The Health Policy Project has ended, but work continues under a new USAID five-year project, Health Policy Plus (HP+).
NEWS & VIEWS
By Taylor Wilkerson, LMI Program Manager, Global Health; Bobby Jefferson, Palladium, VP, Innovations Communication & Technology Practice; and Katie West Slevin, Health Policy Project, Technical Writer
In recent years, Kenyan health care delivery has shifted dramatically. Thanks to decentralization, many of the Kenyan government’s functions, including the delivery of health care, have shifted from the central government out to 47 newly-created counties. Here is how the USAID- and PEPFAR-funded Health Policy Project (HPP) partnered with a key Kenyan health authority to improve services.
Before 2013, most Kenyan public health services were provided primarily through national government health systems. Most health care supplies were managed by the Kenya Medical Supplies Authority (KEMSA), a state-owned health logistics service company set up in 2000. KEMSA would order, store, and distribute the bulk of health care commodities to public sector health providers.
A 2010 constitutional mandate and, later, legislative shifts changed how health care would be delivered. After the 2013 elections, Kenya’s new governance structure began devolving certain roles and functions, including health services, from the national government to 47 newly-created counties. Among other responsibilities, county governments could now purchase their health care supplies from sources other than KEMSA.
This was new territory for KEMSA. They had to ensure their offerings were competitive in this new market-driven world. They partnered with HPP to develop a five-year strategic plan. They had four goals:
Build a dynamic, efficient, and sustainable management/governance structure
- Keep supplies at optimal stock levels
- Meet customer needs efficiently
- Increase demand for commodities and services
- The new strategic plan formed the backbone of the renewed KEMSA operations, refocusing the authority and creating new energy for further changes.
Building a Stronger Management and Governance Structure
Shifting from a monopoly provider to a responsive partner required a lot more than technology implementations. KEMSA and HPP kicked off the efforts with stakeholder interviews and workshops.
“These challenges were resolved by engaging current and potential KEMSA clients,” says Aaron Mulaki, HPP’s health systems and public administration advisor in Kenya. “We needed to identify ways KEMSA's vision, philosophy, focus, and strategic direction should change to meet its customer needs.”
To build a more customer-focused culture, KEMSA created a call center and trained its customer service teams. It set training goals for customer service teams every six months.
Ensuring Supplies Were at Optimal Levels
To reach this goal required the implementation of an Enterprise Resource Planning system. KEMSA needed to be able to process a lot more data quickly. This was more than a technology implementation, it was also a cultural shift.
Meeting Customer Needs Efficiently
KEMSA’s customers were rapidly becoming more sophisticated. They were increasingly tracking their patients’ health outcomes through their own systems improvements on-the-ground. Their expectations were growing. As soon as they heard about new treatments for HIV/AIDS, or better malaria vaccines, they wanted quick access.
A significant technology improvement for this goal was the implementation of an electronic ordering platform, supported by the call center. In the past, KEMSA would ship a pre-selected inventory on a preset schedule. Orders could now be fulfilled on a more responsive schedule, ensuring county-based health authorities did not over-buy products that could then expire.
Increasing Demand for Commodities and Services
KEMSA needed to expand its focus from being solely a provider of supplies to also being a provider of the latest news about medical options. It built a communications infrastructure to inform county-based health authorities about new offerings, thus building new markets.
Sharing the latest medical information with all 47 county-based health authorities also supports a similar level of service across the regions. This is a value-added relationship that shares the burden of keeping up with the latest health technologies.
To build relationships with customers, KEMSA created a database of health care providers who had special interests within the medical supply chain. This allowed them to target information to the right customers.
Behind all of these improvements was the strategic plan KEMSA developed with HPP’s help. The new strategic framework allowed KEMSA to become more agile, data driven, and efficient in responding to its major clients—the 47 county-based health authorities. This change will have positive impacts on health outcomes for all Kenyans and can serve as a model for other countries which choose to decentralize health care services.
The Health Policy Project is a five-year cooperative agreement funded by USAID from September 30, 2010 to September 29, 2015, with select activities extended through March 2016. The project’s HIV activities are supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). It is implemented by Futures Group (now Palladium), in collaboration with Plan International USA, Avenir Health (formerly Futures Institute), Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA).
In partnership with USAID, LMI’s team—which includes Palladium—helps governments and their stakeholders anticipate and address health supply chain needs in order to improve health outcomes. If you are interested in how LMI and our partners, such as Palladium, can help with your health care supply chain needs, please contact Taylor Wilkerson at firstname.lastname@example.org or visit our website at http://www.ghsc.lmi.org/.
Mr. Wilkerson heads the Global Health group at LMI. Previously, Mr. Wilkerson worked for SECOR International Inc., an environmental consulting company. He has an MBA from the University of Maryland, and BS in mechanical engineering from Vanderbilt University.
Mr. Jefferson leads the Innovations Communication and Technology Practice at Palladium. With over 15 years of experience in IT project management, Mr. Jefferson has led design of innovative mHealth, eHealth and DHIS2 solutions. He has also established national Information and Communications Technology Policy regulations for emerging countries and is the technical architect of open source electronic health records in Africa.
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