Devolution versus centralization of various logistic functions of Ethiopian pharmaceutical supply Agency; Qualitative study
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Date
2020-06
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Addis Abeba University
Abstract
Background: The logistic system in most developing countries including Ethiopia is centralized
where the central government has excessive responsibility over various logistic functions such as
planning/budgeting, forecasting, procurement, warehousing and distribution of essential
medicines and medical supplies. However, these countries are suffering from poor stock
availability of essential medicines at service delivery point, shortage of storage space and high
work load in their central warehouses.
Objective: The aim of the study is to explore perception of pharmaceutical supply chain
professionals on devolution versus centralization of various logistic functions of Ethiopian
Pharmaceutical Supply Agency (EPSA).
Method: Qualitative study design was employed. Two cluster offices of EPSA such as Adama
and Northern cluster offices including the head office along with their respective regional health
bureaus and Ministry of health were purposively selected. Accordingly key informants who have
high expertise on pharmaceutical logistic system were selected from designated study sites. The
key informant interview was conducted using tape recorder by federal working language
(Amharic). Finally, the data was analyzed manually using thematic analysis.
Result: Ethiopian public pharmaceutical supply system has raised lots of complaints particularly
over revolving drug fund (RDF) supply. Availability of RDF drugs was highly affected by
centralization of the pharmaceutical supply system. Budgeting, direct receiving and
warehousing, inventory control system were among logistic functions which were chosen to have
low degree of centralization, while procurement was preferred to have high degree of
centralization particularly for small and expensive items.
Conclusion and recommendation: Serving pharmaceutical demand of over hundred million
populations through the current system particularly for RDF products was perceived as difficult.
Hence, either empowering cluster offices to exercise within central guidance of head office or
devolution of central EPSA to autonomous regional offices was demanded.
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Keywords
Devolution, Decentralization, Pharmaceutical supply system.