Applying Market Mechanisms to Central Medical Stores : Experiences from Burkina Faso, Cameroon, and Senegal
This study summarizes the findings of three assessments of Central Medical Store (CMS) reform and performance in Francophone Africa. The study aims to document and characterize the organizational reform of the CMSs and the impact of the reform on C...
| Main Authors: | , |
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| Format: | Other Health Study |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2013
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2010/07/12605584/applying-market-mechanisms-central-medical-stores-experiences-burkina-faso-cameroon-senegal http://hdl.handle.net/10986/13608 |
| Summary: | This study summarizes the findings of
three assessments of Central Medical Store (CMS) reform and
performance in Francophone Africa. The study aims to
document and characterize the organizational reform of the
CMSs and the impact of the reform on CMS management and
performance in Cameroon, Burkina and Senegal. It seeks
further to assess the extent to which increased autonomy
brought about by such 'marketizing' reforms has
had an impact on intermediate CMS results, service quality,
product quality, and access to medicines. The findings
indicate that organizational reform did contribute towards
improving operational performance which, in turn, influenced
service quality, product quality, and access to CMS-supplied
medicine in these countries. However, improvements in these
areas were premised not simply on increased autonomy, but on
a whole variety of drivers, both internal and external to a
CMS. These include a strong regulatory framework, the
conventions, laws, regulations, and administrative acts that
increase the flexibility of some decision making rights,
whilst constraining others, with an emphasis on social
obligations, accountability, and transparency, as well as
external factors, such as technical assistance, government
subsidies, and relevant external policies, institutions and
regulations. The paper ends by proposing a framework that
could be used both for the design as well as for the
analysis of marketizing reforms in CMSs and other public
sector commodity supply entities in developing countries.
The framework is sufficiently general that, with some
modifications, it could also be applied usefully to the
design and analysis of such reform in other public sector
institutions delivering social services. |
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