The Covid-19 pandemic exposed our inadequacies in management of health supply chains that rely heavily on global interconnectedness. Localisation and alternative sourcing of health commodities to mitigate similar risks in future are paramount.
Undoubtedly, interventions undertaken by both levels of governments (national and county) have had significant impact in not only addressing Covid-19 related commodity issues, but also assuring continuous availability of all essential health commodities.
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 difficult to maintain updated records of consumption patterns and stock levels. At the same time, 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 information technology and communication in providing the necessary capacity for real-time data, analysis, managing exceptions and even supplying alerts for key decisions, cannot be underestimated.
County governments should consider increasing visibility of health commodities. 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. Notable investments made by county governments in ICT infrastructure; improving internet connectivity within and amongst health facilities; and progressively training county staff on inventory management continue to provide the necessary springboard.
Second, county governments have a huge responsibility in shaping the markets for health products and technologies, and indeed stewarding innovation to address citizen’s needs. This calls for close collaboration between county government departments of health services.
Thirdly, revitalisation of the county governments’ 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.
Fourth, striking an effective balance between centralised and decentralised functions is key. It’s necessary that our centralised procurement warehousing and distribution systems undertake routine stress testing.
Kenya Medical Supplies Authority’s (Kemsa) handling of Covid-19 related supplies taught us that we need a better appreciation of the market conditions to mitigate risks that arise from supply concentration. In considering activation of alternative sources of health supplies to Counties, county governments should work closely with Kemsa.
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 as well as rising healthcare costs.
Health workers should keep abreast of societal expectations regarding their duty of care. On the other hand, private sector players should complement county governments in their efforts towards strengthening tracking and traceability of products, embracing digital solutions, and improving logistics for efficiency.
County governments should sustain current efforts aimed at continuously obtaining and sharing information on health commodity 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 of our county health supply chain will be put to test.
It is, therefore, imperative to ensure that 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.