By: Mildred Shieshia, SC4CCM Regional Technical Advisor
Community health workers often juggle many tasks, from navigating difficult rural roads, to carrying medicines long distances, to diagnosing and treating children for common childhood illnesses. Submitting information to higher levels of the health system on conditions treated, number of cases seen and products dispensed is therefore seen as an additional burden. The ability to obtain quality information from the community level is often hindered by infrastructural and capacity challenges.
A supply chain system exists to serve its customers by ensuring timely availability of products as needed. In many resource constrained countries, finding the right amount and mix of supply chain information to inform timely and appropriate decision making remains a challenge. For supply chains to perform optimally one of the key requirements is regular and reliable data. Good data, when analyzed, provides insight to the performance of the supply chain at various levels including the community level –the last mile in improving patient access to treatment. In the community, confidence and trust in community health workers (CHWs) grows when patients feel that in addition to diagnosing illness, CHWs are able to provide medicines for treatment. Routine flow of data to help make decisions on products needed at the community is therefore very important.
Recent advancements in technology have proven beneficial in improving health outcomes through data exchange and information flow while reducing the reporting burden on the health worker. In Malawi, SC4CCM designed and implemented cStock, an SMS web-based system to improve data visibility at the last mile and provide real time actionable data for decision making. The CHWs, also known as Health Surveillance Assistants (HSAs), use basic phones to send just two sets of data- stock levels for up to 19 products and product receipts once they collect products at the health facility. Each data set is sent as one short message text. These two sets of data generate reports on consumption, timeliness , completeness, reporting rates, lead time and order fill rate that inform supply chain performance and decision making at higher levels. At any point in time cStock allows one to have a glimpse of what is happening at the last mile.
cStock – a multifaceted tool also serves as a communication link between the community and higher levels by providing information through reminders, group messages and early warnings. As an early warning system, CHWs use cStock to report emergencies when they run low on stock or when stocked out. cStock also determines resupply quantities for HSAs thus eliminating the need for health facility supervisors to perform manual calculations. Health facility supervisors use the predetermined resupply quantities to pick and pack orders and inform the CHW when their order is ready for collection. This translates into efficient use of travel time as CHWs only travel to pick up products when they know they will be available and increased motivation among CHWs to report since they feel better connected with the higher levels. District and central level data managers also use cStock reports to monitor community level supply chain performance and product consumption levels.
cStock is a simple tool that has helped to support supply chain management for CCM products, improved data visibility at the last mile and provided decision makers with the information they need to efficiently manage stocks and ensure that CHWs have the medicines they need to save the lives of children in their communities.