*Names have been changed to protect individual privacy
Throughout Kenya, people seek health care from CHWs and facilities, and their trust in the health system depends on finding the medicines and care they need. “Commodities are the way the community knows a facility is running,” says Dr. Abass Ishmael, Coordinator of Health Products and Technology on Mfangano Island in Homa Bay County, where distance from the mainland often means slower and more limited access to supplies. “If you come to a facility and see patients go home without treatment, there is a problem.”
Ishmael helps facilities keep track and stock essential commodities for patients. Earlier this year, he supported a pregnant mother named Welma who experienced pre-eclampsia, or dangerously high blood pressure, and faced shortages in obstetric supplies during her delivery. Within 30 minutes, nearby facilities shared medicines through a rapid response system and Welma delivered safely. Across Kenya, too many health workers have a near-miss story like this—attempting to support a patient in a facility without essential commodities available.
This year’s shifts in global health funding tested the resilience of health systems everywhere, marking a critical point for health financing and commodity supply worldwide. In Kenya, national and county governments have made significant strides to strengthen supply chains and safeguard care—but recent changes in U.S. foreign assistance have exacerbated the supply chain’s pressure points, creating a $239 million funding gap in the Kenyan health sector and widespread stockouts. Lwala joined government partners to support the flow of essential medicines and mitigate the destruction caused by the sudden retreat of support.
Strengthening supply chains through community-led health
When community members go to a facility and miss treatment, or CHWs visit their homes without any commodity, the community members often lose trust in the health care providers. They won’t go back,” says Sam Oyugi, Senior Program Manager for Lwala’s adolescents and youth programming. To keep that trust, Lwala has embedded supply chain strengthening into our community-led health model: community health workers (CHWs) are equipped to conduct household visits, facilities maintain reliable stocks of essential medicines, and community health committees voice concerns and hold governments accountable when stockouts occur.
In 2023, we partnered with VillageReach and the Ministry of Health to build a resilient supply chain system in Migori County that integrates these community structures. Together, we assessed needs, invested into workforce development, and rooted our strategy in lasting policy. Through our advocacy, the government added commodity management to the national CHW curriculum and the electronic Community Health Information System, and we co-developed Migori's first ever health products and technology supply chain strategy—only the second in Kenya. This framework now helps track, plan, and budget for lifesaving medicines.
2024 marked another major step, when the national government rolled out 100,000 kits to equip CHWs nationwide. Amid global aid disruptions, these foundations have been vital in sustaining health services and protecting progress in maternal and child health. Leveraging these systems, Lwala acted quickly to ensure that care and commodities continued to reach every household.
“When commodities are available alongside trained staff and strong systems, everything works better. Mothers get timely care, health workers feel supported and motivated, and communities regain trust in their facilities.”
- Hellen Okelleh, Supply Chain Coordinator
Leaping into action for commodities
After the USAID Stop-Work Order was put into effect, Welma went to her local facility to deliver late at night. She suffered from pre-eclampsia, and the nurse-in-charge—the only health worker on site—couldn’t find the medicines needed for the emergency, such as magnesium sulfate to manage high blood pressure and oxytocin to control bleeding. She called Ishmael for help, and he immediately activated a sub-county WhatsApp group to mobilize stock from nearby facilities—a strategy influenced by Lwala’s collaboration with county partners to strengthen stock sharing. Within 30 minutes, Welma received the medicines she needed for a safe delivery.
Stories like Welma’s underscore the critical link between quality improvement in facilities and reliable supply chain—and shaped our rapid response to mitigate funding disruptions. Following the USAID Stop-Work Order, we worked alongside partners across Migori, Homa Bay, and Baringo Counties to assess the situation and act. Through facility audits and staff mentorship, we reviewed available stock and identified critical gaps. We co-designed targeted approaches, leaning on our previous quality improvement work, and helped facilities redistribute overstocked supplies, flag expired drugs early, and minimize both waste and shortages.
Over several months, we worked to secure a supply of maternal, newborn, and child health commodities and family planning for the three counties. In total, Lwala has raised $2.6 million to help bridge the gap and distributed lifesaving commodities to 475 health facilities—192 in Migori, 127 in Baringo, and 156 in Homa Bay—improving stock availability across Lwala-supported counties. Through quick, collaborative responses, we are helping to save mothers and children in our communities. But we knew that emergency support only goes so far, and that we would need strategies for lasting support.
Sustaining momentum with bold policy action
Lwala’s rapid response was built on years of groundwork and strong government partnerships, reinforcing national systems to keep lifesaving medicines within reach of every community. Kenya’s push toward universal health coverage introduced key tools for sustainable financing: the Social Health Authority, Kenya’s new national health insurance system, reimburses facilities for insured patients; meanwhile, the Facility Improvement Financing Act empowers facilities to keep and use their own revenue to meet local needs. Lwala is helping counties translate these policies into practice and advance long-term solutions to reduce reliance on external funding.
We are helping counties harness the Social Health Authority, which reimburses facilities for insured patients and creates a growing pool of domestic revenue. CHWs across our three counties are enrolling households in the insurance system, expanding coverage and generating funds to sustain services. At the same time, to support the current commodities gap and catalyze this system, Lwala supplied essential maternal and child health commodities to facilities in Migori, Homa Bay, and Baringo—preventing service disruptions and supporting facilities in claiming reimbursements.
Through the Facility Improvement Financing Act passed in 2023, facilities can now also use their own revenue for specific health needs, including human resources, operations, and commodities. As we supported commodity stocks to facilities, we made agreements with county government partners that ensured facilities strategically reinvest revenue gathered from the Social Health Authority and other sources to restock and expand what they have in essential medicines, creating a self-sustaining supply cycle. In Migori, 88% of our 147 partner facilities are now purchasing commodities, in part due to revenue generated from the initial commodity stocks donated. In Homa Bay, 80% of facility revenue is retained locally, with growing focus on commodity purchases. Baringo has also enacted Facility Improvement Fund legislation, and we’re working with county leaders to develop regulations and prioritize spending for medicines and supplies.
This work is igniting systemic change. Lwala is working with county governments to expand and protect budget lines for essential health commodities, so facilities and CHWs can deliver uninterrupted care. Homa Bay has increased its funding commitments, and we are advocating for increased funding in Migori and Baringo as well. Through our advocacy, county governments can use reimbursements from the Social Health Authority and Facility Improvement Financing to purchase essential supplies, ensuring frontline health workers have what they need, when they need it.
At the national level, in partnership with VillageReach, Lwala also contributed to the evaluation of Kenya’s 2020-2025 Health Products and Technologies Supply Chain Strategy, integrating community-level commodity management into the national supply chain. Counties are now translating this guidance into action. Migori’s strategy is underway, Homa Bay has completed revisions, and Baringo will begin drafting its own later this year—laying the foundation for resilient, locally led supply chains that ensure every community has reliable access to the medicines and supplies they need.
Lwala also supported national forecasting of family planning commodities through 2028, helping the government anticipate national need and treat contraceptives as a strategic investment.
A resilient future for supply chains
Because systems were in place to support mothers like Welma, her nurse-in-charge, and commodity managers like Ishmael, lives were not lost. Welma’s childbirth ended safely and is a testament to how functional supply chains save lives. Together, we are not just responding to crises—we are building resilience back into Kenya’s health system, one commodity and health worker at a time.
“When you have a robust supply chain, service delivery is not disrupted and you keep community trust in health systems. The community will go to a facility because they know they will get the treatment they need."
- Wycliffe Dunde, Homa Bay County Pharmacist
