supply chain “early warning system” for family planning, hiv and malaria commodities using...
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Supply Chain “Early Warning System” for Family Planning, HIV and Malaria Commodities using Mobile Phone Technology Shows Promise www.ewsghana.com
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Early Warning System (EWS)
• Development and implementation of the EWS in Ghana has been a collaborative process involving many partners, including:o Ghana Health Serviceso USAID Ghana Focus Region Health Project (FRHP)o USAID|DELIVER Project
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Background Non or incomplete stock status reporting from
facilities for decision making at the higher levels
Irregular ordering (not based on max/min, re-order levels)
Resulting in stock out of commodities at all levels (Facility, RMS, CMS)
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Rationale Assist facilities to better identify and address
failures in the supply chain system and manage products’ stocks better
Improve visibility of commodity stock data at facilities and higher levels for managers and other stakeholders so that they take timely remedial action
Assist the health services to ensure consistent availability of commodities at facilities
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System Objectives Provide near real-time stock status information for
tracer commodities in FP, HIV, and Malaria commodities
Improve the timeliness and accuracy of paper-based reporting by the SDPs
Maintain appropriate stock levels and prevent stock outs
Inform and improve supervision of the supply chain system
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• Sept 2010: Concept paper by USAID Focus Region Health Project
• Jan-April 2011: Software development and Pre-test
• April-May 2011: Training conducted• June-December 2011: Piloted in 6 districts in the
focus regions and 113 facilities in the seven other regions
• January 2012: Internal assessment• November 2012: Expansion started
Timeline
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Implementation System designed and set up
Service providers trained
Participating DHMTs, RHMTs, and Central level Managers oriented on using the EWS website
Stocks data reporting started June, 2011 and is ongoing
Monitoring and supportive visits conducted – Desktop and on-site visits
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P&S
Regional Health DirectorateRMS
SSDM National Programmes
District Health Directorate
Health Facilities
CMS
Logistics Management Information Flow
Routine/paper flow of communication
System messages
EWS website access
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How it Works Facility worker enters stock counts
and stock receipt into personal cell phones in the format:
COMMODITY [STOCK ON HAND]. [STOCK RECEIVED]
Sends weekly by SMS to a toll-free short code (“7000” for MTN and “1902” for all other networks except Tigo & Glo)
Data analyzed by web database, feedback to facilities via SMS and to managers via SMS and web
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Screenshot
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Coverage
Reporting on a total 27 tracer commodities (for Malaria, FP, and HIV)
FRHP: 88 sites (health facilities and regional medical stores) in Central, Western, and Greater Accra regions
USAID | DELIVER PROJECT:113 ART sites in the 7 other regions of Ghana
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EWS Assessment Results Weekly reporting rates by facilities - 84% and
78% was timely
Over 90% of health facilities were using bin cards for FP commodities and almost 80% had them updated
EWS reports were consistent with 70% of bin card records available at facilities
Reduction in stock out rate: 32% to 24%
44% of managers had registered and used the EWS website
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Weekly reporting rates of 84% on average
1st 4th 7th 10th 13th 16th 19th 22nd 25th 70%
75%
80%
85%
90%
95%
81%79%
84% 83%
92%
87% 88%
83%
87%
Weeks
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Percentage of facilities with stock keeping records for FP commodities
Male Condom Depo Jadelle76%
78%
80%
82%
84%
86%
88%
90%
92%
94%
96%95 95
92
83
8991
Stock Card Available Stock Card updated
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Scale Up
Designing of the website improved to make it user friendly
Provide monthly reports directly to managers via email and SMS
Expanding geographical coverage in the focus regions to 12 more additional district and all ART sites in Ghana
Expanded the list of tracer commodities to 43
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Conclusions The EWS provides real time stock status for
management use
The system has strengthened stock management (use of bin cards, other paper-based reporting)
Improvement in stock out rates at the facility level
Service providers make ‘extra’ efforts to keep stock due to visibility of stock reports