E-drug: Church based drug supply systems
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I have just posted on the web at
http://dcc2.bumc.bu.edu/richardl/ih820/Resource_materials/
MEDS_JMS/Default.htm
a report titled Drug Supply Systems of Missionary Organizations
Identifying Factors Affecting Expansion and Efficiency:
Case Studies from Uganda and Kenya. The report was prepared
for WHO/EDM by Eriko Kawasaki, MPH. and John P. Patten, MA,
RD. from Boston University School of Public Health
I would encourage E-Druggers to look at this report as it documents
The efficiency of these two organizations and offers them as an
alternative distribution system for Essential Drugs
The executive summary reads:
In many developing countries, difficulties that governments face in
drug supply systems have been addressed by many researchers.
However, there are few detailed studies regarding efficient
management of drug supply systems by mission organizations,
despite their large contribution in many cases to the health care
systems of developing countries. Existing literature has pointed out
that efficiency of mission organizations and their high service quality
are due to a high dependence on foreign donors. In fact, there are
some mission drug supply systems that have become self-
sustainable and have expanded their drug supply capacity to the
5public and private sectors.
In order to identify the key factors for success and obstacles facing
mission run drug store systems, this work is a detailed qualitative
and quantitative study on the drug management systems of the
Mission for Essential Drugs and Supplies (MEDS) in Kenya and the
Joint Medical Store (JMS) in Uganda. The methods of this study,
using in-depth interviews and analysis of data given by the
organizations, have produced a comprehensive overview of both
organizations, and have drawn lessons regarding sustainability and
expansion.
Both MEDS and JMS have grown progressively over the past five
years. MEDS is now a self-sustaining organization, as is JMS,
however two key management positions at JMS are supported by
outside donor funding. MEDS procures mostly from local suppliers,
while JMS relies to a larger degree on international procurement.
MEDS is invested heavily in in-house Quality Assurance and
training for staff and customers, and works closely with the
Ecumenical Pharmaceutical Network (EPN) in training of pharmacy
Assistants to address the shortage of pharmaceutical personnel in
the region. In addition, their efficient managements reflect their low
operational expenditures; with both organizations spending about
10% of the total expenditure on operational costs. About 60% of
these operational cost are allocated for staffing costs.
While both organizations exist in similar environments (with distinct
differences), MEDS provides a smaller number of items (508) while
JMS has 1408 items on their stock list. MEDS provides training for
their clients while JMS has recently emphasized equipment supply
and support. JMS caters predominantly to NGOs, which comprise
70% of their current clientele. Mission units are 30% of their current
customer base. The customer base at MEDS is exactly the
opposite, with 70% of customers mission units and 30% NGOs.
JMS uses a cash and carry system, while MEDS extends credit and
provides delivery services.
The prices charged by the two organizations are very competitive
internationally. For a "basket" of indicator drugs MEDS was 1%
above the MSH Drug Price indicator guide prices. For the same
basket JMS was 13.3% above the same index. MEDS procures
almost entirely (95%) through local suppliers and local agents. JMS
on the other hand procures 50% directly from international suppliers
with the remainder coming from African suppliers or agents. Stock
availability in both organizations is good with rates of about 90%
availability.
JMS and MEDS uses different approaches because of the different
economic environments, however the most important point is that
both organizations maintain high staff motivation levels, and provide
a reliable drug supply systems for their customers. Both
organizations voice a strong commitment to serving the poor in their
respective countries, and achieve this goal through efficiency and
maintaining their purpose. Both organizations are beginning to
supply significant amounts of products to organizations in
neighbouring countries.
MEDS and JMS are vibrant, self-sustaining organizations, which
fulfil a need within their two countries. Governments might consider
exploring areas for linkages and utilizing drug supply infrastructures
of mission organizations. In other Central African countries, support
for similar organizations is worth exploring. Direct support from
international donors in training and computerized operating systems
can contribute to self-sustainability of other mission organizations.
Richard Laing
Associate Professor of International Health
Boston University School of Public Health
715 Albany St, T4W, Boston MA 02118 USA
Tel 617 414-1444 Fax 617 638-4476
E-mail richardl@bu.edu
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