Technical Assistance for Organizing a National Medicine Supply System in the Dominican Republic

Agency for International Development (USAID) and Management Sciences for Health (MSH). The system was designed to address supply management problems, including stock-outs, expired products, and high procurement prices. A study conducted by MSH identified critical problems in supply management, including fragmentation in purchasing, lack of a systematic programming and distribution process, and poor storage and transportation conditions. The MSP authorities supported the proposal to organize an integrated system, which would be managed around the following principles: strengthening of a national unit for medicine management (UNGM), concentration of public procurement in PROMESE/CAL, integration of inventories and distribution systems, and improvement of storage and transportation conditions. The Minister of Health signed the Ministerial Resolution supporting the creation of SUGEMI on July 27, 2010. To implement SUGEMI, the UNGM required legal support to enable decentralized entities and specific units within the MSP central offices to take on new functions. The UNGM had only three recently appointed technicians in 2008, and the unit lacked an explicit definition of its structure and functions. As part of the technical assistance provided by USAID, MSH/SPS drew up an institutional development plan that called for hiring additional staff and an organizational structure that would reflect the operation of SUGEMI within the framework of health sector reform. The UNGM technical team supported the organization of nine Regional Units for Medicine Management (URGMs) and included their operation and strengthening in the management agreements signed by the various SRSs with the MSP. In 2010, MSH/SPS provided support for developing operating procedures for all components of SUGEMI, which involved a review of the country's laws and regulations and validation in working sessions with technicians from various MSP and SRS units. The development of SUGEMI involved the creation of a national unit for medicine management, which would be responsible for ensuring the appropriate selection and use of medicines and carrying out periodic exercises for planning purchases and distributions throughout the entire health network. The system also involved the concentration of public procurement in PROMESE/CAL, which would act as the sole manager of purchases of medicines and health supplies for the entire public health system. The implementation of SUGEMI required the strengthening of the national and regional team responsible for implementation, which involved hiring additional staff and providing training to existing staff. The team was technically and administratively responsible for the sequential implementation of the various components of SUGEMI. The development of SUGEMI also involved the creation of operating procedures to govern system operation, which were completed by December 2010. The implementation of SUGEMI has resulted in improved supply management, including reduced stock-outs and expired products, and improved storage and transportation conditions. The system has also improved the efficiency of public procurement, with PROMESE/CAL acting as the sole manager of purchases of medicines and health supplies for the entire public health system. The development of SUGEMI has also involved the creation of a national unit for medicine management, which is responsible for ensuring the appropriate selection and use of medicines and carrying out periodic exercises for planning purchases and distributions throughout the entire health network.