Data collection on supply chains for essential medicines and medical supplies to health facilities and shops was undertaken in four districts in three regions of Tanzania and four districts in three counties in Kenya. In Tanzania, 32 health facilities (public, private, and faith-based), and 10 private pharmacies and drug shops are included in the data sets; in Kenya the total is 34 health facilities and 21 pharmacies and shops. The data sets include quantitative (STATA) and qualitative (NVivo) data, all anonymised. For each organisation (health facility or shop), basic data includes type of facility or shop, locational details, and details of interviewees’ roles and training. For each country, two quantitative data sets give details, for each facility or shop, of availability, source (manufacturer and country of manufacture), wholesaler, and price a set of tracer essential medicines, and a set of tracer essential supplies and equipment. In addition, for each country there is a qualitative data set of interviews with those responsible for procurement, based on semi-structured interview schedules. This project studied the supply chains of essential medicines and medical equipment and supplies from local industries and imports into the health systems in Tanzania and Kenya. Shortages and unaffordability of these commodities are persistent causes of exclusionary and poor quality health care in low income Africa. The hypothesis is that better integration between industrial and health policies could contribute to higher employment, industrial upgrading, and improved health system performance and accessibility. If this is correct, improved industrial production can improve health service performance while raising economic output: in other words, contribute to inclusive growth. The project interviewed heath facilities, shops and wholesalers in all sectors, in urban and rural contexts, about their procurement practices and problems. Mapping of supply chains was followed by discussion and debate with private sector businesses, and with policymakers in health and industrial sectors, on the scope for and potential benefit of more integrated policy making.
Three regions or counties were purposively chosen in each country, including the capital city in Kenya and the commercial capital in Tanzania, plus two other regions/counties. In each country, four districts were then purposively chosen in these regions/counties to represent a range of income and geographical location (rural/semi-urban/urban, and distance from wholesaling centres). In Tanzania, in each district, three wards were purposively sampled, including one in the commercial and administrative centre of the district and two more distant; all but the Dar es Salaam wards were semi-urban or rural in character. In Kenya, areas were selected to represent different socio-economic makeup, density of settlement and income levels within two very divergent districts of Nairobi, and rural and more urbanised areas across a coastal and an inland rural district. In each area of each district, with the cooperation of the district authorities, health facilities were selected across three sectors (public, private and faith-based), plus private pharmacies and drug shops. In Tanzania the data set consists of interviews and data collection in 32 facilities and 10 pharmacies/shops; in Kenya, 34 facilities and 21 pharmacies and shops. Data collection employed four research instruments: (1) consent form with basic data on each facility or shop: location, level of facility (hospital, clinic, health centre, dispensary ) or type of shop (pharmacy, ADDO (Tanzania only), drug shop), details of interviewees; (2) semi-structured interview schedules for those responsible for procurement of medicines and medical supplies concerning sourcing of supplies, process of procurement, experience and challenges, and judgement of locally manufactured vs. imported supplies; (3) and (4) closed questionnaires containing lists of “tracer” essential medicines, medical supplies and equipment, laboratory supplies and other basic supplies, compiled with expert help in each country, to collect details of availability, source (manufacturer and country of origin), wholesaler, and price for each item. The research instruments and lists of tracer items are provided in Documentation in their English language versions.
