One of the priorities of the new Health Sector Transformation Plan for Ethiopia is to launch an information revolution. The Pharmaceuticals Fund and Supply Agency (PFSA), the government agency responsible for the public sector health care supply chain, is at the forefront of this revolution. With technical assistance from JSI, PFSA has deployed commodity dashboards that provide live data on stock levels, incoming shipments, and past issues across its network of central and 16 regional (hub) warehouses. Data that can help Ethiopia sustain its remarkable achievements in improving health care outcomes by ensuring medicines are available when and where they are needed. PFSA manages thousands of items to ensure that users can quickly and easily access the data they require. Commodities are grouped into various “program” dashboards such as family planning, malaria, and maternal health. Recently, at PFSA’s request, a dashboard that consolidates information on commodities needed for drought response (e.g., sulfur ointment for scabies treatment and measles vaccine) has been deployed.
The foundation of JSI’s work to strengthen supply chain performance in Ethiopia is increasing data visibility. The dashboards, built on the HCMIS Warehouse Management System, developed and implemented at PFSA by JSI with financial support from USAID and the Bill & Melinda Gates Foundation, are the cornerstone of this strategy. Data visibility work is built on three pillars:
- Increasing data visibility—more people have more access to more data.
- Improving data quality, including timeliness of data.
- Strengthening the capacity of staff to use data (which includes making data easier to interpret and use).
HCMIS dashboards were launched this January. Since then, JSI has been focused on strategies to increase their use and the capacity of PFSA staff to use the dashboard data. While training is part of this (we have trained a total of 238 PFSA staff), it is only a small part of our strategy. In fact, we are using data to increase data use. We use Google Analytics to track dashboard use and users, from how many users there are every month (105 in March) to how many pages they open (on average 4.5), and even which dashboard widgets (graphics or tables) they review (move their cursor over).
We learned that the most widely used dashboard is for family planning, and that nobody opened the TB dashboard last month (clearly we need to contact the people managing that program). Often, the simplest, most basic data is the most widely used: the most popular “widget” is a simple table that shows stock on hand by location. We also noticed that staff at a small number of PFSA regional hubs were not using dashboards. Why? A phone call revealed they had poor internet access, so users weren’t able to open the dashboard. Hub managers promised to provide key users with 3G dongles.
We are also using more traditional feedback to improve dashboards. Based on user requests, we are redesigning the landing page to make it easier for staff to find the information they want. And every week we send out an email to update users on changes or improvements to dashboards. This is actually mainly to remind them to log on and use the dashboard; with so many new users and such a new tool, we think it’s vital remind people often about dashboards.
Most importantly, we have developed a mobile dashboard app for smartphones because many users prefer to access data on their smartphones both because it’s more convenient and because connectivity is less of a problem. We actually believe smartphones are the “gateway drug” for data addiction, and that once users return to their office they will log on to their computer to see more.
For too long, our supply chains have foundered on a lack of data visibility, but in Ethiopia we have moved to the next frontier: data use. The Ethiopian supply chain data revolution is at hand.