Tech could be the magic pill for Kenya’s health system

If procurement is guided by real-time consumption data, it can reduce stockouts, cut costs, help proper allocation, and minimise wastage from expired medicines. Kenya is turning to digital systems to keep essential medicines flowing.

A new approach to digital procurement in Kenya is set to reduce stockouts of vital medical supplies like HIV viral load tests. Photo: Francis Agyemang Opok

Kenya has the world’s seventh largest HIV burden, with an estimated 1.4 million people living with the virus. In the last three months of 2025, nearly 400,000 HIV patients did not receive their viral load tests due to medical stockouts. These tests measure the amount of HIV in the blood and are the most accurate way of determining whether antiretroviral therapy (ART)—accessed by 87% of people in Kenya with HIV—is working to suppress the virus.

The shortages had immediate and serious consequences. Melrose Amondi, a nurse at Nakuru County Referral and Teaching Hospital in Kenya’s Rift Valley region, says the stockouts caused significant distress for patients and put their health at risk. “It is stressful for patients and health workers and strains healthcare systems,” she says. “[Without monitoring] a patient can rapidly progress to full-blown AIDS and death from deadly opportunistic diseases like pneumonia, meningitis, and tuberculosis.”

It is hoped that a new approach to digital procurement being rolled out across Kenya that allows for real-time tracking and inventory management will help prevent future stockouts and ensure patients receive uninterrupted care.

Coping with widespread stockouts

Donor countries and organisations fund at least 70% of HIV, TB, and malaria treatment programmes in Kenya. At present, the country is grappling with severe procurement disruptions and widespread stockouts of medicines and other commodities caused by dwindling donor support and internal procurement bottlenecks.

Dismus Mugisha, a regional procurement expert and officer in Uganda’s Ministry of Health says Kenya, Uganda, and Tanzania—and more broadly low- and middle-income countries (LMICs)—are struggling to keep pace with shifting financial landscapes, dwindling donor funding, changing policy priorities, and evolving disease burdens.

“You can only budget for today or tomorrow based on availability of resources. Procurement in LMICs is a hand-to-mouth process due to chronic underfunding,” he says, noting that about 95% of people in Africa live in a country that has not met the targets set out in the Abuja Declaration that requires countries to allocate at least 15% of their national budgets to improve healthcare.

Manual record-keeping is cumbersome and difficult to monitor or track, undermining data collection from health services. Photo: Joyce Chimbi

At a practical level, Mugisha says an overreliance on manual record-keeping undermines procurement systems, especially amid the current challenges. Files are often scattered across departments, can be lost, and are vulnerable to human error. Fragmented paper-based systems are difficult to track or audit, limiting visibility across supply chains and exacerbating stockouts.

“Weak data management leads to poor visibility of supply chains, leading to chronic stockouts and patients going without drugs or services, or paying out-of-pocket,” Mugisha explains.

This is evidenced by limited adoption of digital health systems across the continent. In 2020, only 27% of African countries had established national policies to support digital health initiatives. By 2023, one study found 43 out of 54 countries did not have an updated post-2020 digital health strategic plan.

Real-time procurement dashboards

It is against this backdrop that in 2023 Kenya’s Digital Health Agency introduced digital platforms, including procurement and supply chain dashboards, that allow for real-time tracking, forecasting, and inventory management of medical supplies distributed across Kenya’s 47 counties, ensuring that what is recorded in the system matches the stock on the shelves. A health worker can in minutes log in and see health products such as medicines, family planning commodities, and vaccines available at their facility or community health unit.

The dashboards provide real-time data on planned versus actual expenditure, procurement timelines, supplier performance, and commodity consumption at the hospital.

Nearly all public hospitals are mandated to process procurement through the digital system. Nakuru County’s health procurement dashboards, for example, cover all 227 public health facilities and 350 community health units, with each unit serving at least 1,000 households, as well as 11 surrounding geographic regions encompassing a total catchment area of nearly 2.54 million people.

At Nakuru County Referral and Teaching Hospital, Amondi says the county’s procurement dashboards allow health workers to see not just the amount of antiretroviral drugs consumed and the number of patients receiving them, but equally critically, they can identify any rise in HIV rates and the age groups of people affected. “We then respond very quickly by escalating HIV awareness campaigns, diagnosis, treatment, and prevention in those areas,” Amondi says.

More broadly, she explains that the dashboards provide real-time data on planned versus actual expenditure, procurement timelines, supplier performance, and commodity consumption at the hospital. “Large hospitals have a dedicated procurement department. Their dashboard shows where logistical issues are, as the root causes of stockouts range from late requisition of supplies by the hospital, delayed delivery processes, delayed decision making at the county or national government level, or even delayed payment of supplies,” she says.

Reducing shortages, delays, and wastage

At a national level, these digital dashboards are effective real-time data mining tools. They show who received what, when, and their consumption patterns. They enable the ministry and health officials across the country to use data to take actions that promote timely delivery of stock in line with needs specific to each health facility, eliminating delays, wastage, and shortages.

