Impact of COVID-19 on the supply chain of essential health commodities: a mixed method study, in Dar es Salaam, Tanzania

Ipagala et al. Journal of Pharmaceutical Policy and Practice https://doi.org/10.1186/s40545-023-00617-1 (2023) 16:103 Journal of Pharmaceutical Policy and Practice Open Access RESEARCH Impact of COVID‑19 on the supply chain of essential health commodities: a mixed method study, in Dar es Salaam, Tanzania Pius Ipagala1, Eulambius M. Mlugu1*, Rogers Mwakalukwa2 and Godeliver A. Kagashe1 Abstract Background The outbreak of COVID-19 in the late 2019 led to major global health crises, including morbidities and mortalities. The pandemic has adversely affected the supply chain of essential health commodities globally. However, such data from sub-Saharan Africa including Tanzania are largely limited. We assessed the impact of COVID-19 on the supply chain of essential health commodities in Tanzania. Method A cross-sectional study with pragmatic mixed method design was conducted in Dar es Salaam region from January to June 2021. Grounded theory was adopted to purposeful select key informants (n = 15) from importers of essential health commodities and local pharmaceutical manufacturers. Community pharmacy dispensers (n = 242) were also recruited for the quantitative part of this study. The prices of selected tracer health commodities were extracted from the Tanzania Medicine and Medical Device Authority (TMDA) Regulatory Information Management system. The mean unit prices 1 year before the pandemic were compared with the mean prices 1 year during the pandemic using paired t test. Thematic analysis was used for qualitative data. Results The information regarding the impact of COVID-19 on the supply chain of essential health commodities was synthesized into three main themes namely, reduced availability of health commodities, increased price of health commodities and increased lead time for imported essential health commodities during COVID-19. Majority (90%) of community pharmacy dispensers reported that COVID-19 reduced the availability of essential health commodities. Azithromycin, Paracetamol, Multivitamin and Vitamin C tablets were the highly demanded products and their mean unit prices increased significantly during COVID-19 as compared to 1 year before the pandemic (p < 0.05). Conclusions COVID-19 led to shortage, increased prices and delayed delivery of essential health commodities. This might happen in the future whenever unexpected crises causing disruption in the supply chain occur underscoring the need for the country preparedness measures. Keywords COVID-19, Supply chain, Essential health commodities, Tanzania *Correspondence: Eulambius M. Mlugu 1 Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania 2 Department of Pharmacognosy, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania Background Essential health commodities are products that meet the top healthcare needs of a population [1]. These products are critical in saving human lives, which sets health supply chains apart from other supply chains [2]. The health supply chain cycle includes selecting health commodities, quantifying the needed amounts, procuring, distributing, and ensuring rational use. In Tanzania, the Medical Stores Department (MSD), a government © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Ipagala et al. Journal of Pharmaceutical Policy and Practice (2023) 16:103 agency, is responsible for procurement, storage, and distribution of health commodities in the public sector. The MSD receives funding from the government and other donors to procure pharmaceuticals, which are then distributed to health facilities and managed through an electronic Logistic Management Information System (eLMIS) [3]. When health commodities are out of stock at the MSD, health facilities use the private Prime Vendor System (PVS), which is commonly known as JAZIA, to bridge the supply gap [4]. In addition, Tanzania has more than 1,500 private registered retail pharmacies serving the public and about 45 Market Authorization holders importing health commodities to the country [5]. Tanzania like other countries in sub-Saharan Africa imports the majority of its health commodities, including raw materials and finished product [6]. Pandemics and natural disasters pose risks to the health supply chain, causing demand–supply disruptions. The COVID-19 pandemic adversely affected the global health in various ways. To control the effects of COVID19 pandemic, the World Health Organization (WHO) recommended various strategies including lock down, social distancing, wearing face masks and washing hands with soap and running water or sanitizer. Implementation of the control strategies resulted in ceasing of international flights, closing some manufacturing industries and reducing workers, to comply with social distancing. This caused disruptions in different stages of health commodities supply chain [7] including production, procurement, and distribution, [8, 9]. Albeit, Tanzania was not spared from the effects of the pandemic, there are limited data on the impact of COVID-19 pandemic on the supply chain of health commodities from Tanzania. The COVID-19 pandemic has resulted in an increased demand for health commodities used to manage COVID19-related conditions, which may shift the supply chain, affecting the availability and prices of essential health commodities for managing other diseases [10]. This shift may delay country’s efforts to achieve its sustainable development goals. This study investigated the impact of the COVID-19 pandemic on the supply chain of selected health commodities in Dar es Salaam, Tanzania’s largest business city. The findings may inform targeted interventions and preparedness for sustainable supply of essential health commodities. Methods Study design and setting This cross-sectional study assessed the impact of (...truncated)