Transformation of the Tanzania medical stores department through global fund support: an impact assessment study

Background The Tanzania government sought support from The Global Fund to Fight AIDs, Tuberculosis and Malaria to reform its Medical Stores Department, with the aim of improving performance. The study sought to assess the impact of the reforms and document the lessons learnt.Methods Quantitative and...

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Main Authors: Patrick Githendu, Linden Morrison, Rosemary Silaa, Sai Pothapregada, Sarah Asiimwe, Rafiu Idris, Tatjana Peterson, Emma Davidson, Abaleng Lesego, Neema Mwale, Sako Mayrick Mwakalobo, Laurean Rugambwa Bwanakunu, Tom Achoki
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e040276.full
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author Patrick Githendu
Linden Morrison
Rosemary Silaa
Sai Pothapregada
Sarah Asiimwe
Rafiu Idris
Tatjana Peterson
Emma Davidson
Abaleng Lesego
Neema Mwale
Sako Mayrick Mwakalobo
Laurean Rugambwa Bwanakunu
Tom Achoki
author_facet Patrick Githendu
Linden Morrison
Rosemary Silaa
Sai Pothapregada
Sarah Asiimwe
Rafiu Idris
Tatjana Peterson
Emma Davidson
Abaleng Lesego
Neema Mwale
Sako Mayrick Mwakalobo
Laurean Rugambwa Bwanakunu
Tom Achoki
author_sort Patrick Githendu
collection DOAJ
description Background The Tanzania government sought support from The Global Fund to Fight AIDs, Tuberculosis and Malaria to reform its Medical Stores Department, with the aim of improving performance. The study sought to assess the impact of the reforms and document the lessons learnt.Methods Quantitative and qualitative research methods were applied to assess the impact of the reforms. The quantitative part entailed a review of operational and financial data covering the period before and after the implementation of the reforms. Interrupted time series analysis was used to determine the change in average availability of essential health commodities at health zones. Qualitative data were collected through 41 key informant interviews. Participants were identified through stakeholder mapping, purposive and snowballing sampling techniques and responses were analysed through thematic content analysis.Results Availability of essential health commodities increased significantly by 12.6% (95% CI 9.6% to 15.6%) after the reforms and continued to increase on a monthly basis by 0.2% (95%CI 0.0% to 0.3%) relative to the preintervention trend. Sales increased by 56.6% while the cost of goods sold increased by 88.6% between 2014/2015 and 2017/2018. Surplus income increased by 56.4% between 2014/2015 and 2017/2018 with reductions in rent and fuel expenditure. There was consensus among study participants that the reforms were instrumental in improving performance of the Medical Stores Department.Conclusion Positive results were realised through the reforms. However, despite the progress, there were risks such as the increasing government receivable that could jeopardise the sustainability of the gains. Therefore, multistakeholder efforts are necessary to make progress and expand public health.
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spelling doaj-art-3de020df548a4a2ab4afe8a6b3e45e232024-11-26T15:25:11ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-040276Transformation of the Tanzania medical stores department through global fund support: an impact assessment studyPatrick Githendu0Linden Morrison1Rosemary Silaa2Sai Pothapregada3Sarah Asiimwe4Rafiu Idris5Tatjana Peterson6Emma Davidson7Abaleng Lesego8Neema Mwale9Sako Mayrick Mwakalobo10Laurean Rugambwa Bwanakunu11Tom Achoki12The Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Genève, SwitzerlandThe Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, SwitzerlandIndependent Consultants, Dar es Salaam, Tanzania, United Republic ofThe Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Genève, SwitzerlandThe Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Genève, SwitzerlandThe Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Genève, SwitzerlandThe Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Genève, SwitzerlandIndependent Consultants, Dar es Salaam, Tanzania, United Republic ofAfrica Institute for Health Policy Foundation, Nairobi, KenyaTanzania Medical Stores Department, Dar es Salaam, Tanzania, United Republic ofTanzania Medical Stores Department, Dar es Salaam, Tanzania, United Republic ofTanzania Medical Stores Department, Dar es Salaam, Tanzania, United Republic ofAfrica Institute for Health Policy, Nairobi, KenyaBackground The Tanzania government sought support from The Global Fund to Fight AIDs, Tuberculosis and Malaria to reform its Medical Stores Department, with the aim of improving performance. The study sought to assess the impact of the reforms and document the lessons learnt.Methods Quantitative and qualitative research methods were applied to assess the impact of the reforms. The quantitative part entailed a review of operational and financial data covering the period before and after the implementation of the reforms. Interrupted time series analysis was used to determine the change in average availability of essential health commodities at health zones. Qualitative data were collected through 41 key informant interviews. Participants were identified through stakeholder mapping, purposive and snowballing sampling techniques and responses were analysed through thematic content analysis.Results Availability of essential health commodities increased significantly by 12.6% (95% CI 9.6% to 15.6%) after the reforms and continued to increase on a monthly basis by 0.2% (95%CI 0.0% to 0.3%) relative to the preintervention trend. Sales increased by 56.6% while the cost of goods sold increased by 88.6% between 2014/2015 and 2017/2018. Surplus income increased by 56.4% between 2014/2015 and 2017/2018 with reductions in rent and fuel expenditure. There was consensus among study participants that the reforms were instrumental in improving performance of the Medical Stores Department.Conclusion Positive results were realised through the reforms. However, despite the progress, there were risks such as the increasing government receivable that could jeopardise the sustainability of the gains. Therefore, multistakeholder efforts are necessary to make progress and expand public health.https://bmjopen.bmj.com/content/10/11/e040276.full
spellingShingle Patrick Githendu
Linden Morrison
Rosemary Silaa
Sai Pothapregada
Sarah Asiimwe
Rafiu Idris
Tatjana Peterson
Emma Davidson
Abaleng Lesego
Neema Mwale
Sako Mayrick Mwakalobo
Laurean Rugambwa Bwanakunu
Tom Achoki
Transformation of the Tanzania medical stores department through global fund support: an impact assessment study
BMJ Open
title Transformation of the Tanzania medical stores department through global fund support: an impact assessment study
title_full Transformation of the Tanzania medical stores department through global fund support: an impact assessment study
title_fullStr Transformation of the Tanzania medical stores department through global fund support: an impact assessment study
title_full_unstemmed Transformation of the Tanzania medical stores department through global fund support: an impact assessment study
title_short Transformation of the Tanzania medical stores department through global fund support: an impact assessment study
title_sort transformation of the tanzania medical stores department through global fund support an impact assessment study
url https://bmjopen.bmj.com/content/10/11/e040276.full
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