A Guide to Best Practices in Subnational Procurement of MNCH Commodities in the Public Sector

In response to political reform or problems with centrally controlled health product supply, many low- and middle-income countries have decentralized the procurement of health commodities, including those for maternal, newborn, and child health (MNCH), to a province, district, or even facility level. However, if good procurement practices are not in place, such as appropriate standard operating procedures and oversight and adequate management of conflicts of interest, subnational procurement can compromise product quality, affordability, and ultimately, availability. This guide uses case studies and other examples to describe best practices to procure quality-assured, low-cost MNCH medicines and supplies in addition to three mechanisms to address subnational procurement challenges: central framework agreements, prime vendor programs, and e-procurement systems.