cstock: a sustainable approach to using mhealth to … · ... a sustainable approach to using...
TRANSCRIPT
1
cSto
ck:
A s
ust
ain
ab
le a
pp
roa
ch t
o u
sin
g m
He
alt
h
to s
up
po
rt t
he
co
mm
un
ity
he
alt
h s
up
ply
ch
ain
2
Un
iqu
e C
ha
lle
ng
es
face
d b
y C
HW
s:
•R
em
ote
, ru
ral
loca
tio
ns,
dif
ficu
lt g
eo
gra
ph
y:
tr
an
sit
to r
esu
pp
ly p
oin
ts c
an
be
lo
ng
an
d d
iffi
cult
•Li
mit
ed
tra
nsp
ort
ati
on
op
tio
ns,
oft
en
no
n-m
oto
rize
d:
su
ch a
s b
ike
s, f
oo
t, d
on
keys
, p
ub
lic
tra
nsp
ort
•Lo
w li
tera
cy a
mo
ng
CH
Ws:
ch
all
en
ge
s in
re
po
rtin
g,
reco
rdin
g a
nd
su
bm
itti
ng
da
ta
•La
ck o
f in
fra
stru
ctu
re:
o
fte
n n
o d
ed
ica
ted
fa
cili
ty t
o w
ork
fro
m
Li
mit
ed
sto
rag
e s
pa
ce
•A
t th
e e
nd
of
the
su
pp
ly c
ha
in
w
he
n t
he
re a
re s
ho
rta
ge
s o
f e
sse
nti
al
me
dic
ine
s in
th
e s
yste
m C
HW
s o
fte
n
mis
s o
ut
on
su
pp
lie
s
SC
4C
CM
Pro
ject
SC
4C
CM
is
a le
arn
ing
pro
ject
th
at
ide
nti
fie
s p
rov
en
, si
mp
le,
aff
ord
ab
le s
olu
tio
ns
tha
t a
dd
ress
un
iqu
e s
up
ply
ch
ain
ch
all
en
ge
s
face
d b
y C
HW
s.
3
SC
4C
CM
Pa
thw
ay
to
Su
pp
ly C
ha
in
Su
sta
ina
bil
ity
To s
ust
ain
an
inn
ova
tio
n, i
ssu
es
of
sca
lab
ilit
y, in
teg
rati
on
an
d in
stit
uti
on
ali
zati
on
mu
st b
e c
on
sid
ere
d f
rom
th
e s
tart
,
du
rin
g t
he
de
sig
n a
nd
im
ple
me
nta
tio
n p
ha
se.
4
Co
un
try
Co
nte
xt
•H
ea
th S
urv
eil
lan
ce A
ssis
tan
ts (
CH
Ws)
in
tro
du
ced
in
19
70
s fo
r h
ea
lth
pro
mo
tio
n a
nd
sa
nit
ati
on
act
ivit
ies
•C
HW
s a
re p
aid
ca
dre
of
MO
H
•C
CM
wa
s in
itia
ted
in
Ma
law
i in
20
08
, C
HW
s in
ha
rd t
o r
ea
ch a
rea
s
pro
vid
e C
CM
•T
he
re a
re c
urr
en
tly
ove
r 3
00
0 v
illa
ge
cli
nic
s
•C
HW
s ca
n m
an
ag
e u
p t
o 1
9 p
rod
uct
s fo
r C
CM
, F
P a
nd
HIV
Te
stin
g
Ma
law
i O
ve
rvie
w
SM
S-b
ase
d s
yste
m t
o
ma
na
ge
re
po
rtin
g a
nd
resu
pp
ly p
roce
ss:
cSto
ck
Pa
rt o
f S
olu
tio
n:
Ba
seli
ne
Fin
din
gs
-2
01
0
•O
nly
27
% o
f C
HW
s h
ad
all
CC
M p
rod
uct
s* n
ee
de
d i
n
sto
ck D
OV
•4
3%
of
CH
Ws
rep
ort
ed
th
ey
su
bm
it a
re
po
rt
con
tain
ing
lo
gis
tics
da
ta t
o H
Cs
•O
nly
13
% o
f H
Cs
rep
ort
ed
CH
W d
ata
se
pa
rate
ly f
rom
the
ir o
wn
da
ta t
o d
istr
icts
•9
4%
of
HSA
s su
rve
yed
ha
d a
mo
bil
e p
ho
ne
, 8
5%
ha
d
ne
two
rk c
ove
rag
e a
t le
ast
so
me
tim
es
*cot
rim
oxaz
ole,
LA
1x6
and/
or L
A2x
6, O
RS
Dis
tric
t a
nd
Ce
ntr
al
leve
ls m
on
ito
r
resu
pp
ly a
nd
sto
ck
leve
ls t
hro
ug
h S
MS
ale
rts
an
d a
da
shb
oa
rd
3.
