As more countries embark on health sector reform (HSR) efforts, decentralization is a common approach to moving decision-making to lower levels in health systems. Often, it includes decentralizing logistics systems for health services, opposing the commercial sector logistics approach of centralizing logistics functions to improve effectiveness, efficiency and customer service.
We base this discussion on a study of implications of HSR for contraceptive logistics conducted in Ghana, Kenya, Tanzania and Zambia, where decentralization has either begun or is planned. Conclusions are pertinent to policy makers in developing countries as well as public health professionals advising ministries of health (MOHs) on issues relating to reproductive health and HSR.
We focus this analysis on our data relating to decentralization and examine the functioning of health logistics systems in the countries where decentralization was a major focus of HSR efforts: Ghana and Zambia. We pay special attention to issues surrounding the availability of full-supply items such as contraceptives and condoms for HIV prevention.
Decentralizing specific logistics functions, such as procurement and management of information systems and human resources does not tend to result in good performance in decentralized logistics systems; they are most efficient if handled centrally. District managers in decentralized systems face difficult decisions for financing full-supply items, for example.
Public health logistics systems can improve customer service and logistics efficiency and effectiveness by adopting commercial logistics systems practices, particularly if accompanied by comprehensive planning for decentralized logistics functions. Centralizing some logistics functions might improve availability of critical items for primary health.
See deliver.jsi.comLearning Objectives: At the conclusion of this session, participants will be able to discuss reasons for centralizing some logistics functions for health supplies needed in full-supply (those needed to meet demand) within decentralized health systems.
Keywords: Health Reform, Policy/Policy Development
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
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