As Malawi transitions from a simple, targeted distribution system with one distributor to a more complex, multi-distributor system designed to achieve universal coverage, it is clear that its existing procurement processes will need to keep pace with the new reality. In November 2011 Crown Agents USA (CA-USA) began work on the first phase of the National Distribution of Long Lasting Insecticide Treated Nets (LLINs) to Public Health Facilities in Malawi project, a project funded by USAID under the President's Malaria Initiative (PMI).
Working alongside Population Services International (PSI), the prime contractor, and Malawi's National Malaria Control Program (NMCP), CA-USA has been tasked with analyzing the current national distribution system, create a national distribution strategy and supply plan, and ensure sustainability by training and developing the skills of the NMCP staff.
The main focus of the project's recently completed first phase was to see what was happening on the ground, visiting a sample of health facilities where LLINs are being dispensed and observing the local staff in action. Over a three month period, Crown Agents' Distribution and Capacity Advisor (consultant), Mr. Happy Kondowe, travelled throughout Malawi, from Chitipa in the North, to Nsanje in the South, and to Mchinji and Mangochi in the West and East respectively, covering a total of 7970km. On this journey Mr. Kondowe faced a variety of obstacles which ranged from travelling on dry riverbeds doubling as roads, to fuel shortages, and even linguistic challenges when asking for directions. He visited a total of 39 health facilities in 10 districts. Each visit consisted of a review of the facilities' distribution and forecasting processes, a formal count of the number of LLINs available at that time to ensure that the health center's records reflected the correct information, as well as conducting interviews with staff involved in the distribution of LLINs, specifically nurses and medical officers, using a skills questionnaire developed to analyze local capacity.
By early February 2012 CA-USA had visited all health facilities that were designated to be reviewed and presented a formal report of findings to PSI and the NMCP. The second phase of the project, which will build on the findings from the first phase, will focus on the design and development of the new distribution and supply plan, as well as the drafting of the capacity development plan.