He
alt
h C
en
ter
rece
ive
s re
qu
est
via
SM
S a
nd
no
tifi
es
HSA
eit
he
r “o
rde
r re
ad
y”
or
“ou
t o
f st
ock
”.cSto
ck:
Da
ta a
nd
Pro
du
ct F
low
1.
HSA
se
nd
s S
MS
wit
h
SO
He
ach
mo
nth
2.
cSto
ckca
lcu
late
s th
e r
esu
pp
ly
qu
an
tity
an
d s
en
ds
SM
S t
o H
C
Ph
arm
acy
4.
HSA
s co
lle
cts
pro
du
cts
an
d s
en
ds
SM
S w
ith
re
ceip
t
Th
e d
ash
bo
ard
dis
pla
ys
rep
ort
ing
rate
s, s
tock
ou
ts,
lea
d
tim
es,
co
nsu
mp
tio
n
an
d m
ore
6S s
In a
dd
itio
n t
o c
Sto
ck,
SC
4C
CM
intr
od
uce
d D
istr
ict
Pro
du
ct A
va
ila
bil
ity
Te
am
s
(DP
ATs
) th
at
use
th
e in
cre
ase
d d
ata
vis
ibil
ity
to
imp
rove
pe
rfo
rma
nce
Pe
rfo
rma
nce
Pla
n
•S
up
ply
ch
ain
pe
rfo
rma
nce
ind
ica
tors
an
d t
arg
ets
•cS
tock
da
ta a
nd
re
sup
ply
wo
rksh
ee
ts u
sed
to
tra
ck
pe
rfo
rma
nce
•Fo
rma
l re
cog
nit
ion
sys
tem
to d
rive
SC
pe
rfo
rma
nce
•M
an
ag
em
en
t d
iari
es
use
d
to t
rack
iss
ue
s a
nd
act
ion
s
take
n
DP
AT/
HP
AT
Me
eti
ng
s
•Q
ua
rte
rly D
istr
ict
Me
eti
ng
s
wit
h D
istr
ict
sta
ff a
nd
CH
W
sup
erv
iso
rs
•M
on
thly
HC
Me
eti
ng
s w
ith
HC
an
d C
HW
s
•To
pic
s d
iscu
sse
d i
ncl
ud
e
-P
erf
orm
an
ce p
lan
s &
reco
gn
itio
n
-R
ep
ort
ing
tim
elin
ess
an
d c
om
ple
ten
ess
-S
tock
ma
na
ge
me
nt
,
exp
irie
s &
ove
rsto
cks,
an
d p
rod
uct
ava
ilab
ility cS
tock
Da
ta
En
ha
nce
d M
an
ag
em
en
t (E
M)
Dis
tric
t P
rod
uct
Av
ail
ab
ilit
y T
ea
ms
7
Sca
lab
ilit
yIn
teg
rati
on
Inst
itu
tio
na
liza
tio
n
Use
s b
asi
c G
SM
ph
on
es
•H
SAs
an
d H
C s
taff
use
the
ir p
ers
on
al
ph
on
es
to
rep
ort
da
ta v
ia S
MS
on
a
toll
fre
e p
ho
ne
lin
e
Co
lle
cts
min
imu
m d
ata
•H
SAs
in M
ala
wi
ma
na
ge
up
to
19
pro
du
cts
•st
ock
on
ha
nd
an
d
rece
ipts
da
ta
Ho
stin
g d
ata
on
Th
e C
lou
d
•in
exp
en
sive
, re
lia
ble
an
d
ea
sy t
o m
an
ag
e f
or
a
sma
ll s
yste
m l
ike
cS
tock
Str
ea
mli
ne
s e
xis
tin
g
resu
pp
ly p
roce
ss
•C
alc
ula
tes
qu
an
titi
es
for
HC
s, r
ed
uci
ng
th
e b
urd
en
of
calc
ula
tio
n
•A
dv
ise
s H
SAs
wh
en
sto
ck
is a
vail
ab
le f
or
coll
ect
ion
pre
ven
tin
