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The 6th Global Health Supply Chain Summit
Using Data to Strengthen Supply Chain Performance
for HIV and AIDS Commodities in Swaziland
Gashaw Shiferaw
[SPEAKERS NAMES]
November
18 -20, 2013[DATE]
Addis Ababa, Ethiopia
Outline
• Background
• Methodology
• Results
• Conclusions
Background
• Swaziland has the world’s highest HIV prevalence, 26%
• The supply of life-saving antiretroviral (ARV) medicines
and other HIV commodity has historically been hampered
by long procurement lead times, inappropriate stock
management and inefficient quantification/forecasting
• Inadequate supply and frequent stock outs was often
exacerbated by the lack of a reliable data and logistics
management information system (LMIS) to inform
decisions like quantification and resupply
• To ensure an uninterrupted supply of ARVs, the
Swaziland Ministry of Health (MOH) worked with partners,
to design and implement an adequate LMIS in support to
the national HIV and AIDS program.
Background
• In this respect, the Systems for Improved Access to
Pharmaceuticals and Services (SIAPS) Program is
collaborating with the MOH to help strengthen the national
ART supply chain system including LMIS to improving the
availability and utilization of data for decision making
Methodology
• The SIAPS Program and its predecessor, the
Strengthening Pharmaceutical Systems Program (SPS),
worked with the Ministry of Health of Swaziland and other
partners to conduct an initial situation analysis
• The analysis results were used to help design and
implement an LMIS and tools to support the national
antiretroviral therapy (ART) program and the central
medical store
• The electronic inventory management tool, RxSolution,
was selected as a data collection instrument and was
introduced to all ART sites
– The aim of RxSolution is to facilitate the collection,
aggregation, and reporting of critical patient and inventory
management information for HIV and AIDS to feed the LMIS.
Methodology
• Health facility staff, National AIDS program staff, CMS and
other relevant stakeholders were trained on the use of
both LMIS and RxSolution
• A Central Unit for data management and information
analysis was established and a TWG was established to
oversee the implementation and use of the information for
decision making
Results
• Reports now allow users to access critical information
such as total number of ART patients, number of patients
per treatment regimen, percentage of treatment switches,
consumption, and stock data for the different HIV and
AIDS products.
• As the data is available from various levels of the health
system, it supports short- and long-term supply chain
decisions.
Results
• The introduction of LMIS and electronic tool has—
– Improved the availability of data—reporting rate has increased
from 56 percent in 2011 to 95 percent in 2013
– Improved timely reporting from 50% in 2011 to 77% in June
2013
• Improved quality of reports: Completeness, Calculations
• Improved communication/linkage between CMS and facilities
• The readily available information improves patient
management:
– For example, the available data allowed the smooth transition of
76 percent of adult patients from Stavudine to a Tenofovir and
Zidovudine based regimen
– Decreased expiry of ARVs—in one case, 230,000 US dollars
(USD) worth of Stavudine was kept from expiring
Results
Reporting rates –(Trends ) for ART LMIS, 2013
100%
97%
97%
97%
95%
54%
Baseline,2010 April
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Results
Results
• 100% stock availability for key ARVs at facilities.
• 100% Order Fill Rate reached for key ARVs
• Information coming to the CMS through the LMIS has
been used for resupply, to develop the national forecast &
supply plan, and monitoring.
• Helped the MoH avoid unnecessary orders to the tune of
USD 6.2 million (2012/2013 FY).
• Inventory management information has improved the
short- and long-term planning and decision making around
the supply chain of HIV and AIDS commodities.
Results
% of ART sites keeping recommended minimum stock levels on tracer drugs
100%
90%
87%
82%
80%
83%
76%
72%
70%
60%
50%
40%
30%
20%
10%
0%
Q1 2012
Q2 2012
Q3 2012
Q4 2012
Q1 2013
Conclusion
• The effective design and implementation of sound LMIS,
coupled with the effective use of electronic tools, enhance
the performance of HIV and AIDS programs. This has
been achieved by:
– improving the effectiveness and efficiency of the program
supply chain, hence promoting availability and accessibility
to life saving products; and cost saving
– providing the necessary information required to guide the
implementation and scale-up of care and treatment
programs.
Acknowledgements
• Kingdom of Swaziland Ministry of Health
– CMS
– SNAP
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•
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Management Sciences for Health
USAID | SIAPS
Clinton Health Access Initiative(CHAI)
MSF