Hospital staff at USAID SUSTAIN-supported healthcare facilities are finding the use of short text message (SMS) reminders effective in improving reporting and ordering for medicines and health supplies.
In Uganda, facilities receive hard copy order and delivery schedules from the National Medical Store (NMS) to enable them to track delivery dates, plan, and prepare medicine orders before the deadline. In most facilities, it is common practice to find NMS order schedules pinned on the walls in the store rooms. Though the printed schedules act as a constant reminder to hospital staff to track order submission dates, the rate of ordering and reporting countrywide has remained low.
In 2010, the SUSTAIN project, in partnership with the Ministry of Health, conducted a baseline supervision performance assessment at 16 supported hospital stores. Hospitals scored a 35% average rate on the ordering and reporting indicator. The SMS platform serves up to 112 hospital staff at the 16 supported facilities including pharmacists, hospital directors, and in-charges at the anti-retroviral therapy, tuberculosis, antenatal, and laboratory clinics, and in the stores.
Copy of the short text message that order focal persons at SUSTAIN-supported hospitals receive
The messages are sent one week before order submission deadline and performance data shows that the SMS initiative has been effective.
At Gombe General Hospital, the reporting and ordering indicator was low at 1.5 (on a scale of 1‒5) during the first supervision performance visit conducted in December 2010. The SUSTAIN logistics team worked tirelessly with the hospital teams to identify order focal persons, and trained and mentored them in order calculation and good ordering and reporting practices to improve the hospital performance. In addition, staff involved in the order generation process received SMS reminders from SUSTAIN to ensure timely submission of their orders to NMS. By June 2013, Gombe Hospital had improved from 1.5 to 5, achieving a maximum score for the ordering and reporting indicator. The other hospitals have seen similar improvements. In fact, all supported hospitals recorded an average rate of 91 percent for ordering and reporting, 96 percent for availability of tracer medicines, and 91 percent for other medicines.
“We always receive order schedules and pin them on the walls. But sometimes, the people working on orders are in the field and deadlines pass without noticing. When I receive the text message, it is an instant reminder I cannot ignore because it comes one week before the order submission deadline,” explains Kenneth Tusiime, Head of the Pharmacy Department at Jinja Regional Referral Hospital.
Kenneth Tusiime, Head of Pharmacy at Jinja Regional Referral Hospital cross- checks the NMS delivery schedule with a colleague. On the upper left hangs a hard copy of NMS delivery schedule.
A combined strategy that employs both the traditional hard copy order schedules and the SMS technique, if introduced for all facilities, could reduce medicine stock-outs, a critical issue for service delivery in Uganda’s public health facilities. SUSTAIN is committed to improving supply chain and commodity management systems at Regional Referral Hospitals and General Hospitals to effectively leverage supplies and drugs available through the national public system
Written by; Julian Natukunda, Communications Specialist and Gladys Tugume, Senior Pharmaceutical logistics Technical Advisor with contributions from Jessica Ziegler, Knowledge Management Specialist - URC