UNDP Ukraine experience: what can we do to improve public procurement in the health sector?
14 Mar 2017
What do we know about modern Ukraine? Of course, it’s a big European country known for its lush landscape and warm hospitality. At the same time, this is also a country facing a military conflict in the East, occupation of its territory, and over a million of internally displaced people, all this while in economic recession. Despite all this, the government of Ukraine cannot afford not to push through much needed reforms, and has listed healthcare reform as one of its priorities.
In 2015, anti-corruption organizations and patients’ groups successfully lobbied for a new piece of legislation, allowing public procurement of health products through international organizations. This was an emergency measure to deal with a situation where life-saving medicines had been missing from public hospitals due to the inefficiencies of public health procurement. The Ministry of Health of Ukraine therefore requested UNDP to support the procurement and distribution of health products related to eight different State Health Programmes (for the 2015 procurement cycle) and 23 State Health Programmes (for the 2016 procurement cycle).
At the time, UNDP Ukraine had a small health-related team, but recognized the stringent necessity of such assistance to the government to solve the immediate crisis, while at the same time support mid- to long-term efforts to reform the health procurement and supply management system. On our side we had UNDP’s extensive expertise in public procurement and in anti-corruption, making us confident we could help establish a procurement system that corresponds to the highest international standards.
We built our approach mindful of the time limitation: the law on procurement through international organization will expire in early 2019. This gave us and the Ministry a very clear deadline for the establishment and full operationalization of the system of public health procurement. We realized we needed extra resources to build the health procurement capacity and support the system’s reform. Once these additional resources were granted by the UNDP Istanbul Regional Hub at end 2015, we started working to strengthen the public procurement system in the healthcare sector, while ensuring rapid access to essential medicines and other medical products in Ukraine.
In 2016, our main focus was on actual procurement processes, but we also fully reached our objectives in two main directions: firstly, by supporting the creation of a new health procurement agency, and secondly by helping develop online access to available medical stocks.
The first objective was to help the Ministry of Health develop and implement a concept for a new Strategy on procurement reform in public health. The Strategy follows the principles of transparency, accountability and effectiveness and applies an integrated, issue-based and innovative approach. Its aim is the establishment of a transparent and efficient State Health Procurement Agency. This, however, requires significant capacity building and capacity development efforts, and in this regard a series of trainings on Sustainable Procurement in the Health Sector, anti-corruption workshops and procurement conferences for different stakeholders were conducted.
To support this, we also realized that it was key to establish clear and direct communication about the procurement services and reform that we supported. The communication strategy we developed used different approaches: from dissemination of infographics and videos, to the organization of press tours and press briefings for journalists, with a focus on maintaining media relations with key media outlets.
The second strategic direction we focused on was the development of online medical stock systems. These systems enable patients and citizens to monitor in real-time which medicines are available in specific public health facilities following their purchase, removing any possibility for corruption and black-market arrangements. We supported the creation and launch, for the public, of two online platforms in this area:
“E-Liky” (a web platform and mobile apps for patients' use), was piloted in the Rivne oblast. Developed in partnership with the “Patients for Ukraine” organization, it aims to ensure the rights of patients to information (i.e. open data) and access to free medicines.
Digital stock platform (in collaboration with state entity Ukrvaktsina), was piloted in the capital Kyiv and in the Dnipro oblast. This is a professional platform that allows the monitoring of stocks of medicines and also helps to forecast the needs, and maintenance of warehouse inventory.
We still have two years ahead of us, we have more plans to implement in this sphere and still need additional support. We have learnt our lessons and remain ready to keep supporting the government on its reform efforts. To fight corruption in healthcare, we will continue to promote the best international practices and to strengthen the capacity of our counterparts. Keeping in mind our ultimate goal: to support the most vulnerable population of Ukraine for their access to essential medicines and health services. Leaving no one behind to contribute to the SDG Agenda.