Pharmaceutical procurement systems are key cost drivers in pharmaceutical supply chain management (SCM) and are major determinants of pharmaceutical availability, however, public sector pharmaceutical SCM in developing countries continues to be inefficient and ineffective, despite increased investment over the last two decades. Prior to 2018, Trinidad and Tobago’s newspapers were inundated with reports of medicine shortages and stock-outs at public institutions, and the public was expressing concerns about their inability to access medicines at these institutions. The problem led the procurement agency operating on behalf of the Ministry of Health, to implement strategies to reduce medicine shortages and stock-outs, thereby improving its availability for distribution.

The study utilised a mixed-method (MM) quasi-experimental approach to examine the effectiveness of the interventions, to secure contracts for pharmaceuticals in a timely manner, on stock levels at Central Stores; and understand the contextual factors that influenced those interventions. A concurrent embedded MM quasi-experimental pre-post-test research design was employed. The quantitative data (i.e. stock-level data) were analysed statistically and were given more significance in the analyses. Qualitative primary data derived from semi-structured interviews with managers, and the analysis of secondary data from government reports and company documents were used as the contextual backdrop to facilitate the interpretation of the quantitative data and were analysed thematically. Data integration occurred at the interpretation stage.

The findings will determine whether the interventions had an effect on the two dependent variables (i.e. shortages and stock-outs) post-intervention in 2018 and 2019 respectively; and identify the contextual factors such as SCM challenges, and possible facilitators in the implementation of the interventions by the procurement agency.

It is hoped that the findings will assist pharmaceutical SCM practitioners seeking to implement similar interventions in ensuring that the facilitators of the desired outcome are present, and that the barriers are minimised. Additionally, the study can provide evidence for investing in future initiatives to further strengthen the public sector SCM.

Wednesday 19th April, 2023 at 1:00 p.m.

Roseann St Rose has over 20 years of pharmaceutical experience within the Caribbean. She is a supply chain management practitioner with an undergraduate degree in Pharmacy and postgraduate qualifications in Health Administration, Global Health Procurement and Supply Chain Management, and Economic Evaluation of Pharmaceuticals and Medical Technologies. Mrs. St. Rose is the former Head of the Pharmaceutical Division at NIPDEC, which is responsible for the procurement, storage, and distribution of pharmaceuticals to public sector institutions on behalf of the Ministry of Health. She is experienced in the development of national and regional pharmaceutical systems with expertise in pharmaceutical pooled procurement, formulary development and evaluating health products. She developed the Turks and Caicos Islands’ first National Pharmaceutical Policy, was instrumental in the strengthening of the OECS Pharmaceutical Quality Assurance System and has co-authored the paper entitled “Health Systems’ Resilience: COVID-19 Response in Trinidad and Tobago” published in the American journal of tropical medicine and hygiene.