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USAID Global Health Supply Chain Program
Consultancy HR Capacity AND governance oversight
Statement of Work
Purpose: Provide Consultancy services for the supply chain on human resource capacity, Governance, oversight and accountability module of the Zanzibar holistic supply chain review
Period of Performance: February and March 2021
Place of Performance: Zanzibar and Virtual/desk work
The Ministry of Health, Social Welfare, Elderly Gender and Children (MOHSWEGC) Zanzibar embarked on the reform process from the beginning of 1990’s and through these reforms; the ministry became fully fledged in the early 2000’s. The Zanzibar health care delivery system has been divided into tertiary, secondary and primary care services; the primary health care services being spread throughout the islands (Pemba and Unguja)s. The primary health care services have been transferred to President’s Office, Regional Administration, and Local Government Special Department (PORALGSD). The distribution allows good access to primary services to 95% of the population living within or less than 5km to the nearest public health facility.
Through the Chief Pharmacist Office (CPO) and the Central Medical Stores (CMS); MOHSWGEC is responsible for procurement of commodities in collaboration with the Procurement Unit. The CMS is responsible to store and distribute commodities to all public health facilities. The health procurement and logistics systems are challenged by limited qualified human resources and issues related to contract management including order processing, delivery and payment terms. All these issues impact the efficiency of the health procurement system hence compromising availability of health commodities.
In November 2013, the MOHSWEGC conducted a strategic review of the national supply chain for health commodities. The review examined broader systems issues affecting the availability of commodities, the performance of the supply chain, and CMS’s ability to fulfill its responsibilities. Supply chain partners and stakeholders proposed interventions in five key areas: financing, policy, and planning; warehousing, inventory management, and distribution; system design and the LMIS; procurement and the private sector; and human resources. The review recommended CMS transformation; and implementation of the recommendations and resulted to CMS achieving a semi-autonomous status.
Some additional and notable benefits of the 2013 review include storage capacity increase, and improved distribution of health commodities. This improved availability and accessibility at all times. The MOHSWGEC has continued to strengthen collaboration between alternative medical practitioners and health institutions in areas of drug monitoring and research. The cold storage system for drugs in Unguja and Pemba was also strengthened. Whilst a lot has been achieved to date, there are still some gaps that require immediate attention as noted below:
The procurement system for health commodities and supplies is still challenged with lengthy procurement processes, poor specifications for some health commodities, inadequate and unpredictable funding for medicines and inadequate infrastructure contributing to shortages of drugs
The increase of demand for health services has led to increase in number of health facilities and hence it is recommended to strengthen security at HFs premises, health commodity monitoring compliance of rational drug use practices by health providers
Recent initiatives such as digitization of the Zanzibar health system, decentralization of the health care services and modernization of logistics system requires RGOZ to also ensure that the public health supply chain system is upgraded to meet the new expectations
Despite the positive development of the overall Zanzibar health supply chain performance, there are still areas to improve. Based on Zanzibar Annual performance review reports of 2015/16; Zanzibar had experienced stock outs of essential commodities. There was an increase in the proportion of facilities experiencing stock out of tracer drugs from 37% in 2013/14 to 68% in 2015/16.
In addition, according to the performance analysis of the Zanzibar Supply chain action plan 2017/2020, factors such as inadequate funding, poor planning and coordination, inadequate tracking mechanisms and tools, as well as inadequate pharmaceutical human resources at the facility level lead to poor availability of health commodities. Capacity at health facilities to use the Integrated Logistics System (ILS) remains inadequate (knowledge, time, supervision). Overall record keeping (inventory control, prescribing, dispensing) is weak which facilitates leakages of supplies to the private sector. Adherence to good storage practices varies.
Therefore, the MOHSWEGC conducts a holistic review of the health supply chain in order to fully address the observed challenges identified in the entire system. In this case the review will assess the current situation, analyse options available to address areas requiring improvement and develop strategies to strengthen the health supply chain. It is expected that the review will lead to improving management of health commodities ensuring 100% stock availability of essential medicines in all primary health facilities in the country.
The purpose of this scope of work is to review the health supply chain governance, human resources capacity, and leadership and oversight mechanisms. This scope also includes identifying the cadres/professionals involved in executing health supply chain activities over the entire supply chain of health commodities in Zanzibar and identifying optimal staffing for each cadre (Pharmacy, Lab and Diagnostics, biomedical engineering, ICT, procurement, etc.). In addition, the task needs to include assessing the existing structures, roles and responsibilities of different actors in supply chain and identifying how different actors are aligned when it comes to executing supply chain activities, e.g., how does the financing entities contribute in strengthening service delivery. The review must identify HR resources available, capacity gaps and identify key actors who contribute to strengthening HR for supply chain. In addition, the review needs to focus on key contributors to success of the current skills and knowledge. Recommendations of the optimal requirement of human resource at all levels should be presented to the ZHSCR taskforce and the oversight Committee.
Specific tasks to be performed
In collaboration with a team of supply chain experts, the consultant is expected to focus on HR capacity, oversight, governance and accountability of the health supply chain in Zanzibar. The consultant is tasked to identify bottlenecks and enablers to improving HR capacity, oversight and governance in supply chain. Key areas of focus will include literature review, data collection, data cleaning and analysis and report preparation and dissemination. The tasks include:
A. Key areas with HR capacity focus;
B. Key areas focusing on supply chain oversight, governance and accountability;
5. From the information gathered, propose different scenarios and options. Options proposed can be analyzed and based on the cost benefit analysis discuss the appropriate modifications to the current systems or propose new policies and their advantages
6. Summarize the results of the analyzed options in a formal report.
7. Discuss the results with the task force or other identified authorities.
8. Finalize and submit the final formal report to the taskforce and identified authorities.
5. Qualifications and attributes required:
Applicant for this consultancy should be Tanzanian national or lawful resident/institution who possesses following minimum qualifications and can provide documentation supporting capabilities and experience:
1. Demonstrated technical capabilities.
2. Demonstrated consultancy services.
Proposal Submission and Timelines
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