accommodate with challenging customer requirements and product proliferation, Rwanda Ministry of Health has redesigned the integration of health supply chain to profitably deal with market complexity and ultimately meet better customer service. The aim of the research was to evaluate the integration of public health supply chain management in Rwanda. We therefore assess the followings: 1) availability of strategic and governance documents; 2) the process of integrated quantification of public health commodities; 3) the processes of procurement; 4) warehouse and distribution and 5) Logistic Management Information System. Method: A descriptive research design study using qualitative and quantitative data. This design was found suitable, as it enabled the collection of intended data for the study. This study used purposive sampling techniques and used the questionnaire for data collection. Collected data have been manipulated and analyzed by MS excel. Results: Findings from this study revealed that Rwanda National Pharmacy Policy, Standard Treatment Guidelines and National Formulary List and National Pharmaceutical Strategic Plan are the strategic and governance documents that guide the integrated health supply chain system in Rwanda. The process of forecasting and supply planning of public health commodities is well coordinated and integrate all product categories of HIV, Malaria, TB, FP, MCCH, Nutrition and Essential medicines. For forecasting methods, 100% of the respondents confirmed the use morbidity and consumption-based methods while 70% confirmed the use of demographic based method and 60 % the use Service statistic based method. The forecast accuracy of the tracer commodities from all program related product categories has shown that 7 selected health commodities have the forecast accuracy above 85% while one health product has a forecast accuracy of 36.83%. The procurement of health products integrates all health product categories and are procured by MPPD and other implementing partners. 100% of health products from different sources are stored in central medical store/MPPD. LMIS system is integrated to ensure end to end data visibility across all levels of supply chain system. Conclusion: From the results of the study, Rwanda Ministry of Health has adopted the integration of health supply chain management. However, fully integration requires further improvement especially for the procurement process and the integration of vaccines.