Imagine a child falling ill at midnight, the mother rushing her to the nearest public hospital only to be told by the nurse that there are no drugs, and to make matters worse, all the chemists in town are closed. I once read a story of a diabetic patient who opted for alternative therapy of chewing cloves, ginger and garlic to control his blood sugar levels.
Such experiences have been common to patients visiting Kenya’s public hospitals, where shortages of medical supplies are common or system failures cause artificial shortages.The Kenya Medical Supplies Authority (KEMSA) has addressed these issues by transforming from a bureaucratic agency, which it has been for years, to a more independent and competitive medical logistics authority. KEMSA is a state agency whose mandate is to procure, warehouse, and distribute medical commodities to public health facilities in the country’s 47 counties. This is an important milestone that has contributed to improved service delivery.
I witnessed first-hand the impact of these changes when I recently visited KEMSA’s Supply Chain Centre in Nairobi. My mission was to understand its new ‘supermarket-like’ model and how it has positively changed the medical supplies chain across the country. I reminisced about how most Kenyans have had little faith in public hospitals, partly attributable to the acute shortage of medicines and other essential supplies, and how this created a trail of misery for millions of patients who rely on medical services from public hospitals and clinics.
The pharmaceutical industry in Kenya has had its fair share of challenges, ranging from ineffective supply chain systems, inadequate human resources and financing for drugs and other health commodities. This has necessitated reforms, especially now to meet the needs of the country’s devolved health system.
KEMSA’s transformation has been supported by several partners including United States Agency for International Development (USAID), UNICEF, the World Bank, and the Danish International Development Agency (DANIDA), among others. World Bank’s $87 million credit has helped KEMSA to reform its commodity management by paying for the commodities to correct adequacy and unpredictability of financing. This has enabled KEMSA to recapitalize, reconfigure its business model, and to devolve funds for procurement of medical commodities to the counties. The new self- sustainable “supermarket” supply-system model, ensures that supply of medical commodities to public health facilities continues uninterrupted.
KEMSA’s Supply Chain Centre operates 24 hours 7 days a week. The Centre is a massive facility that houses strong warehousing systems whose modern infrastructure enhances fast order processing such as racking, air conditioning, CCTVs, cold-chain storage capabilities, quality assurance laboratories and adequate modern mechanical handling equipment. The Authority has nine (9) regional warehouses across the country. It has also made investments in information communications technology (ICT) to improve its operational efficiencies and all business processes and functions are now fully automated and integrated on an enterprise resource planning (ERP) platform.
The medical supplies are distributed from the KEMSA’s Supply Chain Centre to the door steps of each of the public facilities and testing sites. Presently, KEMSA serves 371 hospitals, 4,415 rural health facilities and 5,047 sites that offer rapid testing across Kenya.
Unlike before, the counties now pool the orders received from health facilities and share them with KEMSA online and pay for their medical commodities on a ‘demand-driven’ supply system. The online portal allows the county health teams to chat with KEMSA staff and to keep track of their orders in real-time. The portal has reduced significantly challenges related to manual ordering processes, creating operational efficiency and cost effectiveness. Also, public health facilities have the option of placing orders for supplies instantly via e-mobile by dialing *651#
KEMSA has the requisite transport system in place which includes outsourced transport, courier service and own fleet. This ensures timely dispatch of all commodities ordered by health facilities from any corner of the country. The counties receive their supply within four working days, down from a month.
“If we place an order today, at most it takes two days and drugs will be here.” says Dr. Irene Muchoki, the Chief Pharmacist at Mama Lucy Kibaki Hospital in Nairobi, who confirmed the notable improvement particularly in the speed of delivery, reasonable pricing, and the quality of products.
According to Dr. John Munyu, KEMSA’s CEO, the new business model is “self-sustaining, has reduced the need for government support, and it is working well in all the 47 counties. Besides, the funds realized from sale of medical commodities to county health facilities are used to replenish stocks. The ERP platform provides timely and accurate supply chain data that helps forecasting, inventory replenishment, and quantification, adds Dr. Munyu.
