Spotlight: Kenya’s medical supply agency transforms to improve service delivery, and save lives

Summary: It is a large warehouse, with racks up to the ceiling. It is big, bright and humming with activity. Workers in white coats are going through purchase orders, using hand held scanners to pick items off the shelves: bottles of cough syrup, inhalers, syringes, antibiotics. We are in Nairobi, at the warehouse of the Kenya Medical Supplies Authority also known by its acronym - KEMSA. It is a state owned company with the mandate to procure, warehouse and distribute healthcare commodities to public health facilities across the country. Dr. John Munyu, chief executive officer at KEMSA: “With the coming of the devolved system of government in the year 2013, the health system underwent a paradigm shift. Previously health was centrally controlled by the central government from Nairobi, but with the adoption of the devolved system of government, the 47 counties are now responsible for health services management in their own counties. Therefore, KEMSA had to change its business model, we had to look at our architecture and reconfigure our business model to be able to serve the counties.” Changing its business model meant that KEMSA had to become much more demand driven. The World Bank, through the Kenya Health Sector Support Project put forward the necessary funds in order to stock KEMSA’s warehouse and provide it with a working capital. This enabled the agency to build a self-sustaining business model: since KEMSA now has its own funds, it can assess the needs of its customers, purchase commodities, process the county’s orders, get paid, and then use the money to replenish stocks and pay suppliers. Dr. Ramana Gandham, lead health specialist with the World Bank based in Nairobi: “The capitalization of KEMSA has really helped them along with the new supply chain management. Earlier, it used to be a much more bureaucratic organization depending on funding from the ministry of health, and there were always delays in cash flow, and as a result supplier payments could not be made in time. The Kenya medical supplies authority is now much more responsive and its model is much more demand driven, responding to the requests made by the county governments.” So how does this new model exactly work? In the past, purchase orders from the counties were sent via mail or courier. Many would end up getting lost and mistakes were made when trying to read someone’s handwriting. Now, health facilities can make their purchases directly through KEMSA’s online ordering portal. Back at the KEMSA warehouse, shopkeepers go through the purchase order, pick the requested items and prepare shipments. Packages are sent directly to the health facility’s doorstep using outsourced transport. Each vehicle is equipped with a GPS that allows KEMSA to track it in real time and make sure there are no delays and every shipment is accounted for. Dr. Irene Muchoki is the chief pharmacist at Mama Lucy Kibaki Hospital in Nairobi. Being a public hospital, Mama Lucy procures most of medical supplies from KEMSA. “I have been around during the whole change in KEMSA. I would say the situation is way better compared to before when the lead times were just really bad so that you find you have run out of drugs completely. Right now there is a big change. We still have a few gaps, there is no system that is 100%, but compared to before, this is awesome, it’s good, it’s much better. For instance if we order today, at most it takes 2 days and drugs will be here.” To learn more about the work of the World Bank in Kenya, please visit www.worldbank.org/kenya.