Supply Chain Assessment of Maternal, Newborn and Child Health Commodities in Ghana’s Private Sector Facilities, Wholesalers, and Retail Pharmacies

Abstract

Background: The private sector in Ghana provides 50% of health services in the country yet there is limited information on the supply chain management of MNCH commodities in this sector. Aim: To understand how MNCH commodities are managed within the private sector. Method: A mixed methods approach was used to capture supply chain related data on a subset of MNCH commodities in the private sector. The sampling strategy included the selection of four regions (Ashanti, Greater Accra, Northern, and Upper East) in Ghana. Quantitative data on product management, availability, source, pricing and registration were collected from retail pharmacies, private health facilities and wholesalers. Additionally qualitative data on factors influencing supply decisions were collected from wholesalers. Results: The study showed that retail pharmacies and wholesalers were less likely to manage injectable products like gentamicin, magnesium sulphate and oxytocin as compared to private health facilities. At all three facility types, amoxicillin DT, chlorhexidine gel and ORS + zinc co-pack were the least managed products. The main reason for non-management of MNCH products was “low or no client demand”. Majority of MNCH products had at least half of the most prevalent brands registered. Regarding product pricing, the results showed lower NHIS prices for certain products compared to selling prices at retail pharmacies and health facilities. Ninety percent of all three facility types met at least half of the storage requirements; with 100% of wholesalers and 96% of health facilities storing oxytocin in a working refrigerator. However, 25% of retail pharmacies did not store oxytocin within the recommended temperature range of 2-8 degrees. Conclusion: The private sector is influenced by commercial factors, which could come at a high cost in terms of availability, accessibility, and affordability for individuals and families. There is the need to create a cost incentive that encourages the private sector to offer and improve access to critical MNCH commodities, including amoxicillin DT, ORS + zinc co-pack, chlorhexidine gel and injectable MNCH products. Keywords: Private sector, MNCH, Supply Chain, Wholesale pharmacies, Retail pharmacies