g u
nn
ece
ssa
ry
tra
vel
to t
he
HC
•W
he
n H
Cs
can
no
t fu
lfil
l
ord
ers
, d
istr
icts
ge
t
imm
ed
iate
SM
S a
lert
s to
faci
lita
te t
ime
ly
rep
len
ish
me
nt
Ite
rati
ve
ap
pro
ach
to
da
shb
oa
rd d
esi
gn
•si
mp
le,
ea
sy-t
o-u
se
da
shb
oa
rd r
ep
ort
s
de
sig
ne
d w
ith
in
pu
t fr
om
the
use
rs 6
mo
nth
s a
fte
r
imp
lem
en
tati
on
Dis
tric
t P
rod
uct
Av
ail
ab
ilit
y
Tea
ms
(DP
AT
)
•In
tro
du
ctio
n o
f D
PATs
cre
ate
d a
str
uct
ure
fo
r
usi
ng
da
ta m
ak
ing
cS
tock
da
ta i
mp
ort
an
t to
th
eir
eve
ry d
ay
wo
rk
Sim
ple
De
sig
n o
f cS
tock
8
Pil
ot
Tim
eli
ne
cSto
ck D
ev
elo
pm
en
t –
6 m
on
ths
cSto
ckTe
st P
eri
od
–1
5 t
o 1
8 m
on
ths
9
Re
sult
sP
rod
uct
Av
ail
ab
ilit
y
�6
2%
of
CH
Ws
ha
d t
he
4 t
race
r d
rug
s* i
n
sto
ck d
ay
of
vis
it
(co
mp
are
d t
o 2
7%
BL)
�H
SAs
in d
istr
icts
usi
ng
cS
tock
an
d D
PATs
ha
d 1
4%
fe
we
r st
ock
ou
ts o
r lo
w s
tock
s
tha
n o
the
r d
istr
icts
on
da
y o
f v
isit
Da
ta V
isib
ilit
y
�M
ore
th
an
80
% o
f C
HW
s re
po
rt l
og
isti
cs
da
ta t
o c
Sto
cke
very
mo
nth
(v
s. 4
3%
at
BL)
Use
of
Da
ta
�9
1%
of
Dru
g S
tore
in
Ch
arg
es
use
cS
tock
to
info
rm r
esu
pp
ly q
ua
nti
tie
s
�5
6%
of
CH
W s
up
erv
iso
rs u
se c
Sto
ckd
ata
for
pe
rfo
rma
nce
mo
nit
ori
ng
Tea
mw
ork
�1
00
% o
f D
istr
ict
& C
HW
Su
pe
rvis
ors
rep
ort
ed
fin
din
g p
rod
uct
ava
ila
bil
ity
te
am
s
use
ful
�9
2%
of
CH
W S
up
erv
iso
rs k
no
w t
he
ir
reco
gn
itio
n p
lan
*cot
rim
oxaz
ole,
LA
1x6
and/
or L
A2x
6, O
RS
10
Tra
nsl
ati
ng
Ev
ide
nce
in
to A
ctio
n
Da
ta V
ali
da
tio
n W
ork
sho
ps
•P
rese
nta
tio
n o
f in
terv
en
tio
n s
pe
cifi
c re
sult
s to
sele
cte
d C
HW
s, H
C, d
istr
ict
sta
ff f
rom
inte
rve
nti
on
dis
tric
ts
•R
evie
w o
f ke
y d
ata
, in
terp
reta
tio
n w
ith
in lo
cal
con
text
•D
iscu
ssio
n o
n e
ffe
ctiv
en
ess
, a
ffo
rda
bili
ty,
valu
e
of
inte
rve
nti
on
co
nsi
de
rin
g r
esu
lts
an
d
exp
eri
en
ce
Th
e P
ath
wa
y t
o S
up
ply
Ch
ain
Su
sta
ina
bil
ity
To
ol
•D
eve
lop
ed
as
a p
lan
nin
g t
oo
l fo
r sc
alin
g a
nd
inst
itu
tio
na
lizin
g i
