Njoroge , Tony; Maundu , Josephine; Wangai , Mary

1. PILOTING THE USE OF MOBILE SHORT 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

2. 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 the lack of consistent, timely and accurate reporting on medicines consumption from rural based health facilities. • Commodity use reporting is very poor, and when reports are received, they are often delayed and incomplete. This results in stock-outs at facilities and hence limits access to medicines.

3. Objectives • To determine the effectiveness of using SMS based reporting systems to improve medicine consumption data reporting from lower level facilities. • To demonstrate the role of district level oversight on improved reporting accuracy and timeliness regarding commodity consumption data.

4. 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 coding system to transmit product logistics data (including Opening Balance, 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

5. Methods • The system, a simple MS Access® database tool, also synchronized data collected between the gateway server and the various districts’ databases to allow for instant data access for the DHMT members. • In Addition, SPS helped train the DHMT members on data review and validation skills for practice during their monthly data dissemination meetings.

6. Results • Reporting from Rural Health Facilities increased in 2 months to over 90% across board, for all priority programs’ datasets. • By the 6th month the districts were able to demonstrate 100% of their facilities submitting timely reports for ART and Laboratory Test Kits usage data.

7. Results

8. Results • Access to the data by DHMT: Using the Data Verification meetings, District health management teams were able to redistribute stocks and to query poor data management practices. • District health management teams were critical in ensuring the success of reporting systems • Store persons were found to be focal in providing 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.

9. Summary and Implications • The use of simple electronic, SMS based reporting systems was found feasible especially in rural health facilities. • Other programs currently implementing SMS reporting platforms: • SMS for Life – Reporting weekly disease surveillance information for district level use (WHO RBM) • Frontline SMS – 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

10. Summary and Implications • Improved reporting from remote areas ensures that equitable access to health services is achieved, despite terrain challenges.

11. Acknowledgements • District Health Management Teams from the three pilot districts (Kiambu East, Muranga South and Thika) • The SPS program and this pilot was made possible via USAID funding