A study of the Ministry of Public Health’s procurement system by United States Agency for International Development (USAID) specialists has determined that it is at the second level of maturity in a five-tier system.

This was revealed at a press conference yesterday by Permanent Secretary of the Ministry Collette Adams.

The five-tier supply chain maturity system ranges from the Canvas level, which is the lowest, to Bronze, then Silver, then Gold and then Accredited.

The Ministry has experienced a series of procurement problems including fraud, leaking of information to bidders and breach of procurement regulations. These problems forced several changes in how the ministry has addressed procurement. On top of all of this there have been numerous reports of shortages of essential drugs at various points over the last four years.

Adams said that attaining the Bronze supply chain maturity level is an important achievement that signals that the supply chain improvement journey is underway.

“To achieve Bronze, the country has trained staff, implemented processes and has some level of functional technology. This has to be applauded, as the most difficult step to make is the first from Canvas to Bronze,” she said.

Adams noted that now the country is in a position to move from the Bronze level to Silver by implementing a systematic and structured improvement programme since Silver builds on Bronze with advanced staff qualifications, introduction of Standard Operating Procedures (SOPs) and improved technology.

“The Supply Chain Maturity Model generated a portfolio of 53 improvement activities which are required to attain the next level. However, each country has its own and sometimes individual and unique challenges, which also require attention,” she said, while adding that part of their attention will focus on continuing to improve the skillset of their procurement staff.

She also said that this year they have planned additional training by the USAID experts in a number of areas, including drafting of the SOPs, implementing a Procurement Tracking Systems Software and taking steps to improve the synergy between the Procurement Unit and the Materials Management Unit (MMU) to improve its collection and distribution cycles of drugs, pharmaceuticals and medical supplies.

Also present at the press conference was USAID Country Director Caroline Healey and the Managing Director of Optimised Operations Martin Ellis.

Ellis, who conducted the 12-day assessment, explained that he looked holistically across the supply chain as it relates to data gathering, forecasting of procurement as well as the processes and technologies used in warehousing, not only centrally but also at the regional level and all the way down to the health facilities.

He said that the assessment considered three mentions – people aspect and organisation, processes and policies, and technology and infrastructure.

“So if you think of that, there were 27 boxes all together and nine stages along with those three dimensions. Then we marked each one to see where we thought they were in the [tier-system] and overall it was a strong Bronze, with some scatterings of Silver. We want to lift all of those boxes up to that silver level and to do that there will be a mixture of nine projects,” Ellis said.

He pointed out that those projects will range from inventory control and process and technology within the span of the entire supply chain, among others.

When questioned on whether an increase in level will result in the phasing out of procurement issues, out of stock items and even surplus issues, Ellis noted that even countries that have attained the highest level – Accredited – have issues from time to time and while progress will not eradicate issues, it will reduce their prevalence. “Bronze is good… You should applaud yourself that you’ve got to that level,” he said.

On further questioning about the cost for implementing the changes, Ellis noted that it is currently being “discussed and defined” but they have a structured and definitive plan of action.

In May 2017, the ministry had announced that an audit of the procurement process in the health sector was being funded and led by the Pan-American Health Organization/ World Health Organization.

The audit followed complaints about the quality of drugs being sourced and allegations of orchestrated shortages of both drugs and medical supplies in the government-run sector.