INVESTING IN DATA, PEOPLE AND

PROCESSES FOR RESILIENT, CONTEXT

SPECIFIC PUBLIC HEALTH SUPPLY CHAINS. BUILDING AN IMPACT TEAM NETWORK ACROSS 10

COUNTIES IN KENYA

Africa Logistics Conference

Yasmin Chandani, inSupply

Dr. Andrew Kisang, Nandi County Pharmacist

INSUPPLY PROJECT

• Two years – funded by The Bill & Melinda Gates

foundation

• Six components linked by cross-cutting themes: • Improving data visibility, analytics and use

• Innovation at the last mile

• Local, regional capacity building, stewardship

• Implemented by JSI Research & Training

Institute

OUR GOAL

To improve the performance and efficiency

of contraceptive, vaccine, and essential

medicine supply chains by increasing the

effective use of data and introducing

management best practices to strengthen

system outcomes.

IMPACT TEAM NET WORK

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.

KENYA: D ISRUPTION IN HEALTH SUPPLIES

Status of Public Health Kenya has seen significant progress in its health indicators in recent decades,

but challenges remain.

Continued high burden of

infectious diseases and emerging

non-communicable

diseases (2014)

Infectious Diseases Maternal Mortality

Maternal mortality rate of

362 per 100,000 live births

(2014)

Infant mortality rate of

37 per 1,000 live births

(2014)

Infant Mortality

Under-five mortality rate of

51 per 1,000 live births

(2014)

Child Mortality

KENYA: D ISRUPTION IN HEALTH SUPPLIES

Political Environment

• In 2010: authority, responsibility, funding for 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

fragmentation of availability of data and of supply chains.

I N C R EAS ING LO C A L IZAT ION : B U ILD IN G ST E WAR DSHIP

Nairobi

Mombasa

Kwale

Kirinyaga

Isiolo

Kajiado

Nandi

Kakamega

Nyamira

Migori

Establish a Leadership Cohort and IMPACT

Teams nationally, across 10 counties

• Facilitate the leadership cohort to meet (virtually or

in person) routinely

• Support regular national, county IMPACT team

meetings

Power these meetings with data

• Analyze existing data

• Support root cause analysis, prioritize interventions,

develop action plans using IT tools, techniques

Facilitate culture of continuous improvement

based on local solutions

INVESTING IN DATA , PEOPLE & PROCESSES

$63m • Common vision and goal across all counties, focused on product

availability

• Communication between levels to facilitate coordination

• Data used for joint identification of problems, performance

monitoring, and development of plans, with targets for improvement

• Structured approaches & tools introduced for problem solving and

developing solutions

• Recognition and peer-to-peer learning for motivation

Core elements of the IMPACT Team Approach

ITT DASHBOARD: ACTIONABLE V ISUALS

Relatively high reporting

rates; but spikes with on-time

RR, affecting availability of

data for timely decision

making

On-time Reporting

Desired Target

Easy to assess gap between

actual and target performance

ITT DASHBOARD: ACTIONABLE V ISUALS

Filtering by sub-county

enables managers to

identify which counties

are driving the delays and

where to focus follow up

action

Drill Down

ITT DASHBOARD RESULTS

Color Coding

Color coding immediately

identifies where challenges

and opportunities for

redistribution exist

Developing local,

regional supply chain

expertise for

sustainability

inSupply is working to build a

pool of regional supply chain

consultants with expertise in

translating private sector

solutions to optimize public

health supply chains, design

context-specific solutions and

provide local support

12

I N C R EAS ING LO C A L IZAT ION : R E GIONA L R E SOURCE S

LESSONS LEARNED FROM NANDI COUNT Y

• Supervision can be more effective if data driven

• Low cost interventions such as staff sensitization during monthly

meetings can have big impact

• Redistibution can help reduce costs through reducing wastages and

expiries and also reduces stockouts

o The dashboards help identify overstocks and understocks to take action

• IMPACT team meetings enable sharing of best practices and motivates

staff to improve

Opportunities for using the IMPACT Team approach to reduce costs

LESSONS LEARNED FROM NANDI COUNT Y

• Let the local staff run the show from the beginning

• Formation of IMPACT teams to include county and subcounty staff to

come up with specific solutions to their challenges i.e let local actors

design solutions to their challenges

• Local ownership trickles from the top i.e you have to start from the

county management then down to facility level

Enhancing Local Ownership

SCALING UP TO CLOSE THE GAP

• Routine leadership calls and meetings to share lessons learned,

identify enablers and barriers to success

• Initial intervention period in 10 focus counties ends in June 2017

• Document and disseminate successes to other counties (via MOH)

• Advocate for funding for scale-up and ensure Leaders from successful

counties can lead a peer-to-peer approach to national scale-up

Where do we go from here?

For more information about

JSI’s work in supply chain, data

visibility, and data use, contact the

JSI Center for Health Logistics

supplychain@jsi.com Follow @jsihealth

insupply@jsi.com

www.insupply.jsi.com

Twitter: @inSupplyJSI

Newsletter: supplychain@jsi.com