Context
Establishing stable health care in the Democratic Republic of the Congo is a huge challenge. Due to the geographical conditions, a comprehensive supply network for the distribution of medications can only be established to a limited extent. The quality of the available medical products is inadequate and there is also a lack of important basic medicines. Experts estimate that the average availability of essential medications in health facilities amounts to 20 per cent of what is actually needed.
Only a small proportion of medical facilities comply with national health care standards. Adequate and comprehensive health care is therefore not ensured. Due to inferior equipment, health centres are often only able to offer inadequate basic and additional medical care. Income from medication sales is not used to reorder products, but rather to cover personnel costs. On top of this, the quality of the ser-vices is in need of improvement. The reason for this is the low level of training and a lack of motiva-tion among health care personnel as a result of payments not being made. The problems in the public health care system are fostering the black market for health care services, favouring, for example, the business of traditional healers and prayer groups.
Objective
A regional medical distribution centre has been established as part of a pilot trial in Bukavu and serves as a model for other provinces in the Democratic Republic of the Congo.
Approach
The project is connected to the Support to the Health System in South Kivu Province (PASS) pro-gramme. It contributes towards the fourth component of this programme (infrastructure, medicine and health information management) and is financed by Gavi, the Vaccine Alliance with funds from the Swiss Agency for Development and Cooperation (SDC).
The project is laying the foundations for the development of a pilot model. In this way, it is improving supply management, the administration of stocks and the distribution of essential medicines to health centres in outlying areas. For this purpose, a new distribution centre is to be established and integrat-ed into the national health care policy with regard to the supply of medicines (PNAME).
To begin with, the project is helping the Ministry of Health of the Province of Bukavu as it accompa-nies and coordinates the process of establishing the distribution centre as a public-benefit associa-tion. The project is working together with other interest groups such as the Federation of Essential Drug Procurement Agencies (FEDECAME) and the health department of South Kivu province (DPS). In this context, it plans to perform feasibility studies defining the legal and technical framework and providing insights into requirements and implementation options in Bukavu. There are also plans to carry out technical studies on constructing the necessary buildings and develop a model looking at the cost coverage and economic efficiency of medication distribution.
In addition, the project comprises construction management for the distribution centre. This will involve a tender for construction services and the procurement of equipment for later operation.
All work steps involved in establishing the distribution centre for medications will be documented, thus creating a template that can also be used in other regions.