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Published on: April 6, 2019
Supply-chain strategies for essential medicines in rural western Kenya during COVID-19
Dan N Tran1, Phelix M Were2, Kibet Kangogo2
1Department of Pharmacy Practice, Temple University School of Pharmacy, Philadelphia, United States of America (USA).
Insights
The revolving fund pharmacy model ensured continuous medicine access during COVID-19. This community approach adapted supply chains and partnered with local health authorities for success.
Area of Science:
- Global Health
- Health Systems Strengthening
- Pharmaceutical Supply Chain Management
Background:
- The COVID-19 pandemic severely disrupted global health systems and medicine supply chains.
- Vulnerable populations in low- and middle-income countries faced significant challenges accessing essential medicines through public health systems.
Purpose of the Study:
- To implement and evaluate rapid supply-chain strategies to ensure continuous access to essential medicines during the COVID-19 pandemic in Kenya.
- To minimize patients' risk of COVID-19 exposure while obtaining necessary medications.
Main Methods:
- Redistributed central medicine stocks to peripheral health facilities for extended local availability.
- Equipped remote health facilities with medicine tackle boxes.
- Facilitated direct medicine deliveries to patients facing access challenges.
- Leveraged a 30-year partnership with local health authorities and an existing revolving fund pharmacy scheme.
Main Results:
- Increased essential medicine stocks at peripheral facilities by over 160% (835,140 units in April 2020 vs. 316,330 in April 2019).
- Provided medicine tackle boxes to an additional 46 health facilities.
- Successfully delivered medications to 84.9% (264/311) of reachable noncommunicable disease patients.
Conclusions:
- The adapted revolving fund pharmacy model successfully maintained uninterrupted patient access to essential medicines during the pandemic.
- Community-based approaches and rapid adaptation of supply-chain infrastructure in partnership with local authorities were key to success.
- The study highlights the resilience of established health partnerships in crisis situations.
Problem:
The coronavirus disease 2019 (COVID-19) pandemic has disrupted health systems worldwide and threatened the supply of essential medicines. Especially affected are vulnerable patients in low- and middle-income countries who can only afford access to public health systems.
Approach:
Soon after physical distancing and curfew orders began on 15 March 2020 in Kenya, we rapidly implemented three supply-chain strategies to ensure a continuous supply of essential medicines while minimizing patients' COVID-19 exposure risks. We redistributed central stocks of medicines to peripheral health facilities to ensure local availability for several months. We equipped smaller, remote health facilities with medicine tackle boxes. We also made deliveries of medicines to patients with difficulty reaching facilities.
Local Setting:
Τo implement these strategies we leveraged our 30-year partnership with local health authorities in rural western Kenya and the existing revolving fund pharmacy scheme serving 85 peripheral health centres.
Relevant Changes:
In April 2020, stocks of essential chronic and non-chronic disease medicines redistributed to peripheral health facilities increased to 835 140 units, as compared with 316 330 units in April 2019. We provided medicine tackle boxes to an additional 46 health facilities. Our team successfully delivered medications to 264 out of 311 patients (84.9%) with noncommunicable diseases whom we were able to reach.
Lessons Learnt:
Our revolving fund pharmacy model has ensured that patients' access to essential medicines has not been interrupted during the pandemic. Success was built on a community approach to extend pharmaceutical services, adapting our current supply-chain infrastructure and working quickly in partnership with local health authorities.
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