Industrial Productivity, Health Sector Performance and Policy Synergies for Inclusive Growth: A Study in Tanzania and Kenya

拟议的项目研究了来自两国当地工业和进口到卫生系统的大宗商品的供应链--基本药品、医疗设备和用品，以及一些其他健康必需品，如消毒剂。这些商品的短缺和负担不起是低收入非洲卫生保健质量差和被排斥在护理之外的持久原因。对于两个选定的案例研究国家，坦桑尼亚和肯尼亚，这两个国家都是低收入国家，但一个(肯尼亚)制造业更发达，我们的目标是检验这样一种假设，即可以确定的工业和卫生政策之间存在未经探索的协同作用，如果得到解决，可能有助于提高每个国家的就业、产业升级和改善卫生系统的绩效和可及性。如果我们是正确的，在更高的生产率、更合适和更便宜的产品以及创新的生产方式方面，工业生产的改善可能会在提高经济产出的同时改善卫生服务业绩：换句话说，它可能有助于包容性增长。拟议的研究将把两组研究人员聚集在一起，他们通常在不同的盒子里工作，将工业专家关注的问题联系起来，研究工业创新开发新产品和工艺并提高工业生产率的空间，以及卫生系统专家关注的加强卫生系统的问题，包括改善获得用品的机会。有零星的证据表明，当地生产的药品可以改善获得基本药品的机会，供应链更短和供应来源多样化可以减少短缺，但卫生专家也对非洲当地生产药品的质量和经济可行性表示怀疑。然而，非洲政策制定者和国际捐助者对支持非洲工业发展，包括当地的药品生产重新产生了兴趣，该项目将为辩论提供新的信息。这是两个东非研究机构，肯尼亚内罗毕的ACTS和坦桑尼亚达累斯萨拉姆的REPOA，以及英国开放大学和兰德欧洲公司之间的研究合作。它汇集了卫生系统和卫生市场、卫生经济学、工业经济学以及技术和创新研究方面的专业知识。研究过程将从一开始就涉及卫生和工业部门的私营部门、非政府组织和公共部门的利益攸关方，因此旨在将经常相互孤立工作的两组政策制定者聚集在一起，就研究结果产生的具体政策选择进行辩论。我们的目标是将这项研究转化为当地和国际政策的影响。

The proposed project studies the supply chains of commodities - essential medicines, medical equipment and supplies, and some other health essentials such as disinfectant - from local industries and from imports into the health systems in the two countries. Shortages and unaffordability of these commodities are persistent causes of poor quality health care and exclusion from care in low income Africa. For two selected case study countries, Tanzania and Kenya, both low income but one (Kenya) with more developed manufacturing, we aim to test the hypothesis that there are unexplored synergies between industrial and health policies that could be identified, and that, if addressed, could contribute to higher employment, industrial upgrading and improved health system performance and accessibility in each country. If we are correct, improved industrial production, in terms of higher producitivity, more appropriate and cheaper products, and innovative methods of production, could improve health service performance while raising economic output: in other words, it could contribute to inclusive growth. The proposed research would bring together two groups of researchers who often work in separate 'boxes, by linking up the concerns of industrial specialists, looking at the scope for industrial innovation to develop new products and processes and raise industrial productivity, and the concerns of health systems specialists with health system strengthening including improving access to supplies. There is patchy evidence that local production of medicines may improve access to essential medicines, and that shorter supply chains and diversification of sources of supply can reduce shortages, but there are also doubts among health specialists about the quality and economic viability of local production of medicines in Africa. There is however renewed interest among African policy makers and international donors in supporting African industrial development, including local production of pharmaceuticals, and this project would contribute new information to assist debate. This is a research collaboration between two East African research institutes, ACTS in Nairobi, Kenya, and REPOA in Dar es Salaam, Tanzania, and the Open University, UK, and Rand Europe. It brings together expertise in health systems and health markets; health economics; industrial economics; and technology and innovation studies. The research process will involve from the start private, NGO and public sector stakeholders in both health and industrial sectors, and thus aims to bring together two groups of policy makers too often working in isolation from each other, to debate concrete policy options that arise from the research findings. We aim to translate the research into local and international policy impact.