Pharmaceutical Kits to Curb Theft and Wastefulness
Since inauguration of the new constitution, the Kenyan Healthcare is devolved with respective counties undertaking the healthcare delivery for their residents. However, they all have to depend on supplies from the centralized KEMSA. KEMSA, is the government agency that procures and distributes the required pharmaceutical products across all the 47 county government facilities.
The processes that has been used has opened loopholes for pilferage and theft of the pharmaceutical products. This is because the system sends same products across the counties and only variable has been the quantities, irrespective of need in that county. Without proper monitoring systems of product usage, some products have ended up expiring in the counters, others have found themselves in private health facilities and chemists, with full labels of the GOK. This means the government ends up loosing not only supplies but the income it should have received from sale of these products. A private practitioner on the other hand is selling at high prices a product that they have acquired at mostly throwaway price. Cases have been reported of where the government facility personnel have directed patients to specific chemists to buy drugs from knowing well the under the table transactions that has happened
With this in mind, and focusing on attaining UHC in Kenya, where there is still a limited access to financial resources, Jayesh Saini recommends that the best way out is to have pharmaceutical kits prepared per county in line with devolved government set up. It is a known fact that there are some health conditions that are pertinent in a region and others that have never been experienced in some regions. The first cause of action would be to identify the disease patterns and occurrences at each county/sub county levels. Once this data is acquired, the next would be to map the diseases with the various pharmaceutical products (formulary) needed to treat or manage the conditions. This mapping is very critical as it gives direction of what should be procured and distributed to the health facilities by KEMSA. Direct requisition as per the kits would cut off the long supply chain, would monitor each health facility consumption patterns and easily detect any issues arising. The reduced supply chain would also cut-off the common diversion of consignments from intended recipients while at the same time ensuring counterfeit pharmaceutical products are removed from the chain. This is because KEMSA would make requisitions based on the kits and suppliers would be given specific kits list to provide for and the required quantities and specifications. Availability of formulary based, disease specific and region-specific products will ensure that the most recurrent conditions in a region and across the country are taken care of efficiently without delays in supplies.
