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“Live their best and healthiest life”: delivering medical supplies to remote islands of Kiribati

It’s no exaggeration to say that pharmacist Moannara Benete literally holds one of the most important positions in the Pacific. Kiribati’s 21 inhabited islands are spread across some 3.5 million square kilometers of ocean, and as head of the pharmacy team at the Kiribati Ministry of Health and Medical Services, Moannara is focused on provision of medical supplies for all the inhabitants of his country; no matter where they live.

This was already a huge challenge before COVID-19, and the pandemic has only amplified these challenges. Medical supplies have been hard to come by and there have been significant delays in their arrival. This has led to an increase in orders for urgent medical supplies, which has driven up prices.

“Procurement of medical supplies is an important part of most health care services”, said Moannara Benetefrom his office in Tarawa, the capital of Kiribati. “Our goal is to improve the overall health of the population by procuring and purchasing quality, cost-effective medical supplies. A well-managed supply program supports economic and social development by keeping people as healthy as possible.

The logistics of managing pharmaceutical supplies on 21 islands spread over 3.5 million square kilometers of ocean is a huge challenge.
Photo: Conor Ashleigh/World Bank

Take control of health service delivery

The World Bank supports Kiribati’s commitment to advancing Universal Health Coverage so that all I-Kiribati can access health services when they need them. A key part of this work is to help track development partner contributions to health programs, so that they are recognized as part of the integrated plans and budgets managed by the Department of Health and Medical Services. By doing so, the department is then able to make the most of all available resources, ensure it understands where support is coming from and when, and take control of health service delivery. in a more effective and holistic way.

While many can access health care when they need it on Kiribati’s main island of Tarawa, it is much more difficult to ensure clinics and pharmacies on the outer islands are stocked with sufficient supplies and equipment.

“I’m really happy with the progress made by the pharmacy team. We have limited resources, but we work well as a team and there is a lot of enthusiasm for what we do,” explains Moannara. “We are improving supply chain management, and now, for the first time, we also have a comprehensive national list of essential medical supplies – which includes medicines, equipment and consumables.”

“Health center staff are now using tablets to track what is coming in and going out. It really helped us develop a better picture of what we need and when we need it.

Kiribati's Chief Pharmacist, Moannara Benete, says the right supply chain and distribution of medical supplies will benefit everyone in Kiribati.  Photo: Rimon Rimon/World Bank
Kiribati’s Chief Pharmacist, Moannara Benete, says the right supply chain and distribution of medical supplies will benefit everyone in Kiribati.
Photo: Rimon Rimon/World Bank

Improving supply chains

Moanara took up a position with the Department of Pharmacy of the Kiribati Ministry of Health and Medical Services in 2011 after earning a degree in pharmacy in Fiji. In 2019, she completed a Masters in Public Health from the University of Melbourne, Australia. She says her studies helped shape her vision for improving the healthcare system at home.

“It made me think that the pharmacy sector was more than just a curative department. I realized that it sits at the center of health service delivery in many ways – spanning the spectrum of preventive, curative, restorative and palliative care needs in this country,” said Moannara. “If we can get the supply chain and distribution in place, then everyone across the islands will benefit.”

Access to contraceptives

One area of ​​particular passion for Moannara is her team’s work on sexual and reproductive health.

“Sexual and reproductive health commodities have traditionally been hard to come by here in Kiribati. We have been dependent on the support of development partners,” she explains. “And with the borders closing due to COVID-19, it became even harder for us to get enough and there was a shortage.

“Yet our the data shows us that the number of married women with access to contraceptives has increased over the past decade, so if we can make sure the supplies are on the shelves, we know people will use them.

Doctor Jennifer ButlerDirector for the Pacific and Representative of the United Nations Population Fund (UNFPA), which supports this sexual and reproductive health work, says improving access to modern contraceptives and life-saving maternal health drugs is a job vital.

“It’s about improving access to contraceptives, increasing visibility of availability – so people know where to get contraceptives – and building more sustainable systems,” said Dr. Butler. “This is essential work with a strong focus on gender equality, human rights and prosperity for all; and is essential for achieving universal health coverage.

Moannara Benete is committed to building the capacity of Kiribati's health system so that all I-Kiribati can access health services when they need them.  Photo: Aislinn Healy/World Bank
Moannara Benete is committed to building the capacity of Kiribati’s health system so that all I-Kiribati can access health services when they need them.
Photo: Aislinn Healy/World Bank

Live their best, healthiest life

Moannara believes ensuring equal access to health services is a big challenge for Kiribati, but one she and her team are ready to meet.

“Our pharmacy team is committed to building the capacity of our healthcare system. We’re driven by opportunities to learn as we go, and we’re certainly learning a lot. Leadership and effective and transparent decision-making are also very important,” said Moannara.

“We want to make sure that everyone has the opportunity to live their best life in the best state of health; no matter who they are or where they live.

World Bank support to the Kiribati Ministry of Health and Medical Services is provided in part by Advanced Universal Health Coveragea multi-donor trust fund set up by Australia Department of Foreign Affairs and Trade in 2015 to support the strengthening of health financing and service delivery systems in countries in East Asia and the Pacific. Other partners include Gavi, the global fundand the Bill and Melinda Gates Foundation.


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This article was first published by The World Bank April 27, 2022

Joan J. Dean

The author Joan J. Dean