Pharmaceutical kits contain selected medicines and medical supplies, in predefined quantities, that are used for primary pharmaceutical supply, supplementary supply, or emergency supply. Emergency health kits are well standardized and widely used by the main international relief agencies, and they can prevent many common problems associated with pharmaceutical donations.
Ration kits provide standard quantities of essential medicines for routine use in rural health care at dispensaries and health centers, and sometimes at hospitals. The relevance of pharmaceutical kits depends on a country’s ability to manage its pharmaceutical supply system; using a kit system can help countries with weak capacity. A pharmaceutical supply system based on kits has the following advantages -
- Selection of a limited range of essential medicines
- Simplified budgeting, procurement, storage, transport, and supply management
- Reduced risk of theft
- More reliable supply
- More rational prescribing
- Possible lower indirect costs
Ration kit systems have the following disadvantages -
- Less flexible contents than in an open-order system
- Difficulty adjusting the medicine list to suit seasonal or regional variations in morbidity
- Possibility of shortages and surpluses
- Special management skills and additional space and staff required for kit packing
- Discouragement of local development of distribution and inventory control skills
- Difficulty in monitoring expiry dates
- Lack of fit in a cost-sharing system
- Large payments when prepacked kits are procured
- Higher direct costs, such as additional handling and packing
Kits should be considered when -
- Pharmaceutical supply to rural areas needs to be drastically improved.
- Pharmaceutical supplies are required for an emergency or time-sensitive situation.
- Record keeping, drug ordering, and inventory control capacities are limited.
- Central medical store capacity is limited.
- Diversion and theft of medicines are common.
Medicine needs are such that the number of different kits can be kept to a minimum.
A distribution system that is completely based on kits is usually viewed as a temporary solution to a logistics problem; however, changing from kits based on a push system to a requisition-based system can be difficult, and combining basic kit distribution with allowing limited ordering for some products may be necessary. Realistically, once a kit system is in place, its convenience paired with the challenges of a pull system often result in this temporary solution lasting much longer than originally planned. A flexible system for distributing medicines should be instituted as soon as the necessary managerial capacity and administrative structures can be created.