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Alternative Public Health Supply Chains: Reconsidering the Role of the Central Medical Store

Download this publicationCentral Medical Stores (CMS) in low-income countries are usually the backbone of public health procurement and distribution models. In practice, however, CMSs have had inadequate performance in areas that include procurement, financial and logistical management, security, and storage. This report identifies a set of approaches that either de-emphasize the CMS, or enact a radical shift in its management. The authors examined the existing logistics systems that incorporate one or more of these approaches in developing countries. These approaches potentially offer a superior solution to improving supply chain performance benefits compared to approaches that continue to emphasize the CMS.

The multiple approaches that are described raise the question of how to choose the approach that most appropriately fits a particular country’s setting. A framework for selecting an approach highlights the technical criteria for judging the suitability of an approach, and considers how to address the inevitable situation when multiple approaches do not meet all the technical criteria. These perspectives make it clear that the choice of one of these alternative models is not the final or entire solution to the CMS dysfunction. John Snow, Inc./USAID | DELIVER PROJECT, 2013.

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