Tanzania's Innovative Approach to Medicine Availability: The Jazia Prime Vendor System

Journal article: Wiedenmayer, K., Mbwasi, R., Mfuko, W. et al. Jazia prime vendor system- a public-private partnership to improve medicine availability in Tanzania: from pilot to scale. J of Pharm Policy and Pract 12, 4 (2019). https://doi.org/10.1186/s40545-019-0163-4

Tanzania has taken a creative step towards enhancing the availability of medicines in its public health facilities through the Jazia prime vendor system. This unique public-private partnership has enlisted a private pharmaceutical supplier to serve as the Prime Vendor. The goal? To fill in the gaps and provide essential medicines to health facilities.

The system's pilot run in the Dodoma region was a success, with the availability of key medicines soaring from 69% in 2014 to an impressive 94% by 2018. The procurement process became more straightforward, transparent, and standardized, paving the way for the system to be adopted across all 26 regions of mainland Tanzania.

Before this system was implemented, Tanzania's Medical Stores Department grappled with numerous challenges. Delayed funding, insufficient governance, staff shortages, and operational inefficiencies frequently led to a scarcity of medicines at service delivery points.

The Jazia system changed the game by streamlining procurement and ensuring a steady supply of medicines through transparent and efficient processes. This improvement was largely due to strong political backing, convincing results from the pilot, dedicated leadership at the district and regional levels, and policy discussions informed by the positive outcomes.

The recent supply chain journal club delved into the system's performance.

The article discusses the implementation of a public-private partnership called the Jazia prime vendor system in Tanzania to improve the availability of medicines in public health facilities. The system involves a private sector pharmaceutical supplier acting as the Prime Vendor to provide complementary medicines needed by the facilities. The pilot of the system in the Dodoma region showed increased availability of tracer medicines from 69% in 2014 to 94% in 2018. The procurement procedures were simplified, standardized, and transparent, and the system was rolled out nationally to all 26 regions of mainland Tanzania.

The main challenges faced by the Medical Stores Department in Tanzania included delays in disbursement of funding for health commodities, an inadequate governance framework, management challenges such as shortage of staff and operational inefficiencies, resulting in stock-outs at health service delivery points.

The Jazia prime vendor system improved the availability of medicines in the pilot region by simplifying procurement procedures, ensuring transparent and standardized processes, and providing a reliable supply of complementary medicines through a public-private partnership approach.

The key factors that led to the national roll-out of the Prime Vendor system in Tanzania included strong political will and support, convincing pilot results, sustained leadership by committed district and regional medical officers, and policy dialogue based on evidence of favorable outcomes.

Discussion during the journal club raised the following key points

Are there recent studies that have been done to assess the performance of the prime vendor system before and after?

Club members found there has been a recent article: Pyuza, D., Mitiku, S., Swalehe, O. et al. Performance of Jazia Prime Vendor System in ensuring availability of health commodities in Singida Region, Tanzania: a pre- and post-evaluation study. J of Pharm Policy and Pract 16, 150 (2023). https://doi.org/10.1186/s40545-023-00660-y

This article evaluates the performance of the Jazia Prime Vendor System (Jazia PVS) in improving the availability of health commodities in public health facilities in Singida Region, Tanzania. The study found that the mean availability of health commodities increased by 4.78% after the adoption of Jazia PVS. However, the fulfillment of orders, delivery time, prompt payment, and pharmacist satisfaction with Jazia PVS were found to be suboptimal. The study concludes that prompt payment to Jazia PVS can enhance the performance of the vendor.

Most of the results from the reviewed article were found to be descriptive, which limited the ability to understand the root causes of sub-optimal performance of the prime vendor system. A mixed study may be more appropriate where the authors can also incorporate a qualitative study to gather in depth insights from health facilities and suppliers on the root cause of the sub-optimal performance of the prime vendor system.

Potential future research:

While the results offered valuable insights, they were mainly descriptive and didn't fully unravel the reasons behind some of the system's shortcomings. Future research is suggested to combine both qualitative and quantitative methods. Starting with an in-depth qualitative analysis could shed light on the underlying issues, followed by a comprehensive quantitative approach to understand how various factors affect the system's performance.