nn
ova
tio
ns
wit
hin
pu
blic
se
cto
r su
pp
ly c
ha
ins
•P
art
icip
an
ts a
sse
ss “
rea
din
ess
” fo
r sc
ale
up
an
d in
stit
uti
on
aliz
ati
on
of
the
inn
ova
tio
n o
n a
sca
le o
f 1
-5 a
nd
th
en
de
velo
p a
ctio
n p
lan
s fo
r h
ow
to
mo
ve t
o t
he
ne
xt le
vel
•F
ive
do
ma
ins
ass
ess
ed
: O
rga
niz
ati
on
al C
oo
rdin
ati
on
, O
rga
niz
ati
on
al
Ca
pa
city
, F
un
din
g &
Re
sou
rce
s,
Co
mm
un
ity &
Sta
ff P
rep
ara
tio
n ,
an
d T
oo
ls &
Te
chn
olo
gy
Sca
le U
p P
ack
ag
e a
nd
Pla
nM
OH
an
d p
art
ne
r co
nse
nsu
s o
n
ele
me
nts
of
inte
rve
nti
on
to
im
ple
me
nt
na
tio
na
lly
A S
tru
ctu
red
, P
lan
ne
d A
pp
roa
ch t
o
Sca
le U
p a
nd
In
stit
uti
on
ali
zati
on
11
Op
era
tio
na
lisi
ng
MO
H o
wn
ers
hip
of
the
in
no
va
tio
n p
ack
ag
e
•Fo
rma
tio
n o
f a
ta
skfo
rce
(MO
H c
ha
ir)
de
dic
ate
d t
o t
he
sca
le u
p a
nd
su
sta
ina
bil
ity
of
SC
in
no
vati
on
s
•F
ind
ing
ch
am
pio
ns
in M
OH
by
ha
vin
g c
en
tra
l le
vel
ad
voca
tes
an
d t
rain
ers
in
eve
ry d
istr
icts
•C
ap
aci
ty b
uil
din
g o
f M
OH
to
pro
vid
e m
an
ag
em
en
t a
nd
lea
de
rsh
ip
•D
eve
lop
me
nt
of
com
pre
he
nsi
ve,
mu
lti-
yea
r co
st e
stim
ate
s fo
r re
sou
rce
mo
bil
iza
tio
n,
in t
he
sh
ort
te
rm,
an
d a
tra
nsi
tio
n p
lan
to
eve
ntu
all
y c
ove
r a
ll c
ost
s
thro
ug
h t
he
MO
H
Sca
le U
p A
nd
In
stit
uti
on
ali
zati
on
Pa
rtn
eri
ng
to
Sca
le
•Im
po
rta
nt
for
sust
ain
ab
ilit
y a
s b
uil
ds
bro
ad
er/
join
t
ow
ne
rsh
ip a
nd
ca
pa
city
th
at
last
s a
fte
r p
roje
ct e
nd
s
Cu
rre
nt
Sta
tus
of
Sca
le u
p
•2
9 o
f 2
9 d
istr
icts
ha
ve c
om
mit
ted
fu
nd
ing
: 9
WH
O,
5 S
ave
th
e C
hil
dre
n,
2 I
WG
, 6
SS
DI,
an
d
7 S
C4
CC
M;
as
of
No
v 2
01
3,
65
% o
f tr
ain
ing
co
vera
ge
ach
ieve
d
12
5 Y
ea
r Tr
an
siti
on
Pla
n
Pu
rpo
se
•P
rovi
de
a s
tru
ctu
red
an
d t
ho
ug
htf
ul
pro
cess
on
wh
at
is r
eq
uir
ed
to
su
sta
in
cSto
cka
nd
th
e D
PA
Ts f
or
the
ne
xt f
ive
ye
ars
to
se
t a
str
on
g f
ou
nd
ati
on
fo
r th
is
tech
no
log
y a
nd
ap
pro
ach
be
com
e a
co
re b
usi
ne
ss p
ract
ice
fo
r th
e M
OH
.
