Evaluation of the Zimbabwe assisted pull system: endline report

The ZAPS, which was piloted in Manicaland province, consolidates management of four existing health commodity distribution systems for the primary healthcare facility level: Delivery Team Topping Up (DTTU); Zimbabwe Informed Push/Primary Health Care Package (ZIP/PHCP); Zimbabwe ARV Distribution System (ZADS); and Essential Medicines Pull System (EMPS). For the hospital level, the ZAPS consolidates the DTTU ZIP/PHCP, while the ZADS and EMPS continue operating as separate systems. The evaluation compared the performance and costs of the ZAPS with these existing distribution systems. The ZAPS pilot maintained supply chain performance and did so at a lower overall cost and more efficiently compared to the four existing supply chain systems. With other factors, such as per-province start­up costs, the comparative sustainability of the ZAPS model, and how ZAPS is financed relative to the existing supply chain model, decisionmakers can use the results of the evaluation to make an informed decision on how to move forward with implementing ZAPS elsewhere in Zimbabwe. (Author abstract)