How to optimise use of healthcare system

Healthcare products comprise medications, vaccines, devices, and surgical and medical procedures used in disease prevention, diagnosis, treatment and rehabilitation.

These are key pillars of Kenya’s road towards Universal Health Coverage. Effective management of health products through good inventories, resilient supply chain systems, rational use, harmonised regulations, and sound policies is critical to ensuring the optimal functioning of healthcare systems.

The Guidelines on Management of Health Products and Technologies in Kenya (2020), which are anchored on the Health Products and Technologies Supply Chain Strategy 2020-2025, provide the framework of information, procedures, and the tools needed to ensure regular and reliable supply of HPTs, their appropriate storage, control, and issuing across the various levels of service delivery.

Despite the guidelines and policies, access to health products and technologies remains a persistent problem in Kenya.

Under devolution, counties continue to grapple with institutional hurdles such as poor financing, inadequate inventory systems, disconnected supply chain management, inadequate human resources, and underused health information systems.

These institutional hurdles manifest themselves in public health facilities. Cash-strapped budgets, poor forecasting, and inadequate restocking translate to regular stock-outs of essential health products, leading to exclusion of a significant ratio of the population from reliable access to essential medicines and an increase in out-of-pocket spend on medical bills.

For health systems to function properly, efficient supply chains are vital to ensure equitable access to affordable, high-quality health products. The National Treasury issued a directive that all counties were to migrate to the Electronic Government Procurement(e-GP) platform by July 1 2025.

The system is envisioned to enhance the transparency, efficiency, and accountability of the public procurement process. However, less than 45 percent of the counties have fully integrated this platform into their process, which signals a gap in policy and implementation adoption. As such, most counties still use hybrid or manual procurement procedures.

Manual procedures pose the threat of inefficient methods of data collection and management, which do not provide reliable, real-time results necessary to inform critical decisions in procurement of HPTs.

To reinforce efficient data-driven decision-making, we propose measures that empower scaled digitalisation efforts and automation.

Real-time dashboards that enhance forecasting accuracy, reduced stockouts, and streamlined reports to ensure that procurement decisions are backed by data.

Recently, the Pharmacy and Poisons Board (PPB) issued standards for the Authentication and Traceability of Health Products and Technologies (2025).

This policy guideline will ensure that medicines and health products are genuine, traceable throughout the supply chain, and protected from falsified or substandard products. By enforcing track and trace of drugs, there will also be generation of crucial data that is important to quantify facility drug consumption data, predict future trends, and inform purchasing.

As these standards are progressively implemented, drug stock-outs will be minimised, thus building public trust in the health supply chain system.

Another source of worry is the procurement officials' inadequate capacity and resources, which results in a lack of oversight and implementation of current standards. To mitigate inadequacies in human resource capacity, there should be a dedicated, well-trained workforce that is essential for an effective and efficient health supply chain.

A report by the World Health Organization (WHO) highlighted the need for a systematic approach that provides technical support for improving skills, monitoring size, composition, skill sets, training needs, and performance of the workforce. This prompts capacity-building measures to increase procurement authorities' skills and competence.

In light of the above and until counties treat management of health products and technologies with the same urgency they reserve for procurement announcements, the gap between purchases and patients will persist.

The milestone worth celebrating is a patient walking into a county hospital and finding the medicine they need, affordable, genuine and available when it is needed.

Devolution will only have delivered on its healthcare promise when counties move beyond purchasing products to building transparent, data-driven and accountable supply chains that keep hospital shelves consistently stocked.