Now a center of excellence for due diligence in delivering medicines and medical supplies, the General Manager NMS,Mr Moses Kamabare shares some of the successes National Medical Stores(NMS) has achieved in the past years.
Setting the path to success had been an uphill task, the agency pitted against enormous challenges. For a long time, delivery of the supplies, under the decentralized arrangements with each district and hospital having its own budget to procure, had been a huge lapse prompting government to reschedule financing of the procurement processes through the center.
The worry was, government didn’t know how the money was being spent. National Medical Stores convinced government to recentralize the financing as a way of government saving on handling fee. Initially, handling fee ranging between shs35 million to shs65 million was used for buying essential medicines and supplies. However, when government recentralized the money at NMS, a measure that mostly affected government health facilities such as the national and regional referral hospitals, general hospitals, and lower health facilities, handling expenses have since reduced by 8 per cent.
Government had realized too that NMS was performing well after the recentralization process and supported it with more funding. Initially in the 2009/10 Financial Year, government had given NMS 70 percent of funding it required. During the following Financial Year, government effected recentralizing all security forces’ hospitals and health facilities.
National Medical Stores also designed the Last Mile Delivery in 2012. This was designed to make sure that medicines are delivered directly to the health centre. The private contractors whom NMS engages in delivering the medicines directly deliver at the door stops of individual government health facility. The agency designed the Last Mile since it had observed that the system of delivering medicines to the District Health Officer, who was then responsible for deliveries at health centers, had its own inefficiencies such as delays; forcing patients to receive medicines late or resorting to buy from private clinics.
The Last Mile innovation was fundamental since it became an experiment for other African countries. National Medical Stores also designed the Delivery Schedule; which is a contract between NMS and all health facilities in the country. The contract is meant to help health facilities understand when to expect medical supplies after making an order. The schedule is also designed with telephone numbers and toll-free lines in case of any challenges and delays in receiving supplies. National Medical Stores is able to share the delivery schedule in all health facilities in the country. Each in charge at a government health facility knows exactly when they have given NMS an order and when they expect NMS to deliver. National Medical Stores has also established eleven regional centres for Customer Care Representatives across the country. These include: Moroto, Mbale, Soroti, Hoima, Gulu, Arua, Kampala, Fort Portal, Mbarara and now Jinja.
In 2012, NMS also took up the delivery of vaccines after realizing that the Ministry of Health that was then handling the programme under UNEPI did not have resources. At the time, Uganda was rated at same level with DRC and South Sudan in immunization. When NMS took over vaccine delivery, vaccination has since moved from 52 percent to 90 percent and currently Uganda and NMS are centres of study on vaccination for the whole world.
To keep pace with the digital era, NMS developed the SmartCare App which enables everybody involved in the chain of delivery to give NMS feedback in time. The app allows a health worker who has received medical supplies to give feedback to NMS if there’s any problem such as delivering short expiry drugs, items not ordered or late delivery. The health worker can log into the system and send complaints to NMS.
Another digital innovation is the Delivery Monitoring Tool(DMT)- an innovation that helps in tracking and informing health workers of medical deliveries from NMS to health facilities. The DMT also informs DHO’s, RDC and each member of parliament of that particular area. The system also gives names and telephone numbers of the health workers who have received the medicines.
After the President realized that there was a lot of theft of government drugs. He ordered to distinguish government drugs from private ones. National Medical Stores created an innovation of embossing the drugs. Today, every medicine that goes to a medical facility has a distinguishing mark of ‘Government of Uganda- Not for Sale’. This means that Ugandans can now distinguish medicines that belong to government and those that do not. Maintaining quality NMS mandate is to maintain the quality of drugs from the time it receives them to the time of delivery. However, after delivery, the mandate is passed on to the health workers.
To maintain quality, NMS has storage facilities with ambient temperature since most medicines are stored at different temperatures. Vaccines are stored in cold rooms and fridges. The quality is maintained until delivery. During transportation, the same temperatures are maintained in trucks. For vaccines, trucks are kept in refrigeration. Our trucks are powered between 2 and 8 degrees centigrade. Some vaccines like Ebola require – 80 degrees centigrade.
Global Alliance for Vaccines and Immunizations (GAVI), World Health Organization (WHO) and UNICEF have certified NMS as the best in vaccine logistics. NMS has since agreed with National Drug Authority to set up its own quality control laboratory to continue carrying out of tests of medicine. Recently, NMS received shs40 billion USAID support for a new Enterprise Resource Planning (ERP) – a computer system which will manage operations of NMS but also link the government body to all facilities in the country.
In the next year, this will be implemented. In the subsequent years, NMS shall connect all referral and general hospitals, health centre IV and II. Currently, NMS depends on manual orders but the new system will link up all hospitals and they can just login and make their orders electronically.