Understanding Public Procurement of Paracetamol and Iron tablets in Nepal’s Health System

Aim The procurement function provides critical opportunities to achieve supply chain cost effectiveness especially in public health logistics system where skill and capacity of the health staff are limited. The public health supply chain continues to face challenges, relating to consistent supply of these two essential drugs due to the inefficient forecasting and procurement processes. These gaps result in frequent stock-outs or overstock and expiry. This study aims to analyze existing procurement processes identify systemic gaps and propose practical, evidence-based solutions to improve procurement efficiency. Method The research employed a mixed-methods approach, using quantitative surveys and qualitative interviews to gather data from various public health institutions. A sample size of 325 health institutions were selected across geographical settings. Data analysis involved both quantitative statistical and qualitative thematic analysis. Result Procurement practices, 40% of health institutions indicated that they procure from exporter, followed by stockist, local manufacturer, and pharmacy. Budget to procure paracetamol and iron tablets, 64% said ‘not enough’ from the health institutions. Method of procurement, 48% of the health institution said they use standard bidding, followed by quotation, and direct purchase. Capacity, 3 among 4 health institution’s staff did not have formal training on public procurement. Conclusions Public procurement practice of health products in Nepal has lot of rooms for improvement. The practice of procurement of health products from the local pharmacy shop should be minimized. The three tiers of the government should allocate adequate and flexible budget for procurement of health products and evidence based quantification/forecasting.