Research Report | August 2023 | Download report.

By Health Action International and Faith to Action Network.

Access to medicines and medical commodities in Marsabit County, Kenya, forms a crucial building block of the health system. Without proper access to quality assured and safe medicines, people are not able to live in optimal health. Sexual and reproductive health (SRH) is a field of care which lies at the basis of healthy societies.

Unfortunately, Kenya experiences challenges with the adequate provision of SRH services and commodities. The maternal mortality rate is estimated to be 362 per 100,000 live births, while the prevalence of modern contraceptive use continues to be low, with 56.9% of currently married women aged 15-49 years, and 59.2% of sexually active unmarried women aged 15-49 years, using a modern contraceptive. However, modern contraceptive use among married women aged 15-49 years is much lower in Isiolo (28.7%), Mandera (1.8%) and Marsabit (5.6%) Counties, with unmet need ranging from 17.3% to 37.6% in these counties. Among sexually active unmarried adolescents aged 15-19 years, there is an unmet need for family planning of 34.5%. This research was conducted to study the availability, affordability and stockouts of 49 SRH commodities which are used for family planning, maternal healthcare, treatment of STIs, treatment of HIV/AIDS, in addition to several test kits and menstrual products, in Isiolo, Mandera and Marsabit Counties in Kenya. This research is essential as it creates a clear overview of the availability and affordability of a comprehensive package of essential SRH commodities in Kenya, which will contribute to the development of evidence-based policies to improve the SRH of women and adolescents. Read through this report, which focuses in particular on the availability, affordability and stockouts of commodities in Marsabit County, Kenya.

Recommendations

Health Financing: This relates to the process of mobilising and managing required finances to ensure provision of health and related services and is attained through ensuring equity, efficiency, transparency, and accountability in resource mobilisation, allocation, and use.

• The County should increase financing for SRH commodities including self-test kits and menstrual health and hygiene products.
• The County should progressively work towards the elimination of payment at the point of use for SRH commodities, especially by the marginalised and indigent populations, through social health insurance and government subsidies to private and faith-based health facilities.
• The County should promote private sector participation in financing of healthcare through public-private partnerships and other mechanisms.
• Through effective multi-stakeholder coordination, resources available from various stakeholders supporting the County should be pooled to increase efficiency in utilization.
• Community members should be supported to strengthen social accountability systems where public officials and service providers account for the use of already allocated resources and efficiency of the supply chain systems for SRH commodities.

Health Products and Technologies: These include essential medicines, medical supplies, vaccines, health technologies, and public health commodities required for provision of services. The County should ensure that effective, safe, and affordable SRH commodities and products are available and rationally used at all times.

• The CHMT should maximize the use of existing commodities and products through redistribution from overstocked to understocked health facilities. This will promote availability.
• The CHMT should consider and apply technologies that are appropriate (accessible, affordable, feasible, and culturally acceptable to the community) in addressing SRH challenges. For example avail and train girls and women on the use of re-usable sanitary towels (also referred to as dignity kits) as these are more affordable than the disposable sanitary towels.
• To promote availability, the CHMT should ensure that the County and health facilities have the essential list of SRH commodities and products and refer to this in acquisition, financing, and other access-enhancing interventions.
• To support the availability of high-quality services, the CHMT should support rational investment in and efficient management of health products and technologies. This aims to ensure the most effective management of patients in line with established guidelines and standards. This will incorporate cost-effective prescribing and other interventions to improve the rational use of drugs and other health products.
• The CHMT should continuously support effective and reliable procurement and supply systems through ensuring timely reporting, requisition and liaising with the suppliers and relevant national government agency where there are challenges related to the supply chain system.