Health System Lessons From the Global Fund-Supported Procurement and Supply Chain Investments in Zimbabwe: A Mixed Methods Study

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), together with its Zimbabwean national and international stakeholders, has continued to invest in health system strengthening to improve public health in the country. These investments have been guided by system-wide strategic assessments to understand the fundamental challenge facing the Zimbabwean health system.

In a new journal article published in BMC Health Services Research, Lawrence Were and co-authors assessed the overall effects of the Global Fund-supported investment in the Zimbabwean national procurement and supply chain management (PSCM) system and documented the lessons learned to inform future programming efforts to strengthen healthcare systems. 

Key findings:

• Approximately 90 percent of public health facilities were covered by the procurement and distribution system. 
• Timeliness of order fulfillment (within 90 days) at the facility level improved from an average of 42 percent to over 90 percent within the four year implementation period. 
• Stockout rates for HIV drugs and test kits declined by 14 percent and 49 percent, respectively. 
• Population coverage for HIV treatment for both adults and children remained consistently high despite the increasing prevalence of people living with HIV. 
• The value of expired commodities was reduced by 93 percent over the four year period. 
• The majority of the system stakeholders interviewed agreed that support from the Global Fund was instrumental in improving the country’s procurement and supply chain capacity. Key areas include improved infrastructure and equipment, data and information systems, health workforce and financing. 
• Many of the participants also cited the Global Fund-supported warehouse optimization as critical to improving inventory management practices.

In conclusion, the authors argue that it is imperative for governments and donors keen to strengthen health systems to pay close attention to the procurement and distribution of medicines and health commodities. There is a need to collaborate through joint planning and implementation to optimize the available resources. Organizational autonomy and sharing of best practices in management while strengthening accountability systems are fundamentally important in the efforts to build institutional capacity.