Commodity Tracking Systems Helps Nurses Provide TB Treatment

"Kwa dawa ya TB ni lazima utembee mpaka upate." (You should never give up when searching for anti-TB medicines).  This is the advice that Esther Wahome gives to her clients when they come to the tuberculosis (TB) clinic in Kayole II, one of the larger public hospitals near Nairobi, Kenya. Esther is a registered community health nurse.  Within a short time, Esther dispenses the drugs to the patient, provides health care advice and updates her records.

Esther’s TB clinic clients are usually referred to the hospital from nearby community health care centers. Kayole II provides free health services and receives nearly 300 outpatients each day.  Esther, a mother of two, has been running the Kayole II TB Clinic for the last three months.

“I like serving in the TB clinic because I get to see patients who are weak regain their strength. Sometimes the patients come in when they are so weak and close to skin and bones that at times I wonder where to inject them. Seeing patients thrive fulfills me and is my joy,” says a smiling Esther.

USAID's Health Commodities and Services Management (HCSM) Program supports the Kayole II TB clinic. The program is implemented by Management Sciences for Health (MSH) in cooperation with the Ministry of Health in Kenya.  The program strengthens systems that deliver health care commodities and related services. HCSM also supports facilities in public, private, and faith-based organizations through training, mentoring, and providing tools that enable better accounting and managing of commodities to help minimize stock outs and ensure access.

The nurses here serve in different clinics — family planning, maternity, prevention of mother-to-child HIV transmission, child welfare, antenatal and postnatal, and comprehensive care clinics on a three to six month rotational basis. Esther says the TB clinic, where she has served multiple several times, is her favorite.

Esther runs the TB clinic on Monday and Friday every week. Before opening her clinic, she gives health talks on nutrition, prevention, signs and symptoms of TB.

She has been a nurse for the past 15 years.  “As a young girl, my elder brother, the first born in our family was a nurse; and, incidentally, he also married a nurse. I visited the two during school holidays and I just admired the work that both my brother and sister-in-law did — caring for people who cannot pay you back. That’s how I look at nursing — a calling to care for the weak and sick.”

In addition to caring, a healthcare worker has to be organized and keep their records up to date to ensure that patients get the medication they need.

“For me the worst thing is to have patient come in and not get medication,” Esther said.

This is something that she hasn’t dealt with thanks to her keenness in record keeping. Esther explains that to manage her commodity supplies, she maintains a commodity tracking system which has monthly records with the beginning balance, closing balance, quantities ordered, positive and negative adjustments; and expiry dates of commodities.

Although at times the TB clinic may lack some medication, they are always in communication with the District TB and Leprosy Coordinator who directs them to other facilities that have the medication they need as they wait for their facilities deliveries.

“I have enough drugs in my store and based on my records, I can estimate how much I will need for the following month. We have also developed networks and work as a team with other facilities and exchange, then replace, drugs so that no patient leaves without receiving treatment,” she explained.

“Sometimes our consumption may be more than our registered patients because of the transit patients. But our records help to ensure that there is no loss of TB drugs. Every time I get something from our stores, I record it in my bin card. It makes my work easier.”