• Counties can consider increasing visibility of health commodities at county, subcounty and facility level, a priority.
• Progress made so far with automation of various aspects of the supply chain system have demonstrated improvements in order management, data quality
Image: OZONE
The surge in demand for Covid-19 response supplies such as personal protective equipment, hand sanitiser, laboratory supplies, medical oxygen and vaccines exposed our inadequacies in management of health supply chain. It has relied heavily on the global interconnectedness.
Localisation and alternative sourcing of health commodities to mitigate similar risks in future became a more urgent agenda. An additional concern was availability of timely, accurate and complete data at all levels to inform demand /supply planning and key decisions in the response. Indeed, on several occasions during the last year, the demand for medical oxygen was overwhelming and caused anxiety amongst citizens.
Undoubtedly, the interventions undertaken by national and county governments have had significant impact in not only addressing Covid-19-related commodities issues, but also assuring continuous availability of all the other essential health materials.
On top of this, there is refocusing of healthcare financing, and exploration of measures to reduce high cost of health products and technologies, whilst simultaneously increasing budgetary allocations. Some critical lessons have emerged regarding resetting county health supply chain priorities for improved responsiveness and resilience in future.
First, we need to optimise visibility and coordination of the county health supply chain. The sheer variety and number of products required to address health needs makes it extremely difficult to maintain updated records of consumption patterns and stock levels.
At the same time, the needs for handling these products and technologies vary. For instance, some vaccines require ultra-cold-chain transportation and storage; some products require reconstitution, while others need dark storage conditions.
The role of ICT in providing the necessary capacity for real time data, analysis, managing exceptions and supplying alerts for key decisions cannot be underestimated. Critical alerts include products with short expiries at the facility level, low and high stock levels, and temperature excursions.
Counties can consider increasing visibility of health commodities at county, subcounty and facility level, a priority.
Progress made so far with automation of various aspects of the supply chain system have demonstrated improvements in order management, data quality for demand and supply planning, and costs savings.
The dream of having a sort of ‘glass pipe’ that supports connection and collaboration among suppliers, transporters, county health managers and service delivery points is thus gradually under realisation.
The notable investments made by county governments in ICT infrastructure improving internet connectivity within and amongst health facilities and progressively training staff on inventory management continue to provide the necessary springboard.
County governments should, therefore, prioritise appropriate digital solutions that enable supply chain visibility and early risk detention.
Second, they have a huge responsibility in shaping the markets for health products and technologies, and stewarding innovation to address citizen’s needs. This includes feedbacking the county specific local markets to promote fair pricing.
To deliver this responsibility, there is need for close collaboration between county departments of health services, and the local training and research institutions, including those delivering vocational training. Full exploration of product range paying attention to items that may already have been considered for preferential procurement lists is necessary in building resilience.
Third, revitalisation of the counties’ functional units responsible for coordinating delivery of critical health supply chain functions such as quantification, acquisition, warehousing, distribution, inventory management, and rational use is more urgent than ever.
So far, the groundwork has been laid out with most counties assigning and dedicating multidisciplinary teams to coordinate health commodities quantification efforts, logistics, and quality assurance processes. Similarly counties have made commitment to increase budgetary allocations for acquisition of quantified commodity needs and supporting systems necessary to get the commodities to the citizens.
Fourth, striking an effective balance between centralised and decentralised functions is key. It’s necessary that our centralised procurement warehousing and distribution system undertakes routine stress testing for its capacity to handle large scale disruptions.
Kemsa’s handling of Covid-19 related supplies taught us that we need a better appreciation of the market conditions and mitigate risks that arise from supply concentration better. In considering activation of alternative sources of health supplies to the counties, the governments should work closely with Kemsa in getting local suppliers within their jurisdictions onboarded as suppliers.
Additionally, collaboration with the suppliers and third-party logistics firms should be enhanced through information and knowledge sharing for more effective demand management. These efforts should also be coupled with streamlining of sharing arrangements for regional warehouses, in order to drive cost savings through operational efficiency.
Fifth, the dire need to create more awareness and promote supply chain accountability has been reaffirmed. The journey of getting health products from source to the citizens is arduous and involves multiple players with varying interests. Similarly, opening up all the processes involved to effectively monitor the movement of multiple products and obtain insights for planning and decision making, is even more demanding.
Citizens must be sensitised on their responsibilities around rational use of health products in the wake of rising threat of antimicrobial resistance, medical waste hazards to the environment as well as rising healthcare costs.
Health workers should keep themselves abreast with the societal expectations regarding their duty of care. On the other hand, private sector players should truly complement counties in their efforts towards strengthening tracking and traceability of products, embracing digital solutions, and improving logistics for efficiency.
Counties should sustain efforts aimed at continuously obtaining and sharing information on health commodities needs, increasing budget allocations, systematically managing key supply chain risks -conflicts of interests, stock outs and expiries.
Predictably, disruptive events will still emerge in the future and the resilience our county health supply chain be put to test.
It is, therefore, our imperative to ensure we progressively strengthen our healthcare supply chain system to remain responsive. Embracing digital solutions for increased visibility and networked collaboration is the way to go.
Mary Mwiti is the CEO Council of Governors