Using Data to Improve Performance and Minimize Waste in Public Health Supply Chains in Kenya: A Case...

Dr. Claver Kimathi,

County Pharmacist Isiolo

USING DATA TO IMPROVE PERFORMANCE AND

MINIMIZE WASTE IN PUBLIC HEALTH SUPPLY

CHAINS IN KENYA: A CASE STUDY OF ISIOLO

COUNTY

Global Health Supply Chain Summit

• In 2010: responsibility and budgetary authority for funding

and providing government services devolved to county

level

• Local decision making and management of health system

can address county-specific needs, but…

• It has also disrupted health service delivery and led to

fragmented demand and supply planning, irregular

replenishment, and gaps in data management cycle

CURRENT KENYA SUPPLY CHAIN CONTEXT

3 Global health Supply Chains. Dar es Salaam Tanzania 2016

ISIOLO COUNTY: CONTEXT

• Population is 143,294 (2009 census)

• The local topography is arid or semi-arid low plains

• Poor road remains at 58.9 years.

• The county has 2 level four health facility and 34

level one facilities

• Furthest health facility is

290 km from Isiolo town and

480km from Nairobi


ISIOLO HEALTH AT A GLANCE

Status of Public Health

Health status remains at

suboptimal level with less

that 50% of the population

accessing healthcare in

Isiolo

*Current=2015

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Children Immunised Births delivered at a

health facility

Contraceptive

Prevalence

County 2012

County Current

Kenya Current


IMPACT TEAM NETWORK

Leadership Network IMPACT Teams

Build dynamic leaders within a

supply chain who are motivated and

possess the competency required to

fulfill essential supply chain

functions, who are empowered to

make decisions and act as change

agents.

Provide a structured approach for

using data, create a culture of team

responsibility for problem solving

and taking actions to improve

performance, and motivate staff to

make changes.

JSI introduced the IMPACT Team Network approach to strengthen county

level capacity for building strong, well-performing supply chains that deliver

products consistently to clients at health facilities

APPROACH TO MAKING DATA ACTIONABLE

Data organized,

analyzed, and

visualized in an

actionable way

Introduced a family

planning and vaccine

dashboard as part of the

Indicator Tracking Tool

(ITT)


APPROACH TO MAKING DATA ACTIONABLE

Color coding allows for

easy visualization of

product availability

Percent of Facilities Stocked Out

May-16

COCs Injectables 1-Rod Implants 2-Rod Implants

Garbatula 9% 4% 16% 20%

Isiolo 8% 0% 10% 0%

Merti 0% 8% 20% 0%

Isiolo County 7% 4% 15% 8%

*Average excludes missing county

CODE:

WHITE No facilities stocked out

YELLOW 1-10% of facilities stocked out

ORANGE More than 10% of facilities stocked out


STRUCTURED APPROACH TO

PERFORMANCE MANAGEMENT

County managers were trained to use

data and the ITT for performance

management Analyze the performance

monthly

Select priority problem

Conduct root cause

analysis

Identify practical actions

Implement selected actions


ACHIEVEMENTS: T I M E L INE SS O F DATA

E N H ANCED

TIMELINESS OF DATA ENHANCED

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pe

rce

nt

of

Faci

litie

s R

ep

ort

ing

Percent of Facilities Reporting and On-Time Reporting

Isiolo County - Total Reporting

Isiolo County - Proportion On-Time

On time reporting is now

equal to total reporting,

ensuring timely

availability of data for

decision making

IMPACT Team start

10

ACHIEVEMENTS: I M P ROVING DATA Q UA L IT Y

IMPROVING DATA QUALITY After the first IMPACT Team meeting, the

county recognized the need to sensitize

each subcounty, starting with Garbatula in

early September. The orientation included

a review of the performance indicators and

targets. The team prioritized improved

data quality.

To reduce reported discrepancies in

stock levels, facility incharges now review

before submitting the report, and conduct

physical counts more regularly.

September data showed fewer

discrepancies between

ending/beginning balances for Oral

Pills (COCs) and 1 Rod Implants

0

500

1000

1500

2000

2500

3000

3500

Aug-16 Garbatula Sep-16 Garbatula

Nu

mb

er

of

Un

its S

tock

Month & Year

Comparison of Beginning-Ending Family

Planning Stock Balances

COC - Beginning Balance

COC - Ending Balance

0

50

100

150

200

250

Aug-16 Garbatula Sep-16 Garbatula

Nu

mb

er

of

Un

its S

tock

Month & Year

Comparison of Beginning-Ending Family

Planning Stock Balances

1-Rod Implants -

Beginning Balance

1-Rod Implants - Ending

Balance

11

• Inclusion of key sub county staff in the IMPACT Team meetings

have enriched the monthly meetings as they interact more with the

data source

• Sharing of the sub county performance with the healthcare workers

who generate the data has helped improve data availability and

quality

• IMPACT team members able to critically review the data and offer

targeted on job training to health facility workers during supportive

supervision

LESSONS LEARNED

LESSONS LEARNED

• This methodology has helped country teams move from routine

data collection exercises to a culture of data driven decision

making

• Inclusion of members from various departments in the IMPACT

team has enriched supply chain problem solving and enhanced

teamwork

• County leadership is eager to apply data analytics and

visualization techniques to other programs

• Strong leadership skills are needed for implementation and

sustaining momentum

ACKNOWLEDGMENTS


THANKS TO OUR GENEROUS SPONSORS


https://www.usaid.gov/

Using Data to Improve Performance and Minimize Waste in Public Health Supply Chains in Kenya: A Case...

Healthcare

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