Abstract:
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.
