Assessing the Supply of Essential Medicines at the Community Level

Children under five in developing countries are susceptible to contracting illnesses like malaria, pneumonia, and diarrhea. For many, accessing a health care center to obtain treatment can be over a day’s commute or more resulting in a lack of access to medicines.

In such situations, trained community health workers (CHW) pick up supplies and medications from the community health centers and go out into their communities to help treat sick children.

In Mali, where malaria is the leading cause of child mortality, over 700 CHWs provide preventive and curative services for simple case management of childhood illnesses in the communities they serve and refer severe cases to the health center. However, on several occasions stock-outs of commodities have occurred leading to a delay in treatment which can cause children to become severely ill or worse die.

The Mali Ministry of Health asked the SIAPS Program to conduct an assessment of the supply chain management system to pinpoint gaps in the system leading to frequent stock-outs of medicines at all service delivery point and especially at the community level.

The findings of the assessment related to community case management signaled many opportunities for improvement. Only fifty percent of CHW collect and transmit required data to the community health centers. Although health providers at the community health centers were trained on community case management and had job aides to assist in their supervision duties, supervision of CHW was infrequent. A national guide for procurement and distribution of essential medicine exists, but the distribution of supplies to the community level is weak resulting in frequent stock-outs of commodities. Overall, there is a need of standard operating procedures (SOPs) to harmonize distribution of commodities and reporting of dispensed medicines.

Currently, SIAPS is working with the MOH on strengthening the overall logistics management information system, improving data collection tools and reporting methods, and working on strengthening communications and supervision between the community health centers and CHWs.

Download and read the assessment.