Inside ambitious Kemsa reforms to end graft, ensure UHC success

Workers load drugs onto a truck at KEMSA's Embakasi warehouse, April 4, 2023. [Samson Wire, Standard]

The Kenya Medical Supplies Authority (Kemsa) has announced it is undertaking far-reaching reforms to ensure the success of the Universal Health Coverage (UHC) programme.

The authority is the only government supplier of health products and technologies (HPTs) in the country, and says it hopes to ensure service providers have adequate essential medical commodities.

In a plan to increase its order fill-rate to 80 per cent, the Acting CEO Andrew Mulwa said procurement processes are undergoing overhaul, including digitising and allocating local manufacturers bigger share of supplies.

“Currently, the order fill-rate stands at 56 per cent. However, the situation is set to change, with the authority finalising the July tenders, which are expected to increase the stock status. This will make Kemsa a one-stop shop for all health products and technologies required in public health facilities,” said Dr Mulwa.

In a recent interview, Health CS Susan Nakhumicha said in March, the authority’s fill rate was below 40 per cent.

Ms Nakhumicha attributed this to the failure by vendors and suppliers to deliver supplies in required quantities in the past two years.

Bulk procurement, according to the authority, will also allow lower the cost of HPTs, making healthcare more affordable and accessible in line with UHC goals.

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Impartial pre-qualification

During its launch last month, President William Ruto maintained that Kenya Kwanza Government has identified healthcare delivery as one of the four pillars of the Bottom-Up Economic Transformation Agenda.

“The authority has enhanced reservation of HPT tenders to local manufacturers to improve affordability and make Kemsa competitive as a procurement agency for health products and technologies,” said Dr Mulwa.

Kenya suffered shortage of medical supplies and commodities during the Covid-19 pandemic following global supply chain challenges.

Among affected commodity supplies were vaccines, gloves, condoms, face masks, personal protective equipment as Kenya, among other low and middle income countries, were not given priority.

Additionally, to guarantee smooth operationalisation of UHC the authority is also overhauling the pre-qualification system.

In July, the new Kemsa board led by chairman Irungu Nyakera revoked the existing list of pre-qualified suppliers and initiated a new and impartial process to pre-qualify suppliers that will offer value for money.

Pre-qualification of suppliers at the authority has paved the way for fair competition and realising the best prices for HPTs, hence lowering the cost of healthcare.

To curb graft, Dr Mulwa added that ongoing contracts have been reviewed and eliminated single sourcing and monopoly actions.

“The review of costly contracts seeks to optimise the authority’s resource allocation to ensure adequate stocks of essential medical supplies in support of UHC,” he said.

The authority, that has in the past reported multiple scandals in procurement process, among them procurement of mosquito nets that was issued to an unqualified bidder, leading to cancellation of local supplier.

The authority came into the limelight in 2020, following the misappropriation of Sh7.8 billion Covid-19 funds.

The authority is also aligning with digitisation, through acquisition of a new enterprise resource planning, to achieve end to end visibility through the supply chain.

This is in line with the enacted Digital Health Act, recently assented by President Ruto. The law will streamline adoption of technology in the health sector, enabling improved data sharing and resource utilisation.

“Digitalisation at Kemsa will also ensure integrity and transparency,” said Dr Mulwa.

Whereas Kemsa is the only public medical and commodity supplier in the country, it has in the past been accused of failing to supply drugs on time, leading to delay in access to healthcare by patients.

But for smooth drugs supply, Dr Mulwa said Kemsa has implemented measures to ensure it significantly reduces the time taken to procure commodities by weeding out unnecessary steps that cause delay.

“Reduction of procurement lead time will shorten the duration in completing the procurement and impact the order fill rate,” added the CEO. Further, the agency has established a robust logistics network to ensure an equitable and last-mile distribution of medical supplies to healthcare facilities across Kenya.

This will help in bridging the healthcare access gap, especially in underserved and remote areas, thereby promoting equity in healthcare services as part of its contribution to achieve UHC.

To ensure smooth supply, the agency is opening new warehouses in Mombasa and Kisumu, which it says will be fully functional to work by mid next year.

Community health workers

In support of Community Health Promoters (CHP), recently empowered by President Ruto to kick-start implementation of UHC, Dr Mulwa said Kemsa is adequately stocked to support the CHPs programme in replenishing the pharmaceutical and non-pharmaceutical consumables.

“Kemsa is collaborating with various stakeholders, including the Ministry of Health, county governments, non-governmental organisations, and international partners to align efforts in expanding healthcare access and achieving UHC,” he noted.

Kenya Kwanza administration is pegging healthcare to preventive and promotive health, which president Ruto maintains will be attained by empowering community health promoters.

In his plan, the President assented four Acts to oversee implementation of UHC, namely Primary Heath Care Act, 2023, Digital Health Act, 2023, Facility Improvement Financing Act,2023 and Social Health Insurance Act, 2023.