Owing to its crucial role in the country’s health sector, Kenya Medical Supplies Authority (KEMSA), has undergone notable reforms to improve on service delivery.
People/Human Resource Reforms
The Board’s assessment revealed a workforce grappling with demotivation and operational inefficiencies, significantly impeding the Authority’s ability to fulfil its mandate. This led to a comprehensive review and optimisation of staffing levels, transitioning from an unsustainable 734 employees (against a staff establishment of 341) to 564 employees. Further the Board is working on developing new Human Resource Instruments in the next three months to have optimal staff numbers for the Authority, further fostering operational agility through strategic role realignment.
ICT Support and Systems
Acknowledging the outdated IT infrastructure, the Board prioritized a technological overhaul, engaging University of Nairobi Enterprise Solutions (UNES) to develop an off the shelf ERP system designed to modernize KEMSA’s operational framework. This was a key achievement that KEMSA had not been able to actualize over the last 11 years.
These reforms have seen the development of ERP’s development to support all facets of KEMSA’s operations, including e-procurement and e-warehousing, automation of performance scorecards and management reporting, enhancing transparency and decision-making processes, establishment of Dashboards for Order Turn Around (OTA), stock status, Order Fill Rate (OFR) and other management reports for visibility.
Warehousing and Logistics Management
Improvements in this sector have been geared towards enhancing distribution efficiency and reducing operational costs, critical for KEMSA’s logistical operations.
This has seen the operationalisation of Kisumu Regional Distribution Centres, with the official launch on 6th March 2024, operationalisation of Mombasa Regional Distribution Centre by June 2024 and a strategic reorganisation of the transport system, with new tenders expected to bring down the distribution costs from Kshs. 1 billion to 600 million. This is based on the new transport policy geared towards reducing distribution costs and improving efficiency of the Authority’s Last Mile Delivery.
Procurement
The Board has instituted comprehensive reforms in procurement practices, aiming to instil fairness, transparency, and accountability, ensuring value for money in all transactions.
This has resulted in rigorous review and restructuring of existing contracts and supplier pre-qualification processes. The move was aimed at eradicating single sourcing and monopoly action thus all contracts that did not meet the required threshold were procedurally terminated.
KEMSA has implemented a revamped supplier pre-qualification process, designed to foster competitive bidding and ensure maximum value for money. The Board instituted a lotting system in procurement, establishing an upper financial threshold that prevents any single bidder from monopolizing contracts.
This strategic move has cultivated a competitive environment across all KEMSA procurement activities. By mitigating the ‘winner takes all’ phenomenon, the lotting system distributes procurement opportunities among multiple suppliers for each item, enhancing the diversity and reliability of supply. As a direct result, this approach has significantly improved the availability of commodities and effectively mitigated the issue of stock outs.
The introduction of a robust monitoring and evaluation frameworkÂ
The e-procurement module, slated for completion by the end of March 2024, is set to significantly enhance transparency within procurement processes. This technological advancement will streamline operations, ensuring a more open and accountable procurement system.
The authority revitalised the leadership of the procurement department by assigning treasury staff through secondment and conducting a comprehensive reshuffle of the existing team. Further, KEMSA is in the final stages of appointing a substantive Procurement Director. The Board is actively reviewing staffing within the procurement department to ensure dynamic distribution throughout the supply chain, thereby preventing prolonged tenure in a single position. This approach aims to enhance operational efficiency and adaptability.
Internal Audit
Reinforcing the Internal Audit function has been paramount, with the Board initiating thorough audits to ensure the transparency and integrity of KEMSA’s procurement activities. The internal audit team carried out audits of the tenders instituted between July-December 2023 and a preliminary report was received by the Board. This report will inform the
Â
Service to the Counties
KEMSA has demonstrated remarkable progress in enhancing service delivery across counties, significantly improving logistical resilience and operational efficiency.
Key among these has been successful deployment of Long-lasting insecticidal nets (LLINs) to remote counties, showcasing logistical excellence and coordinated emergency deliveries during the El Nino disaster. The authority leveraged partnerships with the Kenya Defence Forces (KDF) and dispatched over Ksh 22.5 billion worth of Essential Medicines and Medical Supplies (EMMS).
This monumental effort has seen the delivery of more than 86,040 EMMS and NHSP orders to over 8,954 health facilities, marking a significant milestone in KEMSA’s journey to revitalising its last mile delivery services. The reform initiatives have led to notable enhancements in organisational efficiency, highlighted by a reduction in the Order Turnaround Time (TAT) for hospitals.
As of February 2024, the TAT stands at 15.8 days, a decrease from 16.6 days in April 2023. Furthermore, the TAT for Primary Health Facilities (PHFs) has improved to 16.4 days, down from 19.9 days in April 2023. Additionally, our Order Fulfillment Rate has increased to 62%, up from an average of 49% in March of the previous year.
This story is based on Kemsa Turnaround Status Update – Comprehensive Review Over the Last Ten Months released on February 21, 2024