Supply chains are only as strong as their weakest link. This holds particularly true for health supply chains, where any break or delay can be deadly — life is at risk when communities don’t receive medical supplies on time. At the heart of community health, Community Health Workers (CHWs) play a critical role in achieving Universal Health Coverage (UHC) and improving health outcomes—but only when they have the necessary tools, including access to medicines and supplies.
Around the world, however, CHWs often face stockouts of essential medicines and supplies, a challenge that weakens the entire health system. Recognizing this, Lwala Community Alliance and VillageReach partner with the Kenya Ministry of Health to build a resilient supply chain system that empowers CHWs (Community Health Promoters in Kenya) and ensures uninterrupted access to essential health services. Our current efforts are focused on Migori County, Kenya, and extend to the national level through collaboration with the Ministry of Health.
Tackling Supply Chain Challenges in Migori County
Our journey began with a baseline assessment of Migori County’s health supply chain in March 2023. The findings indicated a 45% stockout rate for essential medicines, including many commodities required for community health services. Such stockouts not only diminish the quality of care CHWs can provide but can also reduce morale. Additionally, the assessment found gaps in stock management, revealing the need for training and mentorship for CHWs and facility-based providers.
Lacking essential supplies makes us feel helpless. When we can’t identify health issues early, it leads to poorer health outcomes in the community. At times, we are forced to refer residents to distant health facilities for services that could have been provided locally,” says Millicent Miruka, a Lwala-supported CHW. “Since we received the CHW kits from the national government last year, we’ve addressed these challenges more effectively and enhanced the care we provide to our community.”
Building CHW Skills for Better Commodity Management
Our strategy emphasizes equipping CHWs with the skills they need for effective commodity management. VillageReach and Lwala partnered to develop a training curriculum for CHWs on the supply chain. “The training comprehensively covers all aspects of commodity management from ordering and reporting to proper storage and handling,”. says Hellen Okello, Lwala’s Supply Chain Coordinator. “In addition, we are conducting training sessions within health facilities to enhance the competency of health care workers in commodity management and reporting”.
Zipporah Owino, the Nurse in charge at Magacha Health Dispensary collects medical supplies from the
pharmacy. Photo credit: Joseph Ngaruiya
With 80% of CHWs in Migori County now equipped with essential supplies and resources to provide basic health services to their communities, this training helps them manage their supply of medicines, keep accurate records, and make informed decisions on restocking. Following a successful pilot in Migori County, this training was officially integrated as a module in the recently revised National CHW Curriculum. This achievement is evidence of how a local initiative can have a positive, sustainable impact at the national level.
“From the start, it was clear that addressing these challenges required a comprehensive and an integrated strategy that encompassed workforce development, strengthening of supply chain governance structures and continuous improvement through supply chain audits” noted George Nzioka, Senior Supply Chain Manager at VillageReach.
Using Data to Improve Supply Chain Decisions
At the heart of our approach is an electronic inventory management tool that simplifies inventory control and data collection. We have integrated a commodity management module into the electronic community health information system (eCHIS)—a new digital platform for CHWs developed by government and community health partners in Kenya.
This integration empowers CHWs to make informed decisions for optimizing stock. We are currently in the advanced stages of piloting this module in Migori County, paving the way for its broader implementation. We have also collaborated with other community health and technology partners in Kenya to document best practices for digital CHW stock management in this technical brief.
Hellen Okello, Supply Chain Coordinator at Lwala Community Alliance, trains CHWs alongside George Nzioka, Senior Manager of Supply Chain at VillageReach, at the Magacha Dispensary in Suna West, Migori County, Kenya. Photo credit: Joseph Ngaruiya
Driving Lasting Change in Supply Chains
Our advocacy efforts are focused on integrating CHWs into the county and national supply chain tools, processes, policies and strategies. In Migori, we worked with the county government to develop the Migori County Supply Chain Strategy–the first in Migori, and the second in Kenya–which includes commodities used by CHWs. This collaborative effort seeks to transform the planning and budgeting of essential commodities, aiming to reduce stockouts and improve access to life-saving medicines.
By prioritizing the integration of community health commodities into our forecasting and planning strategies, we are ensuring Migori County can effectively meet its stock needs and enhance the delivery of critical health services.
To further strengthen supply chain operations, we provide technical support to health products and technologies units (HPTUs) at both county and sub-county levels. HPTUs were formed to ensure access to health products and technologies of assured quality, safety, efficacy, and cost-effectiveness. We are also conducting thorough audits of supply chains to identify areas for improvement, working closely with the government to refine standard operating procedures for supply chain management at the community level in Migori County and the national level.
A CHW checks the blood pressure of a Magacha community member. Photo credit: Joseph Ngaruiya
Stories of Success
Our efforts are beginning to bear fruit. We are seeing improved access to essential medicines due to enhanced commodity management training. Introducing a mentorship framework for CHWs has improved service delivery and made health interventions more effective “In my community, I serve 80 households, visiting at least seven each day. Before heading out, I ensure I have my health education tools, equipment and supplies in my bag,” shares Millicent Miruka, a CHW supported by Lwala in Migori County. “Having these tools gives me the confidence to serve my community and deliver high-quality health care services.”
Looking Ahead
We are in the early stages of implementing the Supply Chain for Primary Health Care (SC4PHC) solution in Kenya, focusing on building robust supply chain systems at both the national and county levels. Our goal is to scale up these initiatives and ensure that every community has access to essential health services.
“This effort is about more than just strengthening supply chains; it’s about building a healthier future for all Kenyans,” says Julius Mbeya, Lwala Co-CEO. “By empowering CHWs and equipping them with the resources and support they need, we can create a world where every community has access to the health services needed to thrive.”
CHWs with commodities at Magacha Dispensary in Suna West, Migori County. Photo credit: Joseph Ngaruiya