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Quality Home Care in Namibia: Empowering Families Through Essential Supplies
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The Challenge In resource-limited settings, home-based care (HBC) kits are transforming how palliative care is administered to people living with HIV/AIDS and other chronic illnesses. The kits include basic medicines, essentials for personal hygiene, and materials for protecting caregivers from infection. In Namibia, which has an HIV prevalence rate of almost 20 percent, HBC kits offer a convenient way for families and caregivers to provide quality care at home. Yet these kits are effective only if they are readily available, moving through a secure supply chain. Namibia’s Ministry of Health and Social Services (MoHSS) enlisted SCMS to conduct a situational analysis of the country’s logistics management system for HBC.
The assessment revealed a largely unplanned system of HBC kit distribution, with 87 percent of respondents reporting random receipt and distribution.
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Program ImplementationConducted in April and May 2008, the SCMS assessment uncovered critical gaps in many areas. A pioneering initiative in HBC logistics, the assessment encompassed all 13 regions of Namibia and included 116 respondents. It solicited information through four types of data collection tools and covered key areas of logistics management, including information systems, inventory control procedures, HBC kit distribution and reporting methods, and monitoring and supervision of storage conditions. Respondents were selected through a combination of targeted and systematic random sampling. They included nongovernmental organization/community-based organization managers in charge of home-based care, ministry representatives in the Family Health Division, primary health care supervisors, home-based caregivers, clinic nurses, and persons responsible for the pharmacy or storeroom where HBC supplies are stored and managed.
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Results and OutcomesThe assessment revealed a largely unplanned system of HBC kit distribution, with 87 percent of respondents reporting random receipt and distribution. Stockouts were frequent, stock balances irregularly monitored, and storage areas insufficient. Written guidelines were lacking for proper storage and for supervising those with critical logistics responsibilities. Most respondents did not have documented distribution schedules or their own transportation to convey kits to service delivery points when they received supplies from the MoHSS. One in three respondents had encountered expired products in kits, while two in three had received kits without packing lists. The assessment concluded that Namibia’s HBC supply chain system must be systematically strengthened to sustain the needs of the country’s palliative care program. Based on study results, the MoHSS has endorsed a supply system redesign to ensure kits are continuously available for HBC providers and integrate HBC kits into the overall pharmaceutical supply system.
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