1

Supply Chain “Early Warning System” for Family Planning, HIV and Malaria Commodities using Mobile Phone Technology Shows Promise www.ewsghana.com

2

Early Warning System (EWS)

• Development and implementation of the EWS in Ghana has been a collaborative process involving many partners, including:o Ghana Health Serviceso USAID Ghana Focus Region Health Project (FRHP)o USAID|DELIVER Project

3

Background Non or incomplete stock status reporting from

facilities for decision making at the higher levels

Irregular ordering (not based on max/min, re-order levels)

Resulting in stock out of commodities at all levels (Facility, RMS, CMS)

4

Rationale Assist facilities to better identify and address

failures in the supply chain system and manage products’ stocks better

Improve visibility of commodity stock data at facilities and higher levels for managers and other stakeholders so that they take timely remedial action

Assist the health services to ensure consistent availability of commodities at facilities

System Objectives Provide near real-time stock status information for

tracer commodities in FP, HIV, and Malaria commodities

Improve the timeliness and accuracy of paper-based reporting by the SDPs

Maintain appropriate stock levels and prevent stock outs

Inform and improve supervision of the supply chain system

5

6

• Sept 2010: Concept paper by USAID Focus Region Health Project

• Jan-April 2011: Software development and Pre-test

• April-May 2011: Training conducted• June-December 2011: Piloted in 6 districts in the

focus regions and 113 facilities in the seven other regions

• January 2012: Internal assessment• November 2012: Expansion started

Timeline

7

Implementation System designed and set up

Service providers trained

Participating DHMTs, RHMTs, and Central level Managers oriented on using the EWS website

Stocks data reporting started June, 2011 and is ongoing

Monitoring and supportive visits conducted – Desktop and on-site visits

8

P&S

Regional Health DirectorateRMS

SSDM National Programmes

District Health Directorate

Health Facilities

CMS

Logistics Management Information Flow

Routine/paper flow of communication

System messages

EWS website access

How it Works Facility worker enters stock counts

and stock receipt into personal cell phones in the format:

COMMODITY [STOCK ON HAND]. [STOCK RECEIVED]

Sends weekly by SMS to a toll-free short code (“7000” for MTN and “1902” for all other networks except Tigo & Glo)

Data analyzed by web database, feedback to facilities via SMS and to managers via SMS and web

9

10

Screenshot

11

Coverage

Reporting on a total 27 tracer commodities (for Malaria, FP, and HIV)

FRHP: 88 sites (health facilities and regional medical stores) in Central, Western, and Greater Accra regions

USAID | DELIVER PROJECT:113 ART sites in the 7 other regions of Ghana

12

EWS Assessment Results Weekly reporting rates by facilities - 84% and

78% was timely

Over 90% of health facilities were using bin cards for FP commodities and almost 80% had them updated

EWS reports were consistent with 70% of bin card records available at facilities

Reduction in stock out rate: 32% to 24%

44% of managers had registered and used the EWS website

13

Weekly reporting rates of 84% on average

1st 4th 7th 10th 13th 16th 19th 22nd 25th 70%

75%

80%

85%

90%

95%

81%79%

84% 83%

92%

87% 88%

83%

87%

Weeks

14

Percentage of facilities with stock keeping records for FP commodities

Male Condom Depo Jadelle76%

78%

80%

82%

84%

86%

88%

90%

92%

94%

96%95 95

92

83

8991

Stock Card Available Stock Card updated

15

Scale Up

Designing of the website improved to make it user friendly

Provide monthly reports directly to managers via email and SMS

Expanding geographical coverage in the focus regions to 12 more additional district and all ART sites in Ghana

Expanded the list of tracer commodities to 43

16

Conclusions The EWS provides real time stock status for

management use

The system has strengthened stock management (use of bin cards, other paper-based reporting)

Improvement in stock out rates at the facility level

Service providers make ‘extra’ efforts to keep stock due to visibility of stock reports

17

Please visit the Early Warning System

website:

`

www.ewsghana.com