Digital Health is a broad term which encompasses overlapping technology sectors across healthcare—as evidenced by our Venn diagram representing the Digital Health Landscape. In this “Digital Health in Action” series, we’ll focus on specific examples from each domain to show what an impact the digital health movement is making on healthcare across the world.
Using mobile communication devices to deliver health-related services is increasingly becoming an inseparable component of the global healthcare ecosystem. On the Digital Health Landscape, applications of mHealth in prevention, diagnosis, treatment and patient monitoring are well known, but its utility extends further into other layers of the healthcare community, such as supply chain management.
Enabling access to quality healthcare for all people in a society necessitates the facilitation of free flow and optimal use of health-related goods and systems. Supply chain constraints faced in delivering medical supplies to needed locations in a timely manner can adversely affect the ability of healthcare systems to function effectively.
Stock-out of essential medicines, especially in rural and remote areas, creates a serious bottleneck with tangible impacts on health outcomes. In many developing countries, where patients get free medicines at government-run rural health centers, stock-outs often force them to go to private clinics and pharmacies—adding undo financial burden.
The lack of timely information regarding stock levels of essential medicines impacts the ability of health management authorities to make critical decisions regarding the maintenance of medication supplies, and the ability to forecast the need for drugs and handle emergency orders.
SMS Messages Making a Difference
‘SMS for Life’ is a public-private partnership program that seeks to counter these problems using mobile technology. Using SMS messaging between district health management authorities and point-of-care health facilities that distribute medicines, the visibility of medicine stock levels can be improved—thereby reducing stock-outs.
Part of the ‘Roll Back Malaria’ program, SMS for Life was first launched in 2009 in three districts of Tanzania, covering 229 villages and a population of 1.2 million people. Using SMS messages, mobile telephones, and electronic mapping technology, the initiative facilitated a comprehensive and accurate stock count of all anti-malarial drugs in 129 health facilities.
The district health management authority typically sends a stock-request message to all registered health facility workers. They then count the anti-malarial drug stocks and send the information back to the system using SMS messages. The district health authorities use the received information to electronically map the availability of drugs and orders distribution of drugs to the sites and/or re-distribution between the sites to improve the stock levels.
‘SMS for Life’ Getting Results
During the pilot study period of 21 weeks, the stock count data was provided in 95% cases with 94% accuracy. The proportion of health facilities with no stock of anti-malarial drugs fell from 78% at week 1 to 26% at week 21. In one district, stock-outs were eliminated completely by week 8.
At the beginning of the project, 26% of the point-of-care facilities had no dose form of ACT, an anti-malarial drug, and by the end this figure had been cut to less than 1%. Stock-out issues that previously used to take about one to two months to resolve can now be completed in less than two days.
‘SMS for Life’ Expanding Its Impact
Currently, SMS for Life has been expanded to more than 5,100 health facilities in Tanzania. In Ghana, a full-scale country-wide system is being put in place to track the stock availability of 28 blood products, after a successful pilot project in six districts.
In Kenya, following the completion of an extensive pilot project, a full country scale-up is underway with the help of the National Malaria Control Program (NMCP). A similar scale-up operation is in progress in Cameroon, covering 3,800 health facilities in 91 districts. SMS for Life is also presently being implemented in Congo covering 1,245 health facilities.
By using these types of mhealth applications in countries around the world, solutions are being achieved to meet supply chain challenges—enabling improved access to quality healthcare for communities across the globe.
Shiva Gopal Reddy has a Bachelor's degree in Physics and a Master's in
Applied Psychology and writes frequently on the latest research, impact,
happenings and trends in digital health technology.