1 | “SMS for Life” | Geneva, January 21st. 2010
Today, many health facilities suffer from stock-outs of malaria medicines
Artemisinin:
• Plant• Grow• Harvest
Chemicalprocess:• Arte• Lume
Tabletting& packa-ging ofACT’s
Distri-bution tocountries
Ware-house
Countryware-house
Districtdistri-bution
HealthFacilities& HealthPosts
Pharmaceutical Suppliers
Procurement agents
Patient
National Malaria Control Programs
Tenders
The problem being addressed?
Maintaining adequate supplies of anti-malarial medicines at the health facility level in rural sub-Saharan Africa is a major barrier to effective management of the disease. Lack of visibility of anti-malarial stocks at the health facility level is an important contributor to this problem.
Partnership
NMCP In Country Project Leader: Winifred Mwafongo
Program Director: Jim Barrington
Technical Support: Kevin Ferriday Project Support: Pete Ward
Map Development: Ka-Ping Yee
Project Steering Committee
• Exec. Dir. Roll Back Malaria Partnership (Chair) Prof. Awa Marie Coll-Seck• Tanzania Nat. Malaria Control Program Manager Dr Alex Mwita• PSI Vice President and Global Malaria Control Director Dr. Desmond Chavasse
• Director of the Swiss Tropical Institute Prof. Marcel Tanner • CEO Novartis Foundation for Sustainable Development Prof. Klaus Leisinger • Exec. VP Novartis Malaria Initiatives Mr. Silvio Gabriel• “SMS for Life” Program Director Mr. Jim Barrington
• External Advisor: Bob Snow, Professor of Tropical Public Health, University of Oxford.
Pilot Districts
Dar es Salaam:
Training Sept 21st. 2009
MSD, NMCP, Warehouses
Lindi Rural:Live Sept 28th.
2009 DMO, Dr. Nkungulwe48 Health Facilities
Ulanga:Live Oct. 12th.
2009 DMO, Dr. Bakari
30 Health Facilities
Live Kigoma Rural:
Oct. 19th. 2009DMO, Dr. Edwin Kilimba
51 Health Facilities
9 weeksSurveilance Visits(3) November 23rd.(3) January 4th.(3) February 8th.3 Districts
129 Health Facilities226 Villages1.2 million people.
Average response rate of 95%Data accuracy rate of 94% (physical count)Data accessed on a daily basis (system log)
Lindi Rural – % of the 48 facilities with a stock-out by ACT dosage form.
(57% stock-out to 0% stock-out)
Ulanga – % of the 30 facilities with a stock-out by ACT dosage form
(87% stock-out to 30% stock-out)
Kigoma Rural – % of the 51 facilities with a stock-out by ACT dosage form
(93% stock-out to 47%)
All Districts – % of the 129 Facilities with a stock-out of Quinine Injectable
(36% stock-out to 4% stock-out)
Results
• At the start of the Pilot only 29 of the 129 facilities had all 5 medicines in stock (77% stock-out)
• At the end of the pilot 96 of the 129 had all 5 medicines in stock(26% stock-out). A threefold or 300% improvement.
• At the start of the Pilot 26% of facilities had no ACT of any dosage form in stock.
• At the end of the Pilot 99% of facilities had at least one dose form of ACT in stock.
Recommendations from the Pilot
• Implement the SMS for Life solution in all districts of Tanzania.
• Encourage the use the SMS for Life solution to track other medicines of priority.
• Apply the SMS for Life solution to disease surveillance.
• Implement SMS for Life in other African or non- African countries that have a need to eliminate stock-outs at health facility level.
Positioning of “SMS for Life” • We have a high quality solution that :
– is proven to support the elimination of medicine stock-outs
– is scalable to support any number of health facilities and countries
– is easy to implement. One half day of training per district
– is affordable. Total running costs of less than $100 per health facility per year)
– is sustainable The solution is offered as a commercial service by Vodafone, the largest mobile phone operator in the world
• The project is a unique combination of technology to address supply management issues– The project proves a contribution in the goal of access to malaria medicines for
everyone, when and where needed.
• The system is flexible to support access to other medicines– Once implemented, the system can be expanded to track other essential
medicines.
2011 – 2012• Tanzania should be the first Country to be complete by mid 2011
• Four Pilot districts in Ghana, starting in November 2010 with a goal of countrywide scale-up in Ghana 2011/2012
• We will continue to promote the solution to all countries who have stock-out problems.
• Our main limiting factor to further country implementations is funding.
• Implementing a country the size of Tanzania is approx. $950,000 including Pilot, and Zambia would be approx $550,000 . On-going costs are approx $100 per health facility per year.
Prof. David Mwakyusa , Minister for Health & Social Welfare.
“I’m grateful for what you are doing for my country – I loose a child every five minutes which is a waste from a disease that is completely preventable. I cannot do it alone, I have to do it with people like you. This is a great project and an innovation that I support very much, it’s exciting to me.”