“When everyone is connected, it will be heaven on earth,” said Joseph Chizongo, a data specialist at Medical Stores Limited (MSL) in Zambia.
MSL serves as Zambia’s central medical store and is the source for all drug supplies in the country. Connectivity is its life-blood. Public health systems require dependable and responsive connections at all points—between decisionmakers and funders, caregivers and patients, and especially distributors and facilities. Thanks to a newly implemented electronic logistics management system (eLMIS) in Zambia, the public health system’s connectivity has improved in life-changing ways.
The eLMIS increases access to data on stock consumption and stock availability at health facilities and MSL. Previously, the country used a paper-based system to manage healthcare commodities, but the eLMIS has completely changed the way data is processed. The eLMIS in Zambia includes a facility edition, which automates daily logistics transactions at the service delivery points; and a central edition, which captures data from reports and requisitions that facilities submit every month. Strengthening the connection between these two levels has allowed for decentralized data management at the district level. By increasing data visibility, users from the top to the bottom of the supply chain are empowered to make data-based decisions about their stock management.
More importantly, by replacing the paper-based system with the eLMIS, there are fewer errors, shorter lead times between when reports are delivered to and processed by MSL, and faster approvals on orders to ensure that orders reach health facilities in record time. This more responsive data management system is increasing commodity availability at the facilities; it stands poised to have a major impact on health outcomes for Zambians.
Before the eLMIS was installed, when MSL received a report from one of the districts, data specialists would process it and assess refill quantities based on the commodity status in the MSL warehouse. Because the logistics management unit (LMU) at MSL receives reports from more than 2,000 health facilities every month, paper-based order processing was labor heavy and time consuming.
With investments from USAID, the President’s Emergency Plan for AIDS Relief (PEPFAR), the Gates Foundation, the Rockefeller Foundation, and other strategic partners, the USAID | DELIVER PROJECT (the project) worked with the Zambian Ministry of Health and Ministry of Community Development, Mother and Child Health to deploy an eLMIS to 48 pilot health facilities, beginning in July 2014. Just six months later, in January 2015, the central edition was successfully rolled out to all district community medical offices (DCMO) and provincial health offices, enabling them to view and approve reports from these facilities remotely, instead of the cumbersome process of receiving reports by mail and approving them by hand. By March 2015, MSL had fully migrated to the eLMIS from the previous data management software, Supply Chain Manager; and data specialists reported that the system delivered what it promised—order visibility, speed, and improved service.
Where computers and the Internet are available, staff at the DCMOs can now also enter and analyze their own data. This decentralized data entry process, which used to be entirely concentrated at MSL, greatly relieves the burden on MSL staff. Now, the LMU can process additional reports across all logistics systems and can serve more facilities in a day. The facility edition will be rolled out to an additional 100 facilities in 2015, further decentralizing data entry from MSL to the distribution sites, and increasing MSL’s capacity to ship new orders quickly.
The eLMIS has also improved data quality. Thanks to the automated system, there are fewer errors than data entry and in reading handwritten reports, making the LMU much more efficient. These benefits make for an improved and effective supply chain for health commodities.
With the integrated logistics management system now operational at MSL, Zambia’s central medical store can be more responsive to health facility needs. While efforts continue to increase access to the technology countrywide, the impact is already apparent. “Not all facilities have computers and modems for Internet, so we still have to use some paper reports,” says Chizongo, but the process is well underway.
Currently, each of the 10 data specialists at MSL can process up to 30 orders per day on the eLMIS. In the coming months as the eLMIS is implemented at more facilities, the data burden at the LMU and in the districts will continue to decrease, creating more time for better data analysis and problem solving. Coupled with a recent increase in the number of pickers and packers in the warehouse, MSL will process orders at a much higher rate, meaning that health facