Steady Supply Chains for Steadfast Community Health Workers

April 5th, 2019 | Viewpoint


Community health workers (CHWs) provide preventive, promotive, and curative services to people who live in remote places, especially mothers and children. Community members select CHWs because they have integrity and are committed to the health and well-being of their neighbors. Yet CHWs are often unable to do their work because they cannot get the supplies they need.

Over the last year in Siaya County, Kenya, a team from JSI Research & Training Institute, Inc. (JSI) and inSupply Health has been implementing cStock, a methodology to strengthen the supply of medicines for CHWs. cStock is a mobile-based tool that lets CHWs report their stock levels, letting their supervisors know which supplies—and how much of them—CHWs need. The cStock system also lets pharmacists and managers throughout the health system monitor stock levels on a mobile-enabled or computer dashboard.

Before cStock came to Siaya County, CHWs would go to their health facility every month with paper reports with the hope of getting supplies. They were often turned away because they did not have the correct request forms or health facility staff were not comfortable giving them supplies because they could not account for the stock issued. The launch of cStock has eased these processes and concerns. As one CHW said, “cStock has made reporting easier, save[d] transport…because one reports from the comfort of home.” A CHW supervisor said that “Some [health facility] in-charges found it difficult to give out or order commodities, however after the training…commodities are being ordered and distributed on time when the drugs are there.”

The cStock dashboard provides visibility of CHW stock levels, which was not available before. CHW supervisors find that with cStock they “are in a position to access information that [they] did not have earlier.” A health facility in-charge said “Now even [health facility staff] are able to monitor the work of CHWs as opposed to initially, when CHWs could only interact with the [supervisors] alone.’’

Health facility in-charge and community health assistant in Siaya County
Health facility in-charge and community health assistant in Siaya County.

However, supply chains are complex, and data visibility is only the first step. Change requires coordinated action from people up and down the supply chain. The cStock approach is more than a mobile tool; it includes monthly IMPACT team meetings that convene workers from various levels of the health system to review indicators and dashboards, solve problems, and prioritize actions. The health facility in-charges say that “IMPACT team meetings and the dashboard have brought unity,” and that cStock “has brought team-work to community and facility teams.”

Community health worker and data collector in Siaya County.
Community health worker and data collector in Siaya County.

Although stockouts resulting from systemic shortcomings persist, now managers and county health management team are aware of them because they see them on the dashboard. CHWs are critical to their neighbors, friends, and families, and cStock helps CHW supply them with life-saving products.

Learn more about cStock at inSupply Health’s website. inSupply Health, an affiliate of JSI, is an independent advisory firm based in East Africa that provides clients with customized guidance on supply chain management and design.

Written by Sarah Andersson, Sam Schmader, Yamin Chandani, and Julie Ray

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