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Rethinking health sector procurement as developmental linkages in East Africa

Mackintosh, Maureen; Tibandebage, Paula; Karimi Njeru, Mercy; Kariuki Kungu, Joan; Israel, Caroline and Mujinja, Phares G.M. (2018). Rethinking health sector procurement as developmental linkages in East Africa. Social Science & Medicine, 200 pp. 182–189.

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Health care forms a large economic sector in all countries, and procurement of medicines and other essential commodities necessarily creates economic linkages between a country's health sector and local and international industrial development. These procurement processes may be positive or negative in their effects on populations' access to appropriate treatment and on local industrial development, yet procurement in low and middle income countries (LMICs) remains under-studied: generally analysed, when addressed at all, as a public sector technical and organisational challenge rather than a social and economic element of health system governance shaping its links to the wider economy. This article uses fieldwork in Tanzania and Kenya in 2012–15 to analyse procurement of essential medicines and supplies as a governance process for the health system and its industrial links, drawing on aspects of global value chain theory. We describe procurement work processes as experienced by front line staff in public, faith-based and private sectors, linking these experiences to wholesale funding sources and purchasing practices, and examining their implications for medicines access and for local industrial development within these East African countries. We show that in a context of poor access to reliable medicines,
extensive reliance on private medicines purchase, and increasing globalisation of procurement systems, domestic linkages between health and industrial sectors have been weakened, especially in Tanzania. We argue in consequence for a more developmental perspective on health sector procurement design, including closer policy attention to strengthening vertical and horizontal relational working within local health-industry value chains, in the interests of both wider access to treatment and improved industrial development in Africa.

Item Type: Journal Item
Copyright Holders: 2018 The Authors
ISSN: 0277-9536
Project Funding Details:
Funded Project NameProject IDFunding Body
Industrial productivity, health sector performance and policy synergies for inclusive growth. (D-11-020-MM)ES/J008737/1ESRC (Economic and Social Research Council)
Keywords: procurement; access to treatment; local production of medicines; medical supplies; Tanzania; Kenya; health-industry linkages; health system governance
Academic Unit/School: Faculty of Arts and Social Sciences (FASS) > Social Sciences and Global Studies > Economics
Faculty of Arts and Social Sciences (FASS) > Social Sciences and Global Studies
Faculty of Arts and Social Sciences (FASS)
Research Group: Health and Wellbeing PRA (Priority Research Area)
Innovation, Knowledge & Development research centre (IKD)
Institute for Innovation Generation in the Life Sciences (Innogen)
Item ID: 53358
Depositing User: Maureen Mackintosh
Date Deposited: 07 Feb 2018 14:31
Last Modified: 06 Aug 2019 10:56
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