Role of Supply Chain towards achieving Universal Health Coverage
Kenya Healthcare Federation supply chain committee held the last committee meeting of the year at Kenya Private Sector Alliance (KEPSA) offices on 22nd November 2018 to confer about Public-Private Partnership (PPP) areas in Supply Chain, Innovations in Health Product Distribution/Supply Chain, Promoting Local Manufacturing and the Role of Supply Chain towards achieving Universal Health Coverage (UHC). Dr. Chris Masila of PractHealth chaired the meeting.
Innovation in healthcare is rapidly growing and can contribute positively to healthcare accessibility. However, Mr. Rolando Satzke CEO, COSMOS Limited, raises a major concern that the patient is not put at the center of the innovations and that the quality of medicine must be maintained to the point of delivery. Further, Dr. Christine Sadia, Chair Kenya Medical Women Association, questioned whether the instructions of the prescription would be clear to the patient at point of delivery.
Dr. Nyalita backed the ideas by adding that most of the innovators focus on the commercial side which raises the question on quality. On the matter Mr. Rolando Satzke concluded by saying “I strongly suggest that all innovations should be patient centrered ensuring that all patients should be able to access quality medication without financial strain.” Dr. Anastasia Nyalita updated the committee on price regulations where she informed them that the Pharmacy and Poisons Board(PPB) is working on the price regulation strategies that was mandated by the Ministry of Health(MoH) and the final report will be ready by the beginning the year 2019. It was good to note that Kenya Healthcare Federation is well represented in the technical working group that is working together with the Pharmacy and Poisons Board.
There was a unanimous agreement by the supply chain committee that it will contribute and support UHC. However, price controls gives less opportunity for profit makers to distribute and resell drugs at a margin to typically unreachable markets, eventually resulting in less impact on patients. This argument links to the importance of patient awareness of and understanding of factors affecting commodity prices. Its important to bring this issue up now when the UHC is being strategized. Countries like Japan Switzerland, Ethiopia and Lesotho are good examples of price regulation models.
The committee has also been discussing the parallel importation Act and Dr. Nyalita updated the committee that the Act by PPB has been finalized and was presented at the Ministerial Stakeholder Forum and will be gazzetted. The Act will look into regulations of parallel importation and Illicit Trade.
On national coding of drugs, Dr. Nyalita updated the attendees on the consensus that was reached where KHF was asked to prepare and present a proposal to the Ministry of Health on coding of pharmaceutical products. In the ninth Ministerial Stakeholder Forum, it was agreed that Kenya should select a global pharmaceutical coding system such as the Anatomical Therapeutic Chemical Classification System(ATC) codes as used by PPB to register medicines. Dr. Daniella Munene was requested to work closely with PPB on this in order to propose a workable coding system for medicines. During the Ministerial Stakeholder Forum, it was agreed that the private sector should share an updated paper on the role of the Private Sector in achieving Universal Health Coverage. The presentation should include bottlenecks that should be addressed to increase coverage and access to quality, affordable healthcare for all.
6th Healthcare Management Conference
The 6th annual Healthcare Management conference, organized by Medic East Africa, took place at Kenyatta International Conference Centre ,Nairobi, Kenya from 25th to 27th September 2018.The conference had three different themes for each of the three days. The first day’s theme was “From vision to Action – Reinforcing Healthcare Systems in East Africa, the second day was “The Role of Clinical Officers in the Implementation of Universal Health Coverage” and the third day’s theme was “Quality and Access under Universal Health Coverage”. The objective of the forum was to drive the region towards a health leadership infrastructure that is focused on perfomance and is held accountable for delivering on specific health system goals.
The conference brought together over 150 exhibitors from 18 countries. The first day conference was moderated by Dr. Amit N. Thakker, Chairman, Kenya Healthcare Federation. In his presentation, he emphasized that the key barrier to reinforcing healthcare systems in east Africa are; geographical and financial. Dr. Thakker informed the attendees that over 85% of Kenya population do not have any form of a cover and rely on out of pocket. 50% of the population do not have an access to primary healthcare and this set back results from poverty. He called upon all healthcare workers in attendance to come out strongly in health advocacy because unfavorable health outcomes such as maternal mortality are increasingly becoming a daily occurrence. Dr. Thakker further urged the attendees to capitalize technology, which is in itself revolutionizing daily.
“We need to adopt auxiliary health workers and also strongly recognize community health workers for the big role they play in health. The ministry of health should have considered hiring the specialists that we don’t have instead of employing what we already have because this doesn’t help in filling the identified gaps in the workforce. The BIG 4 Agenda is supposed to ensure creation of job opportunities and 5% of the jobs are expected to come from the health sector. Therefore I call upon the public and private health sector to operate in harmony to see great job creation and ensure good service delivery.” Dr. Amit Thakker, Chairman ,Kenya Healthcare Federation.
Dr. Andrew Mulwa CEC-Health, Makueni County informed the attendees that some of the challenges in the county level towards achieving Universal Health Coverage are: lack of healthcare workers i.e. the recruitment and retention of human resources for health is very low. This is because most of the specialists that are required in the counties, are mostly concentrated in the urban areas. Finance is an important factor affecting access to quality healthcare and is challenge because most of the population does not have a formal employment therefore cannot purchase or contribute to medical cover plans. This leads to over reliance on out of pocket expenditure. He however added that recruitment and retention of the health workers should match the county’s economical abilities.
