From left to right:Orgenes Lema, Technical Advisor Anne Vestskov, Pharmaceutical Advisor; Ernest Makena, Financial and Administrative Manager; Tasimbora Mbise, Office Manager; Ulla Vaeggemose, Project Manager; Mavere Tukai, Pharmaceutical Advisor

Background

MEMS is a central procurement system and quality assurance for all essential laboratory supplies. It is located in Arusha, Tanzania, and serving church health facilities and other not for profit health facilities primarily from the Northern Zone of Tanzania. At MEMS, laboratory supplies are checked for quality prior to distribution to the health facilities. MEMS also provides laboratory related health learning materials and advise on the utilisation of laboratory supplies. Currently, MEMS therefore aims at ensuring appropriate use of laboratory supplies and that laboratory services contribute to the overall improvement of quality of care.

MEMS Development

Due to problems of availability, quality and pricing on the procurement of drugs and other medical supplies the senior management staff from all church health facilities utilising the laboratory services at MEMS unanimously agreed that MEMS should be expanded to include other medical supplies, especially drugs. The extension of MEMS services as demanded by the church health facilities lead to: "Development of an Innovative Service and Supply System to Improve Access to and Usage of Quality Drugs and Medical Supplies" Look also the diagram of MEMS operations.

Strategies for developing a supplementary medical supply system in Tanzania have been discussed extensively with technical and financial support from Management Sciences for Health (MSH), USA via the SEAM Program, Tanzania. MEMS is being expanded into an innovative supply and service organisation. It is envisaged that MEMS working together with a private wholesaler will serve as a one-stop shop for church and other not-for-profit health facilities for drugs and medical supplies. In addition to supplies, MEMS will also focus on the quality assurance, development of communication systems for rural facilities, regular support supervision and on-site training on rational use of diagnostic services and drugs. For an overview please see our poster on "Using a Prime Vendor Pharmaceutical Supply System for Faith-Based Hospitals"; presented at the SEAM Conference, Dec 2003.

As the initial steps towards MEMS expansion, the following activities have been completed:

• Needs assessment to quantify all requirements of drugs and medical supplies for 11 church hospitals in Northern Zone of Tanzania. To get a glance of the exercise please see our poster on "Establishing an Appropriate Quantification Model for a Prime Vendor System"; presented at the SEAM Conference, Dec 2003.
• Develop and implement a system of pre-qualifying vendors.
• Requests for proposal (RFP) to become a prime vendor to supply the hospitals via MEMS, based on the needs assessment results, have been evaluated.
• A prime vendor has been identified not only based on competitive prices, but also on service level and adherence to MEMS quality assurance (QA) systems, national and international quality and regulatory requirements of drugs, medical supplies and medical devices. A summing up of the process is done in the poster: "Using the Internet to Pre-qualify Prime Vendors"; presented at the SEAM Conference, Dec 2003.
• Carry out communication needs assessment to all participating health facilities. Discussions are on-going to install satellite communication systems at the Church health facilities.

• To review, clarify, process and monitor purchases of the participating health facilities from the prime vendor; to coordinate deliveries of supplies to participating health facilities; to ensure quality and quantities of drugs and medical supplies delivered to participating health facilities meet all requirements; and where the prime vendor is unable to supply products, MEMS will arrange for the prime vendor to purchase similar products at no extra cost from an alternative source. MEMS will investigate and respond to any complaints related to goods supplied by the prime vendor.
• MEMS will provide advise on the most appropriate technology available such as selection of appropriate software, which may be useful for inventory management and contribute to improvement of quality of care of patients.
• Update the key staff from participating health facilities on drug and supply management; provide on-site training and regular support supervision to participating health facilities on quality assurance of medical and drug supplies at facility level, good diagnostic practices, record keeping of diseases and rational use of drugs.