Using Data Visibility to Improve Community Health Worker Performance and Increase Product Availability

Problem:

In Malawi, products for treating children at the community level with diarrhea, pneumonia, or malaria were only in stock 34% of the time with health surveillance assistants (HSAs) on the day of visit, according to the 2010 community health supply chain baseline survey results. Problems included chronic weaknesses in data visibility, lack of timely and accurate decision making about preventing or responding to stockouts, and lack of ownership of the problem by all users.

Methods:

One strategy to significantly increase product availability at the HSA level is the Enhanced Management approach, centering on creating teams of district, health center and HSAs who collectively create a vision, mission and performance metrics. Key to this approach is data visibility throughout the supply chain, so that district managers have real-time access to stock levels and impending or current stockouts and can quickly mobilize resources to address the problem. Data visibility is achieved through a routine reporting system using SMS messages, cStock, that has been integrated with an existing logistics management information system, Supply Chain Manager (SCM), to provide a complete stock picture. HSAs send SMS information on stock levels to a central server, which calculates resupply quantities and sends resupply amounts to the resupply point via another SMS so the order can be ready when the HSA arrives.

Results:

The integration of data from cStock into SCM provides district managers with stock data from all HSAs and health centers through a web dashboard highlighting key supply chain metrics. Teams developed vision and mission statements, and identified performance indicators with realistic, achievable targets and recognition plans rewarding good performance. Districts monitor performance indicators via the dashboard and receive SMS alerts for emergency stock situations. Reporting rates and in stock product rates for all CHWs using the SMS system will be presented.