Abstract
Procurement of Medical Supplies in public hospitals has for many years faced a myriad of challenges and constrictions that in many cases are detrimental to public health services delivery.
Disintegrated supply chain management is among the challenges in the public health sector. In 2019 Malawi registered 48% overall availability of medicine in public hospitals. On the other hand an average of 52% stock out of medicines was on the higher side therefore this thesis intended to investigate the possible causes with a focus on role of reformed Public Procurement as policy intervention on how effective it has been in improving drug availability Public Health Services in Malawi. For 39 years since independence Malawi had no public procurement legal framework in place to regulate public sector procurement systems. Following the public outcry against poor public services delivery that was believed to have been caused by glaring procurement system inefficiencies and procurement related corruption, the Government responded with a reform in Public Procurement as a policy intervention. The Public Procurement legal framework was in place by 2003. The government intended to improve supply chain management by regulating its functions, which seem to still be relevant factor for improved public service delivery to date. The Malawi National Health Policy (2018) and the Health Sector Strategy Plan II, 2017 – 2022, (HSSP II), continue to seek improvement of supply chain if health service delivery is to improve.
This thesis therefore assessed the impact of “Public Procurement Reform on Public Health Service Delivery.” The assessment focused on critical broad objectives of the reform, which is efficiency and economy. The reform has posted significant positive strides towards public procurement transparency and accountability in public health service. However, following detailed data collection and analysis, the research has exposed deficiencies on procurement economy and efficiency. Deficient areas being lack of procurement professional capacity, noncompliance with key provisions of the law and absence of store management framework in the reform. These dimensions have related impact on availability of medicines in public health services.
These findings directly hinge on policy implication, knowledge contribution to procurement as a field of study and practice and set a parameter for future research studies.