Starting from Scratch in Timor-Leste : Establishing a Pharmaceutical and Medical Supplies System in a Post-Conflict Context

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dc.creatorHuff-Rousselle, Maggie
dc.date2013-06-05T14:18:15Z
dc.date2013-06-05T14:18:15Z
dc.date2009-06
dc.date.accessioned2026-07-01T01:20:18Z
dc.descriptionThis case study analyses the challenges of establishing a pharmaceutical and medical supplies system in a Timor-Leste post-conflict context. In the aftermath of its separation from Indonesia, the Timor-Leste health infrastructure was in total disarray, with more than a third of health facilities destroyed, and those remaining severely damaged. The crisis in human resources was severe, as more than 80 percent of qualified public-sector staff had returned to Indonesia. The resultant heavy dependence on expatriates was complicated by language incompatibility, and nationals were not well integrated into planning and implementation processes, as an entire public sector infrastructure was being established de nouveau. Despite the fledgling status of the public sector, a sophisticated organizational framework was envisioned for the establishment of the health sector supply system: an autonomous agency that would be a non-profit wholesaler or revolving drug fund and a public sector monopoly. The case study reviews the development of the policy and legal framework for the pharmaceutical sector, and the key phases of the commodity supply system, including: product selection through an essential drugs list; procurement hampered by use of procedures that were not appropriate for purchasing drugs for an entire country; the establishment of a centralized warehousing and distribution system; projected financing of the supply system through development of a business plan for the autonomous agency. In its exploration of the transition from post-conflict situation to health system development, the case study identifies lessons that are broadly applicable to foreign aid and external assistance in other contexts, including the tendency to 'poly-prescribe' overly ambitious and overly sophisticated solutions not pragmatically grounded in the current realities of public sector institutional and human resource constraints and capabilities.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2009/06/10916589/starting-scratch-timor-leste-establishing-pharmaceutical-medical-supplies-system-post-conflict-context
dc.identifierhttps://hdl.handle.net/10986/13760
dc.identifierhttps://doi.org/10.1596/13760
dc.identifier.urihttp://hdl.handle.net/123456789/417180
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationHealth, Nutrition and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.rightsWorld Bank
dc.subjectABUSE
dc.subjectACCESS TO FUNDS
dc.subjectACCOUNTING
dc.subjectAGED
dc.subjectAMOUNT OF MONEY
dc.subjectBALANCE SHEET
dc.subjectBANK ACCOUNT
dc.subjectBRAIN DRAIN
dc.subjectBUSINESS PLAN
dc.subjectCAPSULES
dc.subjectCASH FLOW
dc.subjectCATHETERS
dc.subjectCENTRAL MEDICAL STORES
dc.subjectCHARTS
dc.subjectCHILDHOOD DISEASES
dc.subjectCHILDREN PER WOMAN
dc.subjectCLINICS
dc.subjectCOLD CHAIN
dc.subjectCOMMITTEE ON POPULATION
dc.subjectCOMMODITIES
dc.subjectCOMMODITY
dc.subjectCOMPETITIVE BIDDING
dc.subjectCOMPLICATIONS
dc.subjectCONSUMER
dc.subjectCONSUMERS
dc.subjectCORRUPTION
dc.subjectCOUNTERFEIT DRUGS
dc.subjectCREDIT HISTORY
dc.subjectCREDITS
dc.subjectCUSTOMS CLEARANCE
dc.subjectDEATHS
dc.subjectDEBT
dc.subjectDEBTS
dc.subjectDELIVERY SYSTEMS
dc.subjectDEVELOPING COUNTRIES
dc.subjectDEVELOPMENT PLANNING
dc.subjectDEVELOPMENT STRATEGIES
dc.subjectDIPHTHERIA
dc.subjectDISASTERS
dc.subjectDOCTORS
dc.subjectDONATIONS
dc.subjectDRUG DONATIONS
dc.subjectECONOMIC DEVELOPMENT
dc.subjectEMERGENCIES
dc.subjectEQUITABLE ACCESS
dc.subjectESSENTIAL DRUGS
dc.subjectESSENTIAL DRUGS CONCEPT
dc.subjectESSENTIAL MEDICINES
dc.subjectFAMILY HEALTH
dc.subjectFAMILY HEALTH INTERNATIONAL
dc.subjectFAMILY PLANNING
dc.subjectFERTILITY
dc.subjectFERTILITY RATE
dc.subjectFINANCIAL CONSTRAINT
