Move the Merchandise: An Around-the-Clock Operation to Save a Kenyan Medical Warehouse

This post was originally published on the IntraHealth International blog.

Picture the following scenario: A large warehouse, 13,000 square meters, on the outskirts of Nairobi, Kenya, about 20 kilometers from the city center, is so full of drugs and other medical supplies that there is no space for new deliveries. The warehouse is packed with everything from gauze bandages to malaria pills to antiretroviral drugs—valuable and necessary medical supplies that people need. But the system used to manage and distribute these supplies with less paperwork and greater efficiency, known as the Enterprise Resource Planning system, is not working. This means nothing is moving in or out of the warehouse.

The supplies sit, waiting to be checked in through the system and then sent out to health centers across the 10 regions. The longer this system is down the more we risk wasting tens of thousands of dollars in spoiled medicines because they never get to health workers or patients.

This is the situation I faced last August, when I was sent out as warehouse and distribution advisor to the Kenya Medical Supplies Agency (KEMSA) warehouse, which is owned and run by the government and located near the Jomo Kenyatta International Airport.

I knew it was an emergency situation, and I spent the next two months working to fix the system, pushing hard to meet deadlines, and constantly briefing the chief executive officer (CEO) on our progress.

Finally, we were able to get the Enterprise Resource Planning system working correctly. For example, using the system, the finance department could anticipate how much to pay suppliers without waiting to receive the invoices but by looking at the purchase order receipts. The system also helped us look at the orders from health facilities, generate the task list needed to fill these orders, and document the distribution.

But once we had the system up and running, we were still looking at a backlog in supply distribution of more than four months. So I proposed to the KEMSA CEO that we start a 24-hour warehouse operation so we could move as much inventory out as possible. He agreed, and we began an around-the-clock operation to distribute the warehouse supplies and stop the health facilities’ drug shortages.

With a budget of approximately $8,000 USD, we hired the extra manpower we needed to run this operation and comply with Kenya’s labor laws. The Board of Directors’ technical committee approved the plan in November.

Armed with this approval, we added additional lighting equipment for the night operation and made other necessary improvements. We hired the extra staff, and by January we were ready to launch the 24-hour, six-days-a week operation to save the KEMSA warehouse and its supplies. In just two months, we saw dramatic improvements:

• The warehouse output and distribution increased by over 250%.

• There is now a remarkable visibility of drugs in health facilities all over Kenya.

• The night shift supervisor’s daily reports are now being used to monitor staff performance.

In part, these reforms were made possible by positioning the necessary changes as a part of the KEMSA warehouse’s ongoing reform agenda. Although we made big changes, we did not propose them as a systemic change, which might have led to poor buy-in from staff, a long decision-making process, and a lack of funding. Rather, we asked for quick reforms in an emergency situation.

So far, there is every indication that the KEMSA warehouse will continue to run 24 hours a day until it can meet all its distribution needs. Today, the warehouse is a vibrant medical supplies provider and sets an example for other suppliers in the area.

Capacity Kenya, an IntraHealth International-led, USAID-funded project, works with Kenya’s health care leadership to strengthen human resources for health systems of the public, faith-based, and private health sectors to ensure improved delivery to primary health care and, ultimately, to improve health outcomes of the Kenyan people. It is an associate award of the Capacity Project, the predecessor to CapacityPlus.

Related items:

• Addressing Human Resources Constraints in Public Health Supply Chains

• Beyond Vacancies: Improving Performance and Productivity to Strengthen Health Systems

• Local Solutions, Global Solidarity, and Accountability

Photos courtesy of Wambua Nzioki. (Photo 1: Wambua Nzioki, supply chain advisor to KEMSA, Capacity Kenya. Photo 2: KEMSA warehouse)