Online Program

Human element in electronic health systems: Getting to zero ARV stock-outs in Kenya

Monday, November 2, 2015 : 10:30 a.m. - 10:43 a.m.

Ruth Njoroge, BSc., MSc (United States International University), USAID/Kenya Pharma project, Nairobi, Kenya
Anthony Savelli, MA Public Administration, BPharm University of Pittsburgh, Project Management Unit - Kenya Pharma, Chemonics International, Washington DC, WA
Peter Mwangi, BVM, MSc. (University of Nairobi), Field Operations Department, USAID/Kenya Pharma project, Nairobi, Kenya
James Batuka, USAID/Kenya, Nairobi, Kenya
Background: In Kenya, frequent pharmaceutical stock-outs led to HIV/AIDS patients unable to reliably access antiretroviral (ARV) and opportunistic infection (OI) medication. USAID’s Kenya Pharma project combines a cloud-based electronic supply chain management system (e-SCM) with the mentoring of facility staff to create a dependable pharmaceutical supply chain.

Method: In 174 sites across Kenya, the e-SCM allows facility staff to track stock and place orders. At project start, project field service representatives (FSRs) mentored facility staff on taking inventory and placing orders through the e-SCM instead of submitting on paper. Over time, facility staff began using e-SCM and FSRs remotely monitored the system and provided feedback on data gaps and inconsistencies. Ordering sites then used this feedback to clean up their data and correct errors.

Results: Stock-out rates of ARV and OI drugs fell from 46.2 percent in 2010 to 0 percent in 2014. Currently, 100 percent of facilities receive shipments within four working days of order placement. To continue the feedback loop after the project ends, FSRs are training county pharmacists and staff at the Kenya Medical Supplies Authority (KEMSA) to monitor quality assurance and conduct joint site visits to facilities.

Discussion: An electronic system combined with a people-centered approach enabled the project to reach zero stock outs in 2014. The approach incorporates feedback loops and ongoing interaction, allowing facility staff to take ownership of the e-SCM and use data to make informed decisions. An effective electronic health intervention must include a human element to ensure sustainability.

Learning Areas:

Program planning
Public health administration or related administration
Public health or related research

Learning Objectives:
Explain how incorporating the “human element” into program design improves HIV/AIDS supply chain quality and efficacy. Demonstrate how an electronic information system can identify data quality issues in supply chain management and reduce supply stock outs.

Keyword(s): HIV/AIDS, International Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Chief of Party of Kenya Pharma project with the overall responsibility of ensuring security of HIV commodities in the PEPFAR supported sites in Kenya.In this capacity, i have been monitoring the stock situation and the factors that lead to over/under stocks or even stock outs in a pull system. I have deployed and monitored usage of electronic systems in commodity management and what leads to their successful adoption / failure.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.