Dr. Janet Muriuki, Deputy Chief of Party/ Technical Director – Intrahealth International was in attendance and said “We need to motivate the health workers, to help in reducing immigration. Assessing the reason for immigration, creating a favorable environment for them to work and giving them a good remuneration will also help in retaining the health workers. However, there is low distribution of health workers where majority are concentrated in the urban areas. Question is, are we taking training where it is needed? Are the specialist deployed where they are needed? This should be the initial stage in gap analysis. Technology should be a vital tool in this .This is because it can display the gaps in the human resources and distribution of health workers and track the training of health workers i.e. who needs long term training and who needs short term training. Therefore it’s important to deploy specialist where there is deficiency and not where there is a surplus.” She emphasized that the health sector needs to employ workers who are fit for purpose and the health workers should ensure they are safe in their working environment. This would serve as one of the solutions for curbing immigration of health workers. According to world health organization(WHO),the ratio of health workers to the population per county should be 23:10,000 in Kenya whereas the current ratio is still low as we stand at 13:10,000. Dr. Muriuki noted that the counties with highest health workers deficiency are Isiolo and Wajir.
Ms. Faith Muigai, Regional Director, SafeCare, Pharm Access Foundation reiterated that there is need to need to shift attitude and create a good environment for patient care. We also have to change the narrative if we want to see good service delivery. However, she noted that there is poor or lack of infrastructure to enhance this. There is no independent body that checks the health workers performance thus there is no competition that would drive quality of service delivery. Ms. Faith said that more health facilities should be accredited and the accreditation system need not be a pass or fail model but one of incremental growth. In conclusion, Ms. Faith mentioned that data is required to drive transparency and accountability, that there is need to leverage on public private partnership so as to drive the quality agenda, and finally that there is need to invest in proactive and responsive versus reactive solutions.
Some of the major concerns that were raised from the audience were: there should be an assessment carried out on why there is poor distribution of health workers and even lots of immigration observed among the health workers and come up with a solution. There should also be a safe working environment for the health workers because some of the equipment and medication used exposes them to the dangers of contracting infections or even developing other health conditions. There was a recommendation that the health workers should be trained on disaster management even as we assess the training needs in the healthcare industry. Participants expressed unanimous consensus that there should be capacity building among the leaders to enhance accountability on financial management and on performance of healthcare workers. The policies created should also speak to each other.
The 6th annual Healthcare Management conference was a success bringing together a wide representation of stakeholders. The presenters provided key insights into the challenges and opportunities in the healthcare industry while the audience contributed engaging and thoughtful questions and remarks. If these ideas were implemented, we would expect to see the healthcare industry change for the good of all Kenyans! We look forward to the next conference
China- Kenya Pharmaceutical Trade and Investment Forum
The China Chamber of Commerce for Import and Export of Medicines & Health Products (CCCMHPIE), held a trade and investment forum together with the Ministry of Health Kenya and the private health sector in Kenya on the 30th of August 2018 at the Laico Regency Hotel in Nairobi.
The main aim of the forum was to establish and maintain a good relationship between Kenyan and Chinese healthcare sectors and further explore investment opportunities in the Kenyan pharmaceutical industry. This forum was sponsored by UKAID and brought together participants from Ministry of Health Kenya, Pharmacy and Poisons Board Kenya, the Kenya Healthcare Federation, the Kenya Chamber of Commerce, the Economic & Commercial Counsellor’s Office at the Embassy of the People’s Republic of China, and the China Africa Friendship Association.
Ms. Guo Xiaodan deputy secretary of sub-chamber, department of pharmaceutical, CCCMHPIE, opened the forum by welcoming the guests. In her opening speech, she reiterated that she’s extremely happy to visit Kenya and establish a lasting relationship between Kenyan and Chinese healthcare sectors.
CCCMHPIE was established in May in 1989. It is the most internationalized and influential healthcare industry association in China the key areas of responsibility include: policy and industry coordination, conferences and training, exhibitions registration, consulting, market surveys and analysis reports in traditional Chinese medicines, pharmaceuticals, medical devices & dressings, biopharmaceuticals and functional cosmetics.
In his speech, Mr. Tan Shengcai, head of the Chinese healthcare delegation gave a background of Kenya – China relationship especially in investment. He emphasized that Kenya has been contracting China in building and construction particularly in road construction. There is need to have deeper engagement especially in the healthcare industry. He invited the Chinese healthcare delegates to evaluate the Kenyan market and see possible investment opportunities in the pharmaceutical industry.
Dr. Amit Thakker, Chairman, Kenya Healthcare Federation welcomed the China healthcare delegation to Kenya. In his speech, he informed the attendees that the investment forum is very timely since it touches on two pillars of the BIG 4 Agenda i.e. Manufacturing and Affordable Healthcare for all. He however emphasized that there is need to bridge the gaps in healthcare drivers, such as Human Resource for Health, Healthcare financing healthcare and ICT and Mobile Health.
The Pharmacy and Poisons Board was clear on their regulatory role in the practice of Pharmacy and the Manufacture and Trade in drugs and poisons. The Board aims to implement the appropriate regulatory measures to achieve the highest standards of safety, efficacy and quality for all drugs, chemical substances and medical devices locally manufactured, imported, exported, distributed, sold, or used, to ensure the protection of the consumer as envisaged by the laws regulating drugs in Kenya.
There was a B2B session thereafter conducted by CCCMHPIE where the China delegation had an impactful engagement with the Kenyan health sector, both private and public. The China delegation touched on business opportunities and engagements that can be established between Kenya and China. The Chinese team visited Kenya Medical Supplies Authority (KEMSA) thereafter.