The Question of Quality Ordering of Health Commodities in Tanga Region, IMPACT Approach Becomes Relevant Driver to the Answers
Japhet Simeo,
Eddom Silabi,
Deusdedith James,
Said Ally,
Imakulata Mwalulefu,
Martha Kikwale,
Mathew Mganga,
Ondo Baraka,
Athanas Ntaganyamba,
Winyfrida Emmanuel,
Abdallah Mushi,
Feisal Said,
Ali Msoud,
Daud Msasi,
Ntuli Kapologwe,
Ally Hamza,
Blandina Temba
Issue:
Volume 8, Issue 2, June 2023
Pages:
28-34
Received:
28 March 2023
Accepted:
21 April 2023
Published:
10 May 2023
Abstract: The effective delivery of integrated health services depends on the extent to which the six pillars of a health system as recommended by WHO are adhered to such as adequate human resources for health, service delivery, financing, health system governance, information, quality medicines and technologies. However, to improve supply chain management leading to uninterrupted supply of medicines and other health commodities, the use of data to inform all parts of the health supply chain logistics system, that include product selection, forecasting, quantification, procurement, storage and finally distribution of health commodities, is very important. Previously, Tanga Region had been facing a number of health supply chain issues such as delays in reportingfrom health facilities, a high number of orders for overstocked and no-demand health commodities, unnecessary higher expenditure on health commodities and a high rejection rate for the same R&R rejection reasons. Soon after the introduction of the IMPACT approach in the region, the IMPACT team at the regional level adopted some innovative data-driven strategies at its regular meetingssuch as regular data extraction and analysis to review indicators, monitoring timeliness of reporting as well as data quality, monitoring stock orders to avoid expiry dates, and sharing feedback with councils to take action to address identified gaps. These efforts resulted into decrease in the values of reordered overstocked and not in demand health commodities, massive improvement in terms of reporting timeliness from 76% in January 2022 to 99% in January 2023 and slight increase in the availability of essential health commodities. This study found that improving reporting timeliness and supply chain data quality is a cornerstone towards uninterrupted supply of health commodities and reduced health commodities wastages. Since IMPACT Team techniques has been vital in the identified supply chain improvements then it is an approach that can be applied to improve other supply chain indicators and reduce wastages. Despite the marginal improvement in the availability of health commodities, this study recommends the use of facility formulary-based approach in the calculation of health commodities availability to increase the validity of the results.
Abstract: The effective delivery of integrated health services depends on the extent to which the six pillars of a health system as recommended by WHO are adhered to such as adequate human resources for health, service delivery, financing, health system governance, information, quality medicines and technologies. However, to improve supply chain management l...
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Leadership and Governance Effect in Implementing the IMPACT Approach: A Retrospective Observational Study in Simiyu Region
Boniphace Richard,
Oscar Tenganamba,
Chacha Magige,
Godfrey Justine,
Mathew Mganga,
Eddom Silabi,
Martha Kikwale,
Ondo Baraka,
Iddrissa Hassan,
Abdi Abdallah,
Winfrida Emmanuel,
Athanas Ntaganyamba
Issue:
Volume 8, Issue 2, June 2023
Pages:
35-43
Received:
20 April 2023
Accepted:
16 May 2023
Published:
31 May 2023
Abstract: The Government of Tanzania in collaboration with USAID Global Health Supply Chain-Technical Assistance-Tanzania (USAID GHSC-TA -TZ), JSI-InSupply Health and United Nations Population Fund (UNFPA) rolled out the IMPACT approach in Simiyu Region in 2019. For the purpose of improve data management and visibility of vertical health commodities supply chain system. The objective of this study was to highlight leadership engagement in implementation of IMPACT Approach to improve reporting rates for vertical health commodities. Since introduction of this approach indicators monitored were not improving; the region facilitated the response performance monitoring processes, through IMPACT approach integrating with performance Scorecard as a visual performance tool for some of the indicators, including the process indicators, and used feedback meetings attended by senior leaders in the region to discuss indicator results and identify areas for improvement for councils. The results of this study revealed that, engagement of leaders in decision making influenced positively the IMPACT meetings conducted by teams whereby supply chain challenges including reporting rates discussed. At a