•H
igh
lig
hts
ke
y c
ap
aci
ty b
uil
din
g i
nv
est
me
nts
re
qu
ire
d t
o a
dd
ress
ga
ps
in M
OH
inst
itu
tio
na
l st
ruct
ure
s so
th
at
MO
H i
s a
ble
to
ma
na
ge
of
cSto
cka
t th
e e
nd
of
the
5-y
ea
r tr
an
siti
on
al
pe
rio
d.
13
Su
sta
inin
g
cSto
cka
nd
th
e D
PA
Ts
A c
om
mit
me
nt
to a
pp
rop
ria
te i
nst
itu
tio
na
l
sup
po
rt,
ma
inta
inin
g k
ey
sk
ills
an
d c
ap
aci
ty,
an
d t
ime
ly p
ay
me
nt
of
syst
em
ho
stin
g a
nd
ma
inte
na
nce
co
sts
are
cri
tica
l fo
r
sust
ain
ab
ilit
y o
f a
n m
He
alt
hsy
ste
m
14
Pro
ject
Ma
na
ge
me
nt
•P
roje
ct M
an
ag
em
en
t Te
am
: to
gu
ide
th
e t
ran
siti
on
, in
stit
uti
on
ali
zati
on
an
d
sust
ain
ab
ilit
y o
f cS
tock
.
–P
roje
ct M
an
ag
er
–Sy
ste
m A
dm
inis
tra
tor
-m
on
ito
rs s
yste
m p
erf
orm
an
ce;
ma
na
ge
s a
nd
su
pp
ort
use
rs,
lia
ise
wit
h v
en
do
rs.
–S
en
ior
Log
isti
cs O
ffic
er
-in
tera
ct r
eg
ula
rly
wit
h t
he
Pro
ject
Ma
na
ge
r to
su
pp
ort
th
e
imp
lem
en
tati
on
an
d u
se o
f cS
tock
as
a k
ey
MO
H L
MIS
to
ol.
–P
rog
ram
Lo
gis
tics
Off
ice
rs -
reg
ula
rly
re
vie
w d
ata
on
th
e c
Sto
ckd
ash
bo
ard
an
d r
ep
ort
s
an
d u
se i
t to
im
pro
ve p
rod
uct
ava
ila
bil
ity
fo
r p
rog
ram
pro
du
cts
at
HSA
le
vel.
•P
roje
ct M
an
ag
er:
pro
vid
e a
str
ate
gic
vie
w a
nd
vis
ion
fo
r
the
in
no
vati
on
.
–C
urr
en
tly
pe
rfo
rme
d b
y p
roje
ct
–Ja
nu
ary
20
14
wil
l h
ire
a S
eco
nd
ee
fun
de
d b
y I
WG
fo
r 1
8
mo
nth
s
–S
eco
nd
ee
wil
l w
ork
to
pro
vid
e a
se
am
less
tra
nsi
tio
n f
or
all
pro
cess
es
to M
OH
de
sig
na
ted
pe
rso
n b
efo
re t
he
en
d o
f
the
ir t
erm
.
