title: The Revolving Fund Pharmacy Model: backing up the Ministry of Health supply chain in western Kenya.
abstract: OBJECTIVE
  A pressing challenge in low and middle-income countries (LMIC) is inadequate access to essential medicines, especially for chronic diseases. The Revolving Fund Pharmacy (RFP) model is an initiative to provide high-quality medications consistently to patients, using revenues generated from the sale of medications to sustainably resupply medications. This article describes the utilization of RFPs developed by the Academic Model Providing Access to Healthcare (AMPATH) with the aim of stimulating the implementation of similar models elsewhere to ensure sustainable access to quality and affordable medications in similar LMIC settings.
  
  
  METHODS
  The service evaluation of three pilot RFPs started between April 2011 and January 2012 in select government facilities is described. The evaluation assessed cross-sectional availability of essential medicines before and after implementation of the RFPs, number of patient encounters and the impact of community awareness activities.
  
  
  RESULTS
  Availability of essential medicines in the three pilot RFPs increased from 40%, 36% and <10% to 90%, 94% and 91% respectively. After the first year of operation, the pilot RFPs had a total of 33 714 patient encounters. As of February 2014, almost 3 years after starting up the first RFP, the RFPs had a total of 115 991 patient encounters. In the Eldoret RFP, community awareness activities led to a 51% increase in sales.
  
  
  CONCLUSIONS
  With proper oversight and stakeholder involvement, this model is a potential solution to improve availability of essential medicines in LMICs. These pilots exemplify the feasibility of implementing and scaling up this model in other locations.
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya. imranmanji@hotmail.com.
authors.forename: Imran
authors.initials: I
authors.lastname: Manji
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Simon M
authors.initials: SM
authors.lastname: Manyara
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Jakait
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.|Department of Biomedical Informatics, Columbia University Medical Center, New York, IN, United States.
authors.forename: William
authors.initials: W
authors.lastname: Ogallo
authors.affiliation: Department of Pharmacy Practice, Butler University, College of Pharmacy and Health Sciences, Indianapolis, IN, United States.
authors.forename: Isabel C
authors.initials: IC
authors.lastname: Hagedorn
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lukas
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Eunice J
authors.initials: EJ
authors.lastname: Kosgei
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.|Department of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, IN, United States.
authors.forename: Sonak D
authors.initials: SD
authors.lastname: Pastakia
mesh_terms: D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000191:economics; D018954:Drugs, Essential / Q000191:economics / Q000600:supply & distribution*; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007630:Kenya; D018803:Models, Economic; D010865:Pilot Projects
chemical_list: D018954:Drugs, Essential
keywords: Sub-Saharan Africa; access to medicines; essential medicines; pharmacy