Giving Meaning to Numbers for Informed: Decisions in Kenya’s Malaria Supply Chain

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Lead Paragraph/Summary

The pressure to deliver on the urgent need for health commodities using a manual system is overwhelming. Since 2015, Robert Mwaura, a logistician working for the Division of National Malaria Program (DNMP) at the Ministry of Health (MOH) ensures that enough malaria commodities (medicine and testing /diagnostics kits) are available both at the health facilities and at the Kenya Medical Supplies Authority (KEMSA), which serves as the central warehouse.

FY2020 Q3 Afya Ugavi Success Story Image
FY2020 Q3 Afya Ugavi Success Story Image
Patients receive medicine at the Kombewa county hospital, Kenya. Photo Credit: Dandan Luo
Body Text

In Kenya, malaria is a major public health problem. Three-quarters of the population are at risk of malaria with the lake and coastal regions having the highest burden in the country. The 2019 Kenya Health Information System (KHIS) data reported indicates a malaria incidence rate of 65.7 percent with a total of 4.6 million confirmed cases, and 5 million treated for malaria. These numbers were reported from around 6,000 health facilities that also report on malaria commodities.

Because the system to service commodity orders was manual, mistakes are bound to increase resulting for instance in many health facilities either understocked or overstocked as counties ordered and received commodities without regard for proper determination of re-order quantities, provided they did not exceed their limits, regulated at certain levels of capped quantities. Robert’s work requires him to regularly coordinate with counties to ensure this is addressed and that malaria treatment is available at the health facilities. As life-saving commodities, quick turnaround time is critical, as the orders are patient-focused.

“The manual system was inefficient, and led to wastage through expiry and redistribution, which bore additional costs,” said Robert.

From Numbers to Visuals and Patterns

The United States Agency for International Development (USAID) Afya Ugavi Activity provides comprehensive technical assistance to strengthen Kenya’s supply chains for HIV/AIDS, malaria, family planning, and maternal and child health commodities at both the national and county levels of the health system. Together with HealthIT, KEMSA, DNMP, and county departments of health, we partnered to develop, test, and finalize the country’s health commodities dashboard for malaria. The dashboard enables visualization of reported numbers making it easy for decision makers to analyze emerging patterns and act quickly.

The malaria dashboard is integrated with KHIS and KEMSA’s Logistics Management Information System and is accessible through the District Health Information Software (DHIS2) platform to enable comparison of various data sets, and provide information on critical indicators in a format useful for decision making. Health workers at both county and national levels can view and analyze information to make informed decisions. Dr. Faustina Sakari, a malaria coordinator in Kakamega County, noted that pharmacists can now easily track stock levels and determine resupply commodity needs.

“We also monitor and identify facilities with low indicator scores for follow-up, thus improving on commodity management performance through various technical working groups and health facilities leaders’ forums,” she added.

Results and Benefits

The use of the malaria dashboard has brought additional benefits to supply chain management. First, it is easier to look at the commodity consumption data retrieved from DHIS2, determine commodity needs including product selection, financing, procurement, and delivery, and estimate quantity of each product needed for each quarter or year. This has informed the Kenya Malaria Strategy 2019–2023 forecasting and costing. Second, with an average of 93 percent reporting rate for all health facilities, data is available for decision making at various levels of the health system. Using these data, the tool has enhanced efficiency and reduced operational costs through better commodity management that minimizes the need for redistribution and wastage due expiry of drugs. And third, as health workers access and use the dashboards, they are empowered to make informed decisions not only on the kind of drugs to order, but also the needed quantities. With this system, they have become more accountable in the management of the resources in their care.

Into the Future

USAID – with support from the U.S. President’s Malaria Initiative – continues to support the government of Kenya’s health system by enhancing the technical capacity of DNMP personnel, developing the procurement and supply chain system to more efficiently deliver supplies and commodities to health facilities, improving and streamlining routine malaria data collection, and assisting the DNMP in monitoring its achievements. The malaria dashboard is a key driver in ensuring counties have credible data that promotes sound decisions especially in the implementation of the Kenya Malaria Strategy 2019-2023.

Following the success of the malaria commodity dashboard in promoting end-to-end data visibility for decision making, Afya Ugavi, and HealthIT are supporting initiatives to develop similar dashboards for other health commodities. In addition, we are collaborating with partners to enhance counties’ surveillance to better prepare for future response and management of epidemics and pandemics.

“Afya Ugavi has built my capacity in supply chain data management and introduced to DNMP one of the structures that we can say is truly sustainable. The visualization from the numbers has reformed not just how we work, but also our accountability to those seeking care.” – Robert Mwaura, Logistician, Division of National Malaria Program Kenya, Ministry of Heath

Robert Mwaura