Ultimately, the new model’s enhanced operations have increased demand for medical supplies from the counties by more than 50%. These gains will certainly change the lives of the people served by public health services all over the country.
Such experiences have been common to patients visiting Kenya’s public hospitals, where shortages of medical supplies are common or system failures cause artificial shortages.The Kenya Medical Supplies Authority (KEMSA) has addressed these issues by transforming from a bureaucratic agency, which it has been for years, to a more independent and competitive medical logistics authority. KEMSA is a state agency whose mandate is to procure, warehouse, and distribute medical commodities to public health facilities in the country’s 47 counties. This is an important milestone that has contributed to improved service delivery.
I witnessed first-hand the impact of these changes when I recently visited KEMSA’s Supply Chain Centre in Nairobi. My mission was to understand its new ‘supermarket-like’ model and how it has positively changed the medical supplies chain across the country. I reminisced about how most Kenyans have had little faith in public hospitals, partly attributable to the acute shortage of medicines and other essential supplies, and how this created a trail of misery for millions of patients who rely on medical services from public hospitals and clinics.
The pharmaceutical industry in Kenya has had its fair share of challenges, ranging from ineffective supply chain systems, inadequate human resources and financing for drugs and other health commodities. This has necessitated reforms, especially now to meet the needs of the country’s devolved health system.
KEMSA’s transformation has been supported by several partners including United States Agency for International Development (USAID), UNICEF, the World Bank, and the Danish International Development Agency (DANIDA), among others. World Bank’s $87 million credit has helped KEMSA to reform its commodity management by paying for the commodities to correct adequacy and unpredictability of financing. This has enabled KEMSA to recapitalize, reconfigure its business model, and to devolve funds for procurement of medical commodities to the counties. The new self- sustainable “supermarket” supply-system model, ensures that supply of medical commodities to public health facilities continues uninterrupted.
KEMSA’s Supply Chain Centre operates 24 hours 7 days a week. The Centre is a massive facility that houses strong warehousing systems whose modern infrastructure enhances fast order processing such as racking, air conditioning, CCTVs, cold-chain storage capabilities, quality assurance laboratories and adequate modern mechanical handling equipment. The Authority has nine (9) regional warehouses across the country. It has also made investments in information communications technology (ICT) to improve its operational efficiencies and all business processes and functions are now fully automated and integrated on an enterprise resource planning (ERP) platform.
The medical supplies are distributed from the KEMSA’s Supply Chain Centre to the door steps of each of the public facilities and testing sites. Presently, KEMSA serves 371 hospitals, 4,415 rural health facilities and 5,047 sites that offer rapid testing across Kenya.
Unlike before, the counties now pool the orders received from health facilities and share them with KEMSA online and pay for their medical commodities on a ‘demand-driven’ supply system. The online portal allows the county health teams to chat with KEMSA staff and to keep track of their orders in real-time. The portal has reduced significantly challenges related to manual ordering processes, creating operational efficiency and cost effectiveness. Also, public health facilities have the option of placing orders for supplies instantly via e-mobile by dialing *651#
KEMSA has the requisite transport system in place which includes outsourced transport, courier service and own fleet. This ensures timely dispatch of all commodities ordered by health facilities from any corner of the country. The counties receive their supply within four working days, down from a month.
“If we place an order today, at most it takes two days and drugs will be here.” says Dr. Irene Muchoki, the Chief Pharmacist at Mama Lucy Kibaki Hospital in Nairobi, who confirmed the notable improvement particularly in the speed of delivery, reasonable pricing, and the quality of products.
According to Dr. John Munyu, KEMSA’s CEO, the new business model is “self-sustaining, has reduced the need for government support, and it is working well in all the 47 counties. Besides, the funds realized from sale of medical commodities to county health facilities are used to replenish stocks. The ERP platform provides timely and accurate supply chain data that helps forecasting, inventory replenishment, and quantification, adds Dr. Munyu.
Ultimately, the new model’s enhanced operations have increased demand for medical supplies from the counties by more than 50%. These gains will certainly change the lives of the people served by public health services all over the country.
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