PILOTING THE USE OF MOBILE SHORT MESSAGING SYSTEMS (SMSs) TO
MESSAGING SYSTEMS (SMSs) TO IMPROVE ACCESS TO MEDICINES: EXPERIENCES FROM KENYA
Njoroge, Tony; Maundu, Josephine; Wangai, Mary
Management Sciences for Health/Strengthening Pharmaceutical Systems (MSH/SPS) Program, Nairobi, Kenya
Background
• In order to have commodity security and therefore to provide health services, the integrity of the commodity forecasting, procurement and distribution systems (the supply chain) is critical. • A major challenge to accurate forecasting in Kenya is A major challenge to accurate forecasting in Kenya is
the lack of consistent, timely and accurate reporting on medicines consumption from rural based health f ili i
facilities.
• Commodity use reporting is very poor, and when reports are received they are often delayed and
reports are received, they are often delayed and incomplete. This results in stock‐outs at facilities and hence limits access to medicines.
Objectives
• To determine the effectiveness of using SMS based reporting systems to improve medicine
reporting systems to improve medicine consumption data reporting from lower level facilities.
facilities
• To demonstrate the role of district level oversight on improved reporting accuracy
i
d
ti
and timeliness
d ti li
regarding commodity consumption data.
Methods
• The SPS program worked with 3 districts’ health management teams (DHMTs) to pilot the use of SMSs to report on priority programs’ commodities consumption.
• Health facilities used a
H lth f iliti
d coding system to transmit di
t
t t
it
product logistics data (including Opening Balance, Consumption Losses and End of Period Closing
Consumption, Losses and End of Period Closing Stocks). These were then captured using an SMS gateway to populate the relevant facilities’ database records.
• The system logged the SMS transmission details and provided summary statistics for oversight id d
i i f
i h
Methods
• The system, a simple MS Access® database tool,
also synchronized data collected between the
also synchronized data collected between the gateway server and the various districts’ databases to allow for instant data access for the DHMT
to allow for instant data access for the DHMT
members.
• In Addition, SPS helped train the DHMT members I Additi
SPS h l d t i th DHMT
b
on data review and validation skills for practice d i th i
during their monthly data dissemination meetings.
thl d t di
i ti
ti
Results
• Reporting from Rural Health Facilities increased in 2 months to over 90% across board for all priority
2 months to over 90% across board, for all priority programs’ datasets.
• By the 6
B th 6th month the districts were able to th th di t i t
bl t
demonstrate 100% of their facilities submitting ti l
timely reports for ART and Laboratory Test Kits t f ART d L b t
T t Kit
usage data.
Results
KIAMBU EAST DISTRICT REPORTING RATE
100
90
80
70
60
50
40
30
20
10
0
SEPT
NOV
ART
MALARIA
TB
RH
LAB
Results
• Access to the data by DHMT: Using the Data Verification meetings, District health management meetings, District health management
teams were able to redistribute stocks and to q yp
query poor data management practices.
g
p
• District health management teams were critical in g
p
g y
ensuring the success of reporting systems
• Store persons were found to be focal in providing y
p
accurate district store commodity status, despite the fact that existing priority program commodity use reporting mechanisms had not been making use of their skills at all.
f h
k ll
ll
Summary and Implications
• The use of simple electronic, SMS based reporting systems was found feasible especially in rural
systems was found feasible especially in rural health facilities.
• Other programs currently implementing SMS Oth
tl i l
ti SMS
reporting platforms: – SMS for Life – Reporting weekly disease surveillance information for district level use (WHO RBM)
– Frontline SMS Frontline SMS – Providing SMS based Health information to Providing SMS based Health information to
targeted client groups e.g. on Reproductive Health
– Huduma – Reporting Governance and Service Charter breaches in Rural Facilities, initiated by the clients themselves
Summary and Implications
• Improved reporting from remote areas ensures that equitable access to health services is
that equitable access to health services is achieved, despite terrain challenges. Acknowledgements
• District Health Management Teams from the three pilot districts (Kiambu East, Muranga
pilot districts (Kiambu
East Muranga South and South and
Thika)
• The SPS program and this pilot was made possible Th SPS
d thi il t
d
ibl
via USAID funding