The dashboards remove or reduce supply chain bottlenecks, enabling patients to receive essential medicines and care on time and “at a reduced cost”, Amondi explains. “Some remote and rural health facilities use refrigerators powered by gas or kerosene due to lack of electricity. When the gas is delivered on time, routine child immunisation remains uninterrupted,” she adds.

Across Africa, digital procurement systems are transforming health supply chains in a growing number of the continent's countries, helping to reduce costs and prevent stockouts.

Amondi says pregnant women can safely give birth in such facilities because essential medicines that require refrigeration, including oxytocin—which prevents excessive bleeding after childbirth and is also used to induce labour or manage incomplete or unpreventable abortion—are more reliably available. Facilities equipped to store oxytocin are also more likely to stock other temperature-sensitive medicines, including rabies treatment.

A 2024 study at Kenya's Nakuru County Teaching and Referral Hospital showed that the integration of these digital tools has led to a 22% improvement in procurement efficiency and a 17% reduction in operational costs among state corporations in the region.

Mugisha says the digital systems prevent stockouts, limit wastage, and reduce theft. In some regions in Kenya, up to 60% of medicines procured by county governments are suspected to be stolen. Manual procurement is also more likely to introduce counterfeit, substandard, or falsified medicines as paper-based records make tracking the supply chain more difficult, Mugisha adds.

A gas-powered fridge in a dispensary in Kenya has run out of gas and is awaiting replenishment, disrupting immunisation services. Photo: Joyce Chimbi

Today, across Africa, digital procurement systems are transforming health supply chains in a growing number of the continent's countries, helping to reduce costs and prevent stockouts.

Mugisha says digital procurement systems are “not vulnerable to changing government regimes and priorities or changing financial landscapes and disease burden”. “It is not [up to] the government to dictate how a system should work; the system should tell the government where their priorities should be. If the system shows a high consumption of malaria drugs, only a dysfunctional government would shift their priorities away from malaria.”

From push to pull systems

Yet digital procurement systems alone cannot solve supply chain problems if medicines continue to be distributed through outdated procurement models. Across many African countries, health providers say a central challenge that remains is the persistence of “push” systems that allocate medicines based on availability rather than local need.

Dr Lily Henry Danima, medical director of Maridi Hospital, which supports a high-needs population in Western Equatoria State in South Sudan, says that despite growing adoption of digital procurement tools in African countries, the push system—a centralised, top-down method of allocating medicines and medical equipment—continues to disrupt healthcare delivery.

In South Sudan, Danima says the Ministry of Health stores procured medical stock in a central medical warehouse before supplies are ‘pushed’ to public health facilities. “The process leads to significant logistical inefficiencies and stockouts due to resource misallocation and supply inefficiencies because the government pushes out what is available when it is available, not what is needed when it is needed, as it is all dependent on donor support,” she says.

Indeed, Amondi says a push system means women in Kenya often have to pay for contraceptives in private facilities “due to unavailability of preferred modern contraceptive methods in public facilities, to avoid discomfort and other severe side effects such as bleeding and abdominal pain”.

Danima believes “health providers need a system that enables them to pull what they need, when it is needed so that in turn, patients can also pull the services they need, without having commodities pushed to them.”

She says South Sudan has introduced basic digital stock monitoring through M-Pharmacy, or Mobile Pharmacy, in public health facilities across the country to track and capture stock in real-time, revealing consumption patterns and shortages. She explains digital visibility is undermined when procurement decisions remain centralised. Push systems continue to flood facilities with unwanted supplies, leading to wastage and costly disposal processes.

“For instance, filariasis, a group of neglected tropical diseases, is common in Western Equatoria state but not in Western Bahr el Ghazal or Central Equatoria state. [Yet] all public facilities receive filariasis drugs in equal measure,” Danima says.

Pairing digital platforms that allow for real-time procurement tracking with 'pull' systems will improve how health supplies ultimately reach patients. Photo: Hashtag Melvin

Danima emphasises the need to shift toward pull systems, where procurement is guided by real-time consumption data rather than central allocation. She says this approach can reduce stockouts, lower storage and distribution costs, and minimise wastage from expired medicines.

Looking ahead, experts say meaningful reform will depend on pairing digital visibility with procurement systems that respond to real-time need rather than central allocation. Kenya is targeting faster medicine delivery with the aid of its digital procurement dashboards, aiming to cut wait times from historical highs of 19–24 days to seven days for major hospitals and 10 days for primary health facilities. At the same time, it is seeking to improve essential medicine availability, which currently sits at around 50–60%, below the 80% benchmark set by the World Health Organization (WHO) for acceptable access.

In recognition of the changing funding landscape across the region and a push towards self-sufficiency, plans are now underway to create a regional dashboard showing Africa’s real-time health supply chain to improve planning, warehousing, digital infrastructure, and how health supplies ultimately reach patients.