Discussion

Globally, with the launch of WHO’s guiding strategy document: Ending the neglect to attain the Sustainable Development Goals: A roadmap for neglected tropical diseases (NTD) 2021-2030, there are increasing calls for NTD programme integration. Integration is described both between diseases and with national health systems. Whilst research on health systems integration of NTD programmes is increasing, some components of integration are rarely considered. For example, ensuring appropriate, timely and integrated provision of NTDs medicines and supplies through national supply chain systems is seldom explored and little evidence exists about the enablers and hindrances that the overall integrated approach may place on the national supply chain. Thus, drawing on an evaluation of Liberia’s integrated case management programme for Neglected Tropical Disease, this study aims to describe the enablers and barriers to effective integration of the CM NTDs medical commodities into the national supplies chain system. Qualitative research methods were used in 2019 to collect data from rage of health system actors across all levels of the health system. Through our thematic analysis, we established that a platform exists within which to integrate medicine supplies for NTDs in Liberia, and integration of NTD medicines and supplies within the supply chain can facilitate increased accessibility to NTD services. Hindering factors can be attributed to, pre-existing weaknesses in the supply chain that cannot be solved by one program in isolation, donor reliance and lack of fixed funding for the central medical store (CMS) to procure NTD medicines and supplies. Without adequate consideration and understandings these weaknesses can lead to frequent stock out of NTD medicines at health facilities with significant consequences for health worker motivation and patient access; ultimately compromising the overall success of NTD integration within national health systems.