In late 2010, theft of health commodities funded by health partners was discovered at the former Malawi Central Medical Stores (CMS). This angered health partners and they consequently pulled out of the CMS and established secure parallel supply chains (PSCs). This incidence, together with the reform measures already started, accelerated the establishment of the Central Medical Stores Trust (CMST), which was incorporated as a trust in August 2011. A Board of Trustees was established to provide oversight on CMST performance. In late 2012, a Joint Strategy for Integration of PSCs in Malawi was inaugurated. The Strategy outlined 36 preconditions (benchmarks) in four phases that the CMST must achieve prior to health partners’ reconsidering integration of the PSCs in the country. CMST has been implementing the Joint Strategy benchmarks since 2013. In late 2015, CMST claimed to have achieved most of the benchmarks. This claim triggered the first independent assessment of the benchmarks conducted in February 2016. The assessment established that CMST had an overall achievement of 66 percent; classified as “work in progress.” In October 2017, a reassessment of the benchmarks was conducted. Cumulatively, CMST achieved an overall score of 85 percent; a score considered indicative of CMST readiness to take up supply chain tasks currently being undertaken by PSCs. Importantly, this would require support from stakeholders to work on and achieve the remaining benchmarks as well to sustain what has been gained in the last five years of implementation of the 2012 Joint Integration Strategy. Consequent to these results and considering that to some extent integration of PSCs had already started (see main report), the current assessment key recommendations include: (1) PSC stakeholders should consider (a) engaging the CMST to initiate the process for the preparation of a costed phased integration road map with realistic timelines; (b) long-term technical assistance to CMST, importantly, to support CMST to improve inventory management and stock accuracy; and (c) joint management and close oversight arrangement of CMST; and (2) CMST should review, prioritize, and implement recommendations of the two assessments by embedding them either in their corporate strategy or in integration road map/plans to be prepared jointly with stakeholders.
Implementation of the 2012 Joint Strategy for Supply Chain Integration in Malawi—Second Evaluation Report