Khunyangu Sub County Hospital Spread Rational Use of ACTs at Bumala B, in Western Kenya
Khunyangu Sub-County Hospital is one of the seven high volume hospitals in Busia County, in Western Kenya. It started implementing quality improvement (QI) in June 2014 when the USAID Applying Science to Strengthen and Improve Systems (ASSIST) project introduced its work in Busia County. The hospital experienced Artemesinin Combination Therapy (ACT) stock outs due to irrational dispensing of Artemether-Lumefantrine (ALs). There were no stocks of ACTs in March 2014 prompting a sub county redistribution in April 2014.
In May 2014, ACTs issued were three times more than the number of confirmed cases. ASSIST introduced QI in the facility and the county in June 2014. Employing a range of QI tools and techniques, the facility was able to eliminate irrationally issued ACTs, translating to approximately 7 months of ACTs saved by January 2015. In the months that followed, the team embarked on ensuring good commodity practices with available ACT dose bands securing their stocks further. They began involving other facilities in the sub-county during sub-county continuous medical education (CME) sessions, Bumala B being one of them.
In February 2016, the coach at Khunyangu selected a coach in Bumala B and a Work Improvement Team (WIT). The coach from Khunyangu helped the WIT at Bumala B implement the changes they had tried in Khunyangu to help secure their ACT and follow through on the test-treat-track (3T) model. ACT doses issued in Bumala B have since dropped from a median of 126% to 100%. Bumala B continues rationally using ACTs.