Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 1242
Country/Region: Kenya
Year: 2008
Main Partner: Kenya Medical Supplies Agency
Main Partner Program: NA
Organizational Type: Host Country Government Agency
Funding Agency: USAID
Total Funding: $1,650,000

Funding for Treatment: ARV Drugs (HTXD): $950,000

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

1. LIST OF RELATED ACTIVITIES

This activity relates to activities in Other/Policy and System Strengthening (#8401)Laboratory Infrastructure

(#6990, #8763), HIV/TB (#8713), MTCT (#8757) and HVCT (#8783).

2. ACTIVITY DESCRIPTION

This activity aims to improve the capacity of the Kenya Medical Supplies Agency (KEMSA) in the

procurement, warehousing, distribution, management and reporting of public sector anti-retroviral drugs, as

well as other medical and pharmaceutical commodities related to HIV/AIDS. KEMSA is the government of

Kenya public sector health commodities supply agent involved in ensuring the delivery of all health

commodities including ARVs to public sector health institutions. In the fall of 2006, USAID supported an

independent evaluation of KEMSA, and supported an MOH assessment of the MOH procurement system;

both were to help inform the Ministry of Health (MOH) to develop a new procurement policy. This new policy

is currently being finalized and will decide the role of KEMSA relative to other arms of the Ministry of Health

in procurement. This activity will assist KEMSA continue to develop its role in procurement, warehousing,

distribution, and information management in line with the new MOH policy. The nature of this assistance is

in short and medium-term consultancies to implement their business plan, and strengthen identified weak

areas. One of the major areas for improvement is in information management, and in monitoring and

evaluation of distribution at the "last mile" to make sure that reports are returned to the district warehouse in

order to fully implement a "pull" commodity system. Another challenge is managing the increasingly

complex distribution schedule which includes increased numbers of commodities related to HIV/AIDS, and a

mandate to deliver to points of service rather than district warehouses for some commodities. As a result,

the warehouse is often overflowing, as trucks cannot make distributions fast enough. In 2007 the SCMS

contract started to procure commodities on a large scale for the PEPFAR program, and will distribute most

of them through the KEMSA system. This support will ensure that these commodities are tracked and

distributed in a timely manner and with the required reporting. This support will go directly to KEMSA to hire

short and medium-term logistics consultants or staff experts in areas of greatest need. It may also

contribute to minor renovations and computer equipment as necessary. MCC resources are leveraged in

the KEMSA PEPFAR support.

3. CONTRIBUTION TO OVERALL PROGRAM AREA

This activity will contribute to improving the public sector medical and pharmaceutical supply chain system

for ARVs and other HIV/AIDS-related commodities.

4. LINKS TO OTHER ACTIVITIES

This activity links to other KEMSA support in Other/Policy and System Strengthening (#8401), MSH/SPS

activities in Laboratory Infrastructure, and HIV/TB, and SCMS activities in Laboratory Infrastructure (#8763),

HIV/TB (#8713), MTCT (#8757) and HVCT (#8783).

5. POPULATIONS BEING TARGETED

General population, people living with HIV/AIDS, and KEMSA managers.

6. EMPHASIS AREAS

The major area of emphasis is Logistics, and the minor emphasis areas are Local Organization Capacity

Development and QA/QI/SS.

Funding for Health Systems Strengthening (OHSS): $700,000

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

The only changes to the program since approval in the 2007 COP are:

•Supporting technical assistance to assess the governance structure of KEMSA and advocacy for

improvements.

•Supporting technical assistance to assess the feasibility of providing grants to health facilities for purchase

of commodities.

•Supporting the implementation of tracking surveys to measure progress in HIV/AIDS commodities

distribution and use at the facility-levels.

•Supporting civil society and communities for oversight activities on commodities procurement.

•South-to-south exchanges on procurement best practices.

1. LIST OF RELATED ACTIVITIES

This activity relates to activities in ARV Drugs [#6969 and #6989] Laboratory Infrastructure [#6990 and

#8763], HIV/TB [#8713], MTCT [#8757] and Counselling and Testing [#8783].

2. ACTIVITY DESCRIPTION

This activity seeks to improve the capacity of the Kenya Medical Supplies Agency (KEMSA) in the

procurement, warehousing, distribution, management, and reporting of public sector anti-retroviral drugs, as

well as other medical and pharmaceutical commodities related to HIV/AIDS. KEMSA is the Government of

Kenya public sector health commodities supply agent involved in ensuring the delivery of all health

commodities including anti-retroviral drugs (ARVs) to public sector health institutions. In the fall of 2006,

USAID supported an independent evaluation of KEMSA and a Ministry of Health (MOH) assessment of the

MOH procurement system; both were to help inform the MOH in developing a new procurement policy. This

new policy will decide the role of KEMSA relative to other arms of the MOH in procurement. This activity will

assist KEMSA continue to develop its roe in procurement, warehousing, distribution, and information

management in line with the new MOH policy. The nature of this assistance is in short and medium-term

consultancies to implement their business plan, and strengthen identified weak areas. One of the major

areas for improvement is in information management, and in monitoring and evaluation of distribution at the

"last mile" to make sure that reports are returned to the district warehouse in order to fully implement a "pull"

commodity system. Another challenge is managing the increasingly complex distribution schedule which

includes increased numbers of commodities related to HIV/AIDS, and a mandate to deliver to points of

service rather than district warehouses for some commodities. As a result, the warehouse is often

overflowing, as trucks cannot make distributions fast enough. In FY 2007, the SCMS contract will begin to

procure commodities on a large scale for the Emergency Plan, and will distribute most of them through the

KEMSA system. This support will ensure that these commodities are tracked and distributed in a timely

manner and with the required reporting. This support will go directly to KEMSA to hire short and medium-

term logistics consultants or staff experts in areas of greatest need. It may also contribute to minor

renovations and computer equipment as necessary.

3. CONTRIBUTION TO OVERALL PROGRAM AREA

This activity will contribute to improving the public sector medical and pharmaceutical supply chain system

for ARVs and other HIV/AIDS-related commodities.

4. LINKS TO OTHER ACTIVITIES

This activity links to other KEMSA support in ARV Drugs [#6969 and #6989] Laboratory Infrastructure

[#6990 and #8763], HIV/TB [#8713], MTCT [#8757] and Counselling and Testing [#8783].

5. POPULATIONS BEING TARGETED

KEMSA managers.

6. EMPHASIS AREAS

The major area of emphasis is Logistics, and the minor emphasis areas are Local Organization Capacity

Development and Strategic Information as it relates to maintaining and upgrading KEMSA's information and

reporting system. A new partner will assist KEMSA with plus-up funds to upgrade their Logistics

Management Information System (LMIS), using one system that will integrate inventory, procurement,

distribution, reporting, and pipeline of commodities. These funds will be leveraged with those of other

donors following an assessment of the LM Unit. This activity will also complement MCA activities in Kenya.

7. TARGETS

Number of local organizations provided with technical assistance for HIV-related policy development (Not

applicable)

Number of local organizations provided with technical assistance for HIV-related institutional capacity

building -36

Number of individuals trained in HIV-related policy development (Not applicable)

Number of individuals trained in HIV-related institutional capacity building - 150

Number of individuals trained in HIV-related stigma and discrimination reduction (Not applicable)

Number of individuals trained in HIV-related community mobilization for prevention, care and/or treatment

(Not applicable)

Cross Cutting Budget Categories and Known Amounts Total: $250,000
Food and Nutrition: Commodities $250,000