(2013; 6 pages)
Central Medical Stores (CMSs) usually form the backbone of public health procurement and distribution models in low-income countries (Vogel and Stephens 1989; Yadav, Tata, and Babaley 2011). Traditionally, CMSs have been government-owned enterprises; but, in more recent years, they have been allowed autonomous management, with government oversight (MSH 1997). The role of the CMSs have usually included the national procurement of healthcare commodities, storage and handling of inventory commodities, and distribution of commodities to various sections of the national public health system; and, in some cases, even to the private-sector health system. Although these institutions should have all the components necessary for a supportive supply chain role for healthcare delivery; in practice, many CMSs have had inadequate performance in procurement, financial and logistical management, security, and storage (Govindaraj and Herbst 2010).
To combat inadequate performance, partners have strengthened the CMS capacity and capabilities. However, some partners have considered alternative approaches to strengthening the healthcare supply chain, by either de-emphasizing the CMS or enacting a more radical shift in its role. While partners may still prefer to strengthen the CMS in order to maintain public-sector capacity, partners should also consider allowing commodities to bypass the CMS, establishing institutions that compete with the CMS; or establishing parallel, complementary institutions.
This brief describes these approaches and makes basic recommendations for selecting and implementing them.