Public pharmaceuticals procurement practice and efficency in ethiopia in accordance with the federal public procurement guidelines

Abstract

Worldwide, public procurement (PP) has become an issue of public attention and debate, and has been subjected to reforms, restructuring, rules and regulations. As the demand for medicines and health supplies reflect changes in population health and environmental conditions, so flexibility and responsiveness in procurement practices to aspirations, expectations and needs of the target society is needed. Objective: The aim of this study was to assess the public procurement practice and efficiency of Pharmaceuticals Fund and Supply Agency (PFSA) in accordance with PP guidelines. Materials and methods: A cross sectional study design with both quantitative and qualitative research methods was used. Structured self administered questionnaire, document review using observational checklist and in-depth interview were used for data collection. Sixty one workers in PFSA and Public Procurement Agency (PPA) who are directly involved in public procurement practices and regulations were selected for quantitative study and 8 top and mid level managers in both agencies were involved in the qualitative in depth interview. Document review was done on 30% of one year procurement documents at PFSA. Data were analyzed using SPSS version 21.0. For prediction analysis, the study used logistic regression and odds ratio (OR) with 95% confidence interval (CI). Qualitative data were analyzed based on thematic content analysis. Results: The odds of pharmaceutical procurement efficiency was 16.9 times more likely for high financial thresholds than low financial thresholds AOR (95% CI) =16.9, (CI=3.3, 86.8). Considering nature of pharmaceuticals by the regulation showed 6 times more likely to bring efficient pharmaceutical procurement practices as compared with not considering their nature AOR (95% CI) =6, (CI=1.2, 31) but approved procurement methods didn’t have significant association with procurement efficiency. Conclusion and Recommendation: Low financial thresholds and lack of considerations for pharmaceuticals nature in the PPA guidelines were independent predictors for public pharmaceuticals procurement efficiency. A comprehensive and sector-specific procurement manual having different threshold matrix should be introduced and updated regularly.