The terms ‘electronic data’ and ‘IT’ are not generally associated with Africa’s struggling and under-resourced public healthcare systems, where challenges abound and are exacerbated by paper records, manual processes, labour-intensive administration and poor quality data. In Rwanda, however, the republic’s Ministry of Health has improved the delivery of critical medical supplies throughout the country by implementing an innovative electronic logistics management information system.
In a groundbreaking collaboration with US-based One Network Enterprises and its hosting and support partner, Imperial Logistics group company Resolve, Rwanda’s Ministry of Health has deployed a solution that is the first of its kind: a nationwide chain-of-custody pharmaceutical supply service for HIV/Aids medications and other healthcare products. According to One Network business unit manager Trevor Lambiotte, this project shows how technology and often over-hyped concepts like “the cloud” can and will transform Africa’s public health supply chains.
Outlining the development of this solution, he reveals the Republic of Rwanda’s Ministry of Health was searching for a way to better manage the end-to-end fulfilment and delivery of medical supplies across the country. “The demand channel in Africa for drugs which combat deadly diseases like HIV, malaria and TB is through national governments and their Ministries of Health,” he explains. “They devote funds from their national healthcare budgets to purchasing drugs, and budget deficits are mainly met by international funding agencies such as USAID, The Global Fund and World Health Organisation.”
Lambiotte notes that since up to 40% of the total delivered cost of medicines in Africa is made up of supply chain, distribution and other non-core costs, transformation in this area is essential. “The key challenge, however, is the visibility across the value chain, from planning to execution. Access to electronic data to make effective, timely, informed decisions is one of the critical hurdles for many African Ministries of Health to overcome. The environment is often one in which infrastructure is typically inadequate, computer literacy skills are very limited and there are no standard processes. This backdrop requires an innovative and comprehensive approach to changing the paradigm, in order to achieve an efficient public health supply chain and improve patients’ access to commodities,” he stresses.
In partnering with Resolve and One Network, Rwanda’s pioneering Ministry of Health sought to strengthen the forecasting, supply planning and logistics of all HIV/Aids commodities and other pharmaceutical and health products, as well as support its programmes at hospitals, distribution centres, district pharmacies and healthcare facilities.
Lambiotte elaborates: “For the Ministry of Health, achieving the accurate and timely delivery of critical pharmaceuticals to its people was difficult. The country is highly elevated and its population is predominantly rural. Furthermore, the Ministry’s fulfilment system was largely paper-based and filled with manual processes. They needed an easily accessible solution that was easy to implement and deploy, and flexible enough to overcome the challenges of operating within the country.”
Together with One Network and Resolve, and with the financial and strategic support of the Government of Rwanda, the Ministry of Health achieved this objective. “We successfully designed, built and implemented a computerised logistics management information system that provides health commodity logistics data and order processing functionality,” states Lambiotte “It encompasses demand planning, supply planning, inventory management, transport management and reporting.”
As a result of this system, the Ministry of Health is able to manage and track in real-time the custody and distribution of medical supplies as they flow from distribution centres, hospitals and clinics all the way to the community health workers. It has been implemented in the country’s central warehouses, 30 district pharmacies, 43 district hospitals, two referral hospitals and approximately 527 local health centres. These facilities are using the system to create, collaborate and manage purchase orders, as well as to record daily consumption. The transportation function in the electronic logistics management information system is also being utilised to optimise delivery.
“The Ministry has gained unprecedented visibility and control across its end-to-end supply chain, while reducing its total cost to deploy, maintain and support this supply chain. Reduced waste and improved efficiencies as a result of more efficient supply chain management are further benefits that will be realised. This system is expected to become the backbone that will support the efficient delivery of antiretroviral drugs and other critical healthcare products to the people of Rwanda,” Lambiotte concludes.