Councils level the meetings conducted as per calendar increased from 6.1% April-June 2021 to 84.9% October- December 2022. Moreover, reporting rate of four (4) vertical health commodities which include (Malaria, HIV/AIDS, TB/L and RMNCAH) demonstrated positive increase from 60.5% January 2021 to 84.7 December 2022, and availability of all four vertical health commodities increased from 85% January 2022 to 93% December 2022. The availability of these commodities resulted into improved service delivery at health facility level. The study was a retrospective observation of the implementation of the IMPACT team approach in Simiyu region. It assessed the availability of vertical health commodities as a function of the number of items reported, data used for computation of reporting rate, availability of health commodities and improved service delivery were retrieved from eLMIS and DHIS2. Action and performance improvement plans were developed and tracked using scorecards to ensure that each planned activity is implemented accordingly and the desired supply chain outcomes are achieved. This was followed by convening leadership engagement forums where underperforming councils had to explain and articulate the reasons for their unsatisfactory performance and eventually commit to improving the required indicators. The study concluded that, good governance and leadership engagement played a major role in implementation of IMPACT Approach and achieve the raised outcomes of availability of vertical health commodities, reporting rates for vertical health commodities and improved service delivery.
Abstract: The Government of Tanzania in collaboration with USAID Global Health Supply Chain-Technical Assistance-Tanzania (USAID GHSC-TA -TZ), JSI-InSupply Health and United Nations Population Fund (UNFPA) rolled out the IMPACT approach in Simiyu Region in 2019. For the purpose of improve data management and visibility of vertical health commodities supply c...
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Health Insurance Coverage and Its Socioeconomic and Demographic Determinants in Cameroon
Zakariaou Njoumemi,
Altiné Fadimatou,
Samuel Honore Ntavoua,
Ousseni Mongbet,
Rahimatou Manouore
Issue:
Volume 8, Issue 2, June 2023
Pages:
44-56
Received:
1 June 2023
Accepted:
25 June 2023
Published:
6 July 2023
Abstract: Health insurance coverage is a public health issue for global and national health financing in Africa where countries have gradually begun to implement universal health coverage. This study analyses the socioeconomic and demographic determinants of health insurance coverage in Cameroon using a cross-sectional study design. A nationwide stratified, two-stage sampling was used to sample 33,983 individuals. A logistic regression model was used for both bivariate and multivariate analysis with a statistically significant level of p<0.05. The participants were predominantly male (77%) with a sex ratio of 3.3. The health insurance coverage rate was only 2.06% of people. Urban residents were significantly more likely to be covered (1.54%) compared to rural residents (0.51%; p<0.00). Men (1.52%) were significantly more covered than women (0.54%; p<0.04) and both sexes were cumulatively split between employer health insurance (54.94%), social security (22%), mutual health insurance (12.2%), private commercial insurance (10%) and help/relief from associations/family (0.87%). Working age influences insurance coverage with statistically significant differences among age groups (0.15%, 0.67%, and 1.23%, p<0.00). A high level of education significantly increases insurance coverage with 82.5% of secondary and tertiary education compared to 17.5% for primary and no education (p<0.00). The economic well-being quintile scale influences the susceptibility to health insurance coverage with 76.4% of the rich and/or richer, compared to 13.6% of the middle class, 10% of the poor, and none of the poorest (p<0.00). Compared to the rich, the poorest were 78%, the poor 75%, and the middle class 67%, less likely to be covered by any type of health insurance (p<0.01). Employability positively influences health insurance coverage with statistically significant differences between annual full-time workers (77.6%), seasonal workers (13.6%), and casual workers (8.8%, p<0.00). These findings provided evidence to guide policies for improving equity in financing universal health coverage for people living in low-resource settings.
Abstract: Health insurance coverage is a public health issue for global and national health financing in Africa where countries have gradually begun to implement universal health coverage. This study analyses the socioeconomic and demographic determinants of health insurance coverage in Cameroon using a cross-sectional study design. A nationwide stratified, ...
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