Improving Procurement Practices of MNCH Products in Nepal

Sound procurement practices are crucial to consistent access to quality maternal, newborn, and child health (MNCH) medical products, which can help ensure quality MNCH services and optimal health outcomes. In Nepal, after federalization, local-level governments (LLGs) were given the necessary authority to procure most MNCH medical products and essential medicines. However, the LLGs lack the skills and capacity needed to make appropriate procurement decisions.

To assess procurement practices at the subnational level and ensure the quality and availability of MNCH products, the USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program conducted a mapping study, Subnational Procurement Practices of Maternal, Newborn, and Child Health Medicines in Nepal. The report examined roles and responsibilities of various stakeholders in procurement, procurement mechanisms and the procurement process, training, infrastructure, and financing, laying the groundwork for a framework for improved procurement.

Developing a Procurement Framework around Best Practices

Following the study, MTaPS supported the Government of Nepal to organize a workshop to raise awareness around the need for high-quality subnational MNCH procurement practices and define actionable recommendations to improve current practices. Sixty representatives from seven provinces representing the Ministry of Health and Population’s Department of Health Services (DoHS) and Department of Drug Administration (DDA), as well as provincial and municipality health representatives, participated in the two-day workshop in Banepa March 10–11, 2022. The MTaPS team shared and validated the findings of the subnational procurement practices mapping with the participants, following which participants were oriented to international subnational procurement best practices from Indonesia, New Zealand, and Tanzania. They learned about approaches such as framework agreements, electronic procurement systems, and the use of a prime vendor to procure quality goods at a low cost. Drawing on this, participants produced a set of actionable recommendations for Nepal focusing on procurement, quantification, quality assurance, budgeting, and financial management.

(View or download “Key Recommendations: Improving Subnational Procurement for MNCH in Nepal”).

Overall, the workshop succeeded in convening a broad group of policy makers and practitioners from the national and subnational levels to collectively focus on key challenges with subnational procurement and agree on the need for policy reform.

Group discussion during the Improving Subnational Procurement for MNCH Medicines in Nepal workshop, March 10–11, 2022, Banepa (Photo Credit: Prabin Tamang)

What’s Next

In their closing remarks, the Honorable State Minister of Health, Secretary of Ministry of Health and Population, and Director of the Management Division/DoHS proposed high-level follow-up meetings to discuss key recommendations, such as establishing a framework agreement for the procurement of essential medicines, improving quality of data and data analysis for better quantification through expansion of electronic systems, strengthening budget planning and financial management, and improving storage and distribution practices.

MTaPS has been supporting the Management Division of the DoHS to include the recommendations in the national and local annual workplans and budgets and has already been working with Nepal’s regulatory authority, the DDA, to standardize storage and distribution practices by private wholesalers and public-sector stores.

The improved procurement practices will enable sustained access to quality MNCH products, which are essential for quality health services.