dc.subjectFINANCIAL PLAN
dc.subjectFINANCIAL PLANNING
dc.subjectFINANCIAL RESOURCES
dc.subjectFINANCIAL SYSTEMS
dc.subjectFOCUS GROUP DISCUSSIONS
dc.subjectFORCED MIGRATION
dc.subjectGMP
dc.subjectGOOD MANUFACTURING PRACTICES
dc.subjectGRAPHICS
dc.subjectGROUP DISCUSSIONS
dc.subjectHEALTH ADMINISTRATION
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE SYSTEM
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH INFORMATION
dc.subjectHEALTH INFORMATION SYSTEM
dc.subjectHEALTH INFRASTRUCTURE
dc.subjectHEALTH PLANNING
dc.subjectHEALTH POLICY
dc.subjectHEALTH PROFESSIONALS
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SECTOR REFORM
dc.subjectHEALTH SERVICE
dc.subjectHEALTH SERVICE DELIVERY
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SPECIALIST
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEMS
dc.subjectHEALTH WORKERS
dc.subjectHEALTH-SECTOR
dc.subjectHOSPITAL
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectILLNESS
dc.subjectIMMUNIZATION
dc.subjectINFANT
dc.subjectINFANT MORTALITY
dc.subjectINFANT MORTALITY RATES
dc.subjectINFECTIOUS DISEASES
dc.subjectINFLATION
dc.subjectINFORMATION SYSTEM
dc.subjectINFORMATION SYSTEMS
dc.subjectINTEGRATION
dc.subjectINTERNATIONAL ASSISTANCE
dc.subjectJOB TRAINING
dc.subjectLABOR MARKET
dc.subjectLACK OF AWARENESS
dc.subjectLACK OF KNOWLEDGE
dc.subjectLAWS
dc.subjectLITERACY
dc.subjectLIVE BIRTHS
dc.subjectLOCAL POPULATION
dc.subjectMALARIA
dc.subjectMEASLES
dc.subjectMEDICAL EQUIPMENT
dc.subjectMEDICAL SUPPLIES
dc.subjectMEDICAL] STORES
dc.subjectMEDICINE
dc.subjectMEDICINES
dc.subjectMIGRATION
dc.subjectMINISTRY OF HEALTH
dc.subjectMORTALITY
dc.subjectNATIONAL DRUG
dc.subjectNATIONAL RESEARCH COUNCIL
dc.subjectNATIONALS
dc.subjectNEONATAL HEALTH
dc.subjectNRC
dc.subjectNURSES
dc.subjectNUTRITION
dc.subjectOPERATING COSTS
dc.subjectPATIENT
dc.subjectPATIENTS
dc.subjectPEACEKEEPING
dc.subjectPERSONAL COMMUNICATION
dc.subjectPHARMACEUTICAL
dc.subjectPHARMACEUTICAL INDUSTRY
dc.subjectPHARMACEUTICAL POLICY
dc.subjectPHARMACEUTICAL PROCUREMENT
dc.subjectPHARMACEUTICAL PRODUCTS
dc.subjectPHARMACEUTICAL SECTOR
dc.subjectPHARMACEUTICAL SUPPLY
dc.subjectPHARMACEUTICAL SUPPLY MANAGEMENT
dc.subjectPHARMACEUTICALS
dc.subjectPHARMACIES
dc.subjectPHARMACISTS
dc.subjectPHARMACOLOGY
dc.subjectPHARMACY
dc.subjectPHARMACY ASSISTANTS
dc.subjectPHYSICIAN
dc.subjectPHYSICIANS
dc.subjectPOLICY FRAMEWORK
dc.subjectPOLIO
dc.subjectPOPULATION ACTIVITIES
dc.subjectPREGNANT WOMEN
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIMARY HEALTH CARE FACILITIES
dc.subjectPROCUREMENT
dc.subjectPROGRESS
dc.subjectPROJECT IMPLEMENTATION
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH CARE
dc.subjectPURCHASING
dc.subjectQUALITY ASSURANCE
dc.subjectQUALITY CONTROL
dc.subjectQUALITY OF SERVICES
dc.subjectQUANTITATIVE DATA
dc.subjectQUININE
dc.subjectRAPID GROWTH
dc.subjectRATIONAL DRUG USE
dc.subjectREFUGEES
dc.subjectREGULATORY AUTHORITY
dc.subjectREHABILITATION
dc.subjectREPRODUCTIVE HEALTH
dc.subjectRESOURCE CONSTRAINTS
dc.subjectRESPONSIBILITIES
dc.subjectSALARIES
dc.subjectSALE
dc.subjectSALES
dc.subjectSANITATION
dc.subjectSAVINGS
dc.subjectSENIOR
dc.subjectSERVICE DELIVERY
dc.subjectSHORT SUPPLY
dc.subjectSKILLED STAFF
dc.subjectSMALL COUNTRIES
dc.subjectSOCIAL SCIENCE
dc.subjectSOCIAL SECTORS
dc.subjectSTAKEHOLDER
dc.subjectSTAKEHOLDERS
dc.subjectSTANDARD TREATMENT GUIDELINES
dc.subjectSTOCKS
dc.subjectSUPPLY SYSTEMS
dc.subjectTABLETS
dc.subjectTECHNICAL ASSISTANCE
dc.subjectTECHNICAL INFORMATION
dc.subjectTENDERING
dc.subjectTETANUS
dc.subjectTHERAPEUTICS
dc.subjectTRADITIONAL HEALERS
dc.subjectTRAINING INTERVENTIONS
dc.subjectTRANSPORTATION
dc.subjectTUBERCULOSIS
dc.subjectUNDER-FIVE MORTALITY
dc.subjectUNFPA
dc.subjectVACCINES
dc.subjectVIOLENCE
dc.subjectWASTE
dc.subjectWORKERS
dc.subjectWORKING CAPITAL
dc.subjectWORLD HEALTH ORGANIZATION
dc.titleStarting from Scratch in Timor-Leste : Establishing a Pharmaceutical and Medical Supplies System in a Post-Conflict Context

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