VDD’s inroads against Vaccine Shortages in Zamfara State

By Sadiq Haruna

Even though the federal government of Nigeria, adopted the Push-Plus system of vaccine delivery in 2013, Zamfara State experienced challenges with vaccine supply and availability at the health facility level. This led to large numbers of newborns and infants being completely unvaccinated or not completing the full vaccination course. eHealth Africa began providing third-party logistics (3PL) services to the Zamfara State Primary Health Care Management Board through the Vaccine Direct Delivery project in 2019. Through the service, vaccines are delivered directly to all the government health facilities and 14 local government cold stores in the state.

See the numbers so far:

LOMIS Stock Goes National!

By Joshua Ozugbakun and Emerald Awa-Agwu

How can accurate, real-time health inventory data will improve access to essential medicines and save lives?

With over 23,640 health facilities alone in Nigeria (as at 2005), collecting, managing and keeping track of health commodity stock data can be cumbersome. For the Nigeria Centre for Disease Control and Prevention (NCDC), the agency that is tasked with ensuring that pharmaceutical and health commodities are available in all the 36 states of Nigeria and the Federal Capital Territory, Abuja, this is a major challenge. To effectively prevent, treat and control diseases, medical supplies, and essential medicines must be available at all health facilities, treatment centers, and laboratories at all times. If the NCDC is unable to keep track of its own stock inventory data, its ability to deliver on its mandate will be hindered.

Prior to now, NCDC used to stock, track delivery, and management of pharmaceutical products using paper-based documentation. This method was not only error-prone but made it difficult to access and analyze information about pharmaceutical commodities stock and allocation across the 36 states in Nigeria and Abuja (FCT). This led to delays in the decision-making process to replenish commodities and in turn, stockouts at health facilities and treatment centers. 

The resultant effects of these delays and stockouts are poor health outcomes like high mortality and morbidity rates, low life expectancies, and distrust in the health system. There are already several unpleasant stories of people who had diseases that were not detected or treated adequately because the medical supplies and essential medicines were unavailable, and the statistics only worsen as one goes from urban to rural areas.

Health workers in Chiranchi Primary Health Center using LoMIS Stock to take health stock inventory

The LoMIS Stock mobile application

To address this challenge, NCDC partnered with eHealth Africa to automate its supply chain processes for the distribution of pharmaceutical and laboratory commodities. eHA introduced and scaled up LoMIS Stock, a solution that has been used by the Kano State Primary Health Care Management Board (KSPHCMB) to manage the supply and availability of vaccines and health commodities at last-mile health facilities, since 2014 with great success.

The tool allows health workers to submit reports relating to vaccine stock availability and utilization, alongside other details as required by various users, thus ensuring that near-real-time data relating to vaccine and pharmaceutical stock inventory can be accessed by decision-makers and health program planners for evidence-based planning and action. For example, NCDC’s ability to monitor the real-time stock levels of antiviral medications like Rivabirin at health facilities will ensure that response campaigns are executed in a seamless manner and that Nigeria is better able to respond to outbreaks of viral hemorrhagic diseases.

Since October 2019, eHealth Africa’s Technical team has been working with NCDC’s Supply Chain Unit to configure/customize the tool whilst entering data on its National Stockpile onto the system. Currently, over 300 commodities have been entered onto the system and we expect more commodities to be added in the course of this year. This will ensure that the distribution of these commodities is faster and more efficient and that the agency’s operational processes are targeted and data-driven. 

eHA and NCDC are employing a staggered approach to ensure that the tool is rolled out and adopted by the State Ministries of Health, treatment centers and NCDC-affiliated laboratories across 36 states and FCT of Nigeria by June 2020.  The potential for transforming health service delivery and health information management in Nigeria through technology is limitless.

Practical Solutions to Challenges in Reporting: LoMIS Stock and eIDSR

By Abdullahi Halilu Katuka and Emerald Awa- Agwu

LoMIS Stock is an electronic stock management tool, developed by eHealth Africa as a part of a suite of mobile and web applications that address supply chain and logistics challenges in health systems, especially in Northern Nigeria. LoMIS Stock helps health workers report and keep track of vaccine stock usage and availability at the health facility level. Using these reports, their supervisors can prevent stock-outs at their health facilities by ensuring that vaccines and other commodities are always available. The information from LoMIS Stock also gives governments the real-time data that is needed to plan programs and interventions and to resolve issues.

The LoMIS Stock solution was introduced to Kano State in 2014 and is currently the official logistics management tool for Kano State Primary Health Care Management Board (KSPHCMB). Currently, the State cold store, all 44 Local Government cold stores, and 484 apex health facilities in Kano send weekly reports using the LoMIS Stock application.

Although health facilities reporting times have dropped by over 50% and reporting rates have tripled since the introduction of LoMIS Stock, certain facilities in hard to reach areas were consistently unable to send reports due to mobile data network challenges. Gleaning from lessons learned from a similar challenge encountered with our electronic Integrated Disease Surveillance and Response System (eIDSR) solution in Sierra Leone, eHealth Africa added an SMS compression feature to the LoMIS Stock application.

In Sierra Leone, we have recorded a significant improvement in the number of facilities that send timely reports using the eIDSR application. Health facility workers in Sierra Leone use eIDSR to collect data offline on epidemiologically important diseases and send surveillance reports. Initially, in areas with poor connectivity, the application would store the reports and submit automatically as soon as an internet or mobile connection became available. However, this meant that such facilities didn’t always meet the targets for timely reporting.

Introducing the SMS compression feature enabled health workers in the defaulting facilities to send their weekly reports using a USSD short code if an internet connection or mobile data was unavailable. Thanks to this feature,  all the districts in Sierra Leone consistently exceed the World Health Organization (WHO) African region and national report completeness and timeliness targets.

The USSD feature for LoMIS Stock has been piloted with the pharmaceutical department of KSPHCMB to monitor incoming and outgoing stocks and the results have promising. In the first month, the stock count report at the pilot health facilities shows 100% stock sufficiency reporting and 0% wastage. After the pilot period, the feature will be rolled out to all departments of KSPHCMB to allow better reporting and increased efficiency across health facilities in Kano state.

Innovative problem solving is one of our values at eHealth Africa and this is an example of how eHA develops context-specific solutions to problems in healthcare delivery.