Content area
Full Text
ABSTRACT. In most countries procurement is undervalued compared to the attention paid to other key areas of Public Sector Reforms. Ghana represents a case in point. Under the health reforms in Ghana, the Ministry of Health and its partners (donors, financing institutions and the private sector) recognized the importance of procurement in its Medium-Term Health Sector Strategy for Ghana 1997 to 2001. With the aid of an external consultant, using a highly participatory approach in the development, training, and the implementation of new structures and procedures, good results have been achieved. Although work is ongoing and important challenges still need to be addressed, the authors argue that the new procurement structures now in place can serve as an example of a standardized support system for health reforms.
INTRODUCTION
Procurement is still a much-undervalued area in the public sector. This is particularly true for the health sector. In many countries, hospitals or other health service units do not have qualified procurement personnel. The financial impact of procurement in health care is significant. In The Netherlands, e.g., this impact has been estimated to amount to 40% of the total costs of a hospital (Lenselink & Telgen, 1998). In developing countries, expenditures for drugs and other items range from 25% to 50% of the total health care cost according to the World Health Organization (Management Sciences for Health, 1997). The World Bank has become the largest single source of finance for health in low- and middle-income countries (Falkenberg & Tomson, 2000). Its procurement guidelines and procedures are well developed with contributions by experts from all over the world. They are acceptable to most countries and donors and widely used by major funding institutions.
The authors worked for several years on the development and implementation of new procurement systems in the Ghana health sector. The purpose of this case study is to provide a short description of the Ghana health reforms and the role of procurement, followed by a discussion of the interventions made and their impacts. Although the procurement improvement process is still underway and many challenges have yet to be addressed, the authors argue that the new procurement structures already in place can be used as an inspiring example of a standardized support system for health...