inSupply presentation on data use to improve supply chain performance at the 2016 Global Health Supply Chain Summit

2. Dr. Claver Kimathi,
County Pharmacist Isiolo
USING DATA TO IMPROVE PERFORMANCE AND
MINIMIZE WASTE IN PUBLIC HEALTH SUPPLY
CHAINS IN KENYA: A CASE STUDY OF ISIOLO
COUNTY
Global Health Supply Chain Summit

3. • In 2010: responsibility and budgetary authority for funding
and providing 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
fragmented demand and supply planning, irregular
replenishment, and gaps in data management cycle
CURRENT KENYA SUPPLY CHAIN CONTEXT
3Global health Supply Chains. Dar es SalaamTanzania 2016

4. ISIOLO COUNTY: CONTEXT
• Population is 143,294 (2009 census)
• The local topography is arid or semi-arid low plains
• Poor road remains at 58.9 years.
• The county has 2 level four health facility and 34
level one facilities
• Furthest health facility is
290 km from Isiolo town and
480km from Nairobi
4Global health Supply Chains. Dar es SalaamTanzania 2016

5. ISIOLO HEALTH AT A GLANCE
Status of Public Health
Health status remains at
suboptimal level with less
that 50% of the population
accessing healthcare in
Isiolo
*Current=2015
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Children Immunised Births delivered at a
health facility
Contraceptive
Prevalence
County 2012
County Current
Kenya Current
5Global health Supply Chains. Dar es SalaamTanzania 2016

6. IMPACT TEAM NETWORK
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.
JSI introduced the IMPACT Team Network approach to strengthen county
level capacity for building strong, well-performing supply chains that deliver
products consistently to clients at health facilities

7. APPROACH TO MAKING DATA ACTIONABLE
Data organized,
analyzed, and
visualized in an
actionable way
Introduced a family
planning and vaccine
dashboard as part of the
Indicator Tracking Tool
(ITT)
7Global health Supply Chains. Dar es SalaamTanzania 2016

8. APPROACH TO MAKING DATA ACTIONABLE
Color coding allows for
easy visualization of
product availability
Percent of Facilities Stocked Out
May-16
COCs Injectables 1-Rod Implants 2-Rod Implants
Garbatula 9% 4% 16% 20%
Isiolo 8% 0% 10% 0%
Merti 0% 8% 20% 0%
Isiolo County 7% 4% 15% 8%
*Average excludes missing county
CODE:
WHITE No facilities stocked out
YELLOW 1-10% of facilities stocked out
ORANGE More than 10% of facilities stocked out
8Global health Supply Chains. Dar es SalaamTanzania 2016

9. STRUCTURED APPROACH TO
PERFORMANCE MANAGEMENT
County managers were trained to use
data and the ITT for performance
management
Analyze the
performance
monthly
Select priority
problem
Conduct
root cause
analysis
Identify
practical
actions
Implement
selected actions
9Global health Supply Chains. Dar es SalaamTanzania 2016

10. ACHIEVEMENTS: TIMELINESS OF DATA
ENHANCED
TIMELINESS OF DATA ENHANCED
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
PercentofFacilitiesReporting
Percent of Facilities Reporting and On-Time Reporting
Isiolo County - Total Reporting
Isiolo County - Proportion On-
Time
On time reporting is now
equal to total reporting,
ensuring timely
availability of data for
decision making
IMPACT Team start
10

11. ACHIEVEMENTS: IMPROVING DATA QUALIT Y
IMPROVING DATA QUALITY
After the first IMPACT Team meeting, the
county recognized the need to sensitize
each subcounty, starting with Garbatula in
early September. The orientation included
a review of the performance indicators and
targets. The team prioritized improved
data quality.
To reduce reported discrepancies in
stock levels, facility incharges now review
before submitting the report, and conduct
physical counts more regularly.
September data showed fewer
discrepancies between
ending/beginning balances for Oral
Pills (COCs) and 1 Rod Implants
0
500
1000
1500
2000
2500
3000
3500
Aug-16 Garbatula Sep-16 Garbatula
NumberofUnitsStock
Month & Year
Comparison of Beginning-Ending Family
Planning Stock Balances
COC - Beginning Balance
COC - Ending Balance
0
50
100
150
200
250
Aug-16 Garbatula Sep-16 Garbatula
NumberofUnitsStock
Month & Year
Comparison of Beginning-Ending Family
Planning Stock Balances
1-Rod Implants -
Beginning Balance
1-Rod Implants - Ending
Balance
11

12. • Inclusion of key sub county staff in the IMPACT Team meetings
have enriched the monthly meetings as they interact more with the
data source
• Sharing of the sub county performance with the healthcare workers
who generate the data has helped improve data availability and
quality
• IMPACT team members able to critically review the data and offer
targeted on job training to health facility workers during supportive
supervision
LESSONS LEARNED

13. LESSONS LEARNED
• This methodology has helped country teams move from routine
data collection exercises to a culture of data driven decision
making
• Inclusion of members from various departments in the IMPACT
team has enriched supply chain problem solving and enhanced
teamwork
• County leadership is eager to apply data analytics and
visualization techniques to other programs
• Strong leadership skills are needed for implementation and
sustaining momentum

14. ACKNOWLEDGMENTS
14Global health Supply Chains. Dar es SalaamTanzania 2016

15. THANKS TO OUR GENEROUS SPONSORS
15Global health Supply Chains. Dar es SalaamTanzania 2016