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Strengthening the procurement and supply chain for health in Zimbabwe

UNDP has worked with partners to strengthen the national Procurement and supply chain management (PSM) System in Zimbabwe, for the complete PSM cycle.

This has included; i) carrying out a comprehensive assessment of the Pharmaceutical Supply Chain System in 2013 and using the findings to develop a costed action plan; ii) working with the Ministry of Health and Child Care (MoHCC), the Country Coordination Mechanism (CCM) and key partners to mobilize funding to implement the costed action plan; iii) working with the Ministry of Health and Child Care (MOHCC) and partners in developing strong quantification processes for health products; iv) strengthening quality assurance of health products by the Medicines Control Authority of Zimbabwe (MCAZ); iii) working with the National Pharmaceutical Company (NatPharm)—the central medical store—to develop their capacity since 2011; v) carrying out a comprehensive assessment of the laboratory supply chain system in 2016 and developing a costed action plan for implementation during 2018-2020; and vi) developing a viral load reagent rental agreement for HIV viral load testing. This has all led to increased access to essential medicines and other health products beyond malaria, HIV and tuberculosis.

The capacity of both NatPharm and MOHCC to store and distribute essential medicines has been developed through:
  • the renovation and building of new NatPharm storage warehouses in key provinces
  • the renovation or construction of new pharmacy stores to improve storage conditions at the MoHCC service delivery points
  • the provision, installation and training end-users on two pharmaceutical grade incinerators for waste disposal
  • developing national waste management plan and SOPs
  • working with MOHCC and other partners to have ELMIS to ensure supply chain real time data visibility
  • improvements to cold chain storage and distribution systems through provision of cold room compressors in the central warehouse, refrigerated trucks and data loggers
  • provision of new trucks to NatPharm to support the distribution of health products to health facilities
  • equipment of health facilities with solar power systems ensuring sustainable sources of electricity for cold chain and controlled temperature to store vaccines, medicines and diagnostic tests, and to provide back-up power to the electronic health information system at the health facility level
  • provision and maintenance of laboratory equipment

The infrastructural support has been complemented by work to improve warehouse processes and develop standard operating procedures. UNDP, together with other health partners, is supporting Zimbabwe Assisted Push System (ZAPS). The assisted pull system standardizes systems for primary health care (PHC) facilities in terms of ordering and receiving the products. The ZAPS support makes essential medicines more evenly available to facilities and hospitals. The ordering team leaders from the district travel to each health facility to: agree to the ordering interval; support the counting of all stock; record losses and adjustments; record days out of stock; calculate quantities required for each product; and place orders with NatPharm. The completed orders for all health facilities in the catchment area are sent to the nearest NatPharm branch for processing and subsequent delivery of orders to individual facilities.

Staff from NatPharm and MoHCC have engaged in online postgraduate PSM training, leading to international qualifications. In addition, staff from NatPharm the and MoHCC have completed training and assessment to obtain accreditation from the Chartered Institute of Purchasing and Supply (CIPS).

UNDP has also worked with the Medicines Control Authority of Zimbabwe (MCAZ) since 2010 to develop capacity to provide quality assurance of all health products being procured. Through Global Fund financial support, UNDP, with partners, has supported the MCAZ to improve the infrastructure, equip and develop the capacity of their chemistry laboratory, which obtained WHO prequalification in 2014. The MCAZ is in the process of obtaining WHO prequalification for their microbiology laboratory. The MCAZ is now acting as a quality control laboratory for nationally procured and distributed medicines, and also for other countries in the region, which do not have a WHO-prequalified laboratory. The pharmacovigilance system has also been upgraded for the reporting of adverse drug reaction (ADR), from paper-based to electronic-based system (e-ADR) through international technical assistance in 2017. UNDP has a long-term agreement with MCAZ to support the quality control of medicines for other countries where UNDP provides support.

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