15
•D
ata
an
d a
pp
lica
tio
n h
ost
ing
/ s
erv
er
ma
inte
na
nce
op
tio
ns:
–U
S b
ase
d d
ata
ho
stin
g c
om
pa
ny
(cu
rre
nt)
–Lo
cal
clo
ud
ho
stin
g c
om
pa
ny
–M
OH
ow
ne
d s
erv
er
/ M
OH
hir
e I
T s
up
po
rt
•S
oft
wa
re M
ain
ten
an
ce /
De
ve
lop
me
nt
op
tio
ns:
–U
S b
ase
d s
oft
wa
re d
eve
lop
er
(cu
rre
nt)
–Lo
cal
soft
wa
re d
eve
lop
er
–M
OH
hir
e I
T s
up
po
rt
Ass
ess
me
nt
of
curr
en
t o
pti
on
s fo
r h
ost
ing
/ s
oft
wa
re s
up
po
rt f
or
cSto
ck:
•Lo
cal
cap
aci
ty in
Ma
law
i to
pro
vid
e h
ost
ing
se
rvic
es
an
d/o
r so
ftw
are
de
velo
pm
en
t is
in
em
erg
ing
sta
ge
s.
•M
OH
do
es
no
t h
ave
su
ita
ble
in
fra
stru
ctu
re o
r st
aff
at
this
sta
ge
to
ho
st o
r m
ain
tain
cS
tock
in
ho
use
.
•T
he
re i
s p
ote
nti
al
op
po
rtu
nit
y i
n t
he
me
diu
m t
erm
to
le
vera
ge
oth
er
syst
em
s w
ith
in M
OH
for
infr
ast
ruct
ure
su
pp
ort
, e
.g.
dh
is2
•C
urr
en
t re
com
me
nd
ati
on
to
ma
inta
in U
S b
ase
d d
ata
ho
stin
g c
om
pa
ny
an
d U
S b
ase
d
soft
wa
re d
eve
lop
me
nt
com
pa
ny
Su
sta
inin
g t
he
cS
tock
Sy
ste
m
16
Co
mm
un
ity
He
alt
h S
up
ply
Ch
ain
Pe
rfo
rma
nce
Mo
nit
ori
ng
Th
e f
orm
ati
on
of
dis
tric
t p
rod
uct
av
ail
ab
ilit
y t
ea
ms
(DP
ATs
) h
ave
be
en
cri
tica
l to
th
e s
ucc
ess
of
cSto
ck
as
this
is
the
me
cha
nis
m t
hro
ug
h w
hic
h u
sers
be
gin
to w
ork
as
a t
ea
m a
nd
ap
pre
cia
te h
ow
da
ta c
an
be
use
d t
o i
mp
rove
pe
rfo
rma
nce
.
17
Less
on
s Le
arn
ed
•C
on
sid
er
sust
ain
ab
ilit
y -
sca
lab
ilit
y, in
stit
uti
on
ali
zati
on
an
d
inte
gra
tio
n –
fro
m t
he
de
sig
n p
ha
se
•K
ee
p t
he
de
sig
n s
imp
le a
nd
su
ita
ble
fo
r th
e c
on
text
•P
lan
to
re
vis
it s
om
e o
f d
esi
gn
ea
rly in
th
e p
ilo
t w
he
n u
sers
ha
ve
exp
eri
en
ce t
o d
raw
fro
m
•E
nga
ge
pa
rtn
ers
an
d M
OH
fro
m t
he
ou
tse
t a
nd
co
nsi
de
rin
g
pa
rtn
eri
ng
fo
r sc
ale
up
•C
lou
d h
ost
ing
is a
ch
ea
p,
reli
ab
le a
nd
ea
sy t
o m
an
ag
e o
pti
on
fo
r
sma
ll s
cale
sys
tem
s
•C
om
bin
ing
an
mH
ea
lth
solu
tio
n w
ith
inte
rve
nti
on
s th
at
intr
od
uce
stru
ctu
red
pro
cess
es
for
rou
tin
e u
se o
f d
ata
so
sta
ff v
alu
e t
he
to
ol
•D
eve
lop
a t
ran
siti
on
pla
n w
ell
be
fore
th
e e
nd
of
the
pro
ject
an
d
he
lp s
et
the
gro
un
d w
ork
fo
r su
sta
ina
bil
ity
18
Th
an
k y
ou
! V
isit
us
at
sc4
ccm
.jsi
.co
m