IMPLEMENTING PARTNER: National Citizen’s Movement for Free Elections (NAMFREL)
YEARS: 2008-2009 (Phase I); 2010-2011 (Phase II)
GRANT AMOUNT: $23,296 (Phase I); $35,425 (Phase II)
The National Citizen’s Movement for Free Elections (NAMFREL), a local CSO in the Philippines, carried out the “Medicine Monitoring Project” (MMP) in partnership with the Department of Health (DOH). The project first started in 2004 and received funding from PTF in two phases during 2008/2009 and 2010/2011. The first phase served to test the feasibility of the approach which was then – after successful completion – scaled up in a second phase. The project focused on establishing citizen monitoring to control corruption in the delivery of health services, working with hospitals and Centers for Health Development (CHDs) to establish a more transparent and efficient system of procuring and stocking medicines. The project aimed to engage and encourage communities to monitor the delivery of health services and to institutionalize third party monitoring.
Corruption Problem Addressed
The project set out to address the availability and affordability of essential drugs and medicines in DOH hospitals and CHDs across the country, targeting availability and affordability of medicines. Prior to the project intervention citizens had been prevented and commonly barred from access to low cost and yet high quality medicines. Causes were identified in inefficient procurement processes, inaccurate deliveries and poor distribution as well as inadequate warehousing and stocking of essential medicines. All of these symptoms were a result of corrupt behavior as the root cause for the distortions observed in the service delivery.
Actions Taken by NAMFREL
NAMFREL agreed with the DOH to monitor, track and follow a variety of procurement activities, using its existent network of over 100 NAMFREL chapters nationwide to mobilize volunteers and CSOs from within the communities. Volunteers engaged in:
- monitoring procurement activities in every hospital and regional health offices managed by DOH.
- monitoring delivery of essential medicines in selected hospitals and regional health offices.
- monitoring inventories, warehouses and medicine stocks as well as hospitals’ and CHDs’ internal systems for checking inventories.
- monitoring distribution of essential pharmaceutical products to entitled hospital recipients.
Local chapter leader conducted capacity building workshops and built coalitions with local CSOs to carry out the tasks, educating volunteers to successfully monitor the various reporting formats used by hospitals, suppliers, and the procurement secretariat.
During the implementation of the second phase, NAMFREL included a warehouse and pricing survey monitoring component. The price monitoring represented a lesson learnt from the MMP1 to help the DOH Bids & Awards Committee (BAC) officers to determine what a reasonable budget for the purchase of drugs and medicines would amount to.
Impact and Results Achieved
Since the inception of the program in 2004, NAMFREL noticed the following improvements in the health sector:
- The reputation of the DOH has dramatically increased based on scorecards completed by both government and civil society as well as validated through public opinion surveys.
- NAMFREL has successfully monitored procurement worth 1.7 Billion Pesos.
- The availability of essential medicines has improved considerably.
- The discrepancy in the delivery of the drugs and medicines to hospital and regional health offices has been reduced significantly.
- Most of the hospitals and regional health offices and BAC officers are more responsive to the role of NAMFREL volunteer-observers in the various stages of the procurement process.
- Bidding prices are more competitive and reflect a more realistic market price.
An important lesson learnt is the importance of the role of champions to bolster the push toward greater transparency and accountability. Securing the support of the DHO as well as the head of individual hospitals has been vital to ensure success in the effort to follow through with the the various monitoring exercises initiated.