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Why public hospitals run out of drugs

NAIROBI, August 11 – It is common for one seeking medical attention in public hospitals to be informed they have run short of essential drugs.

This is despite the presence of the Kenya Medical Supplies Agency (KEMSA) that is in charge of procurement of medicine for use in all public health facilities across Kenya.

The agency is also allocated an annual budget from the government for distribution of the procured medicines to all health facilities across the country.

“We have given them about Sh100 million in this financial year for distribution,” informs Medical Services Permanent Secretary Dr Hezron Nyangito in an interview with Capital News.

Each hospital is allocated a quota of how much drugs it should be given while dispensaries and health facilities have a distribution schedule of when the drugs are supplied.

So, if the agency has the money for distribution and there are enough drugs in the stores it begs the question – how come some facilities, even in the urban centres, still lack the drugs often forcing patients to buy them from the parallel market?

“That’s one of the issues we are investigating,” asserts the PS referring to a nine-member taskforce that was set up early July to probe the Agency’s operations.

“Is it inefficiency on the side of the contracted company to deliver or is it pure incompetence on the side of management? You can have all the money and drugs but if you don’t have good planning skills then you can have that problem.”

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KEMSA’s Chief Executive Officer Charles Kandie and the Board of Directors were sent packing by Medical Services Minister Anyang Nyongo to pave way for investigations.

The PS however notes that the blame cannot squarely lie on KEMSA but at the hospital level as well.

“The drugs can be delivered to the hospitals but are later stolen and sold in private chemists and this is where we need vigilance by Kenyans, hospital staff and the law enforcement officers.”

“We need to strengthen all aspects of the procurement chain to ensure that we have systems that work to avoid corruption,” he said.

There are also times when the KEMSA warehouse has excess drugs.

This, Nyangito explains, occurs when there are supplements from development partners which are normally not budgeted for.
“At that point the PS is supposed to source for more money to facilitate distribution of the medicines,” he says.

“What we have put in place now is that if there is any donation two things have to happen- either we request the donor to also provide funds for distribution of the same or the ministry has to find some way of getting funds for that distribution.”

He also acknowledges that the distribution chain is between KEMSA and the Ministry of Medical Services hence the blame can also be on the part of the ministry.

“For example my officers who are in charge of procurement, how are they monitoring, is the Chief Financial Officer who gives funds to KEMSA doing so quickly enough for the agency to respond.”

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The distribution chain also involves ensuring the product being supplied in hospitals is exactly the same as what was approved to avoid supply of substandard drugs.

“The problem we have here is the leakage. When they are being moved from the stores to the hospitals, sometimes they can be replaced with others if there are no proper mechanisms.”

“That’s why we expect the pharmacists in the health facilities as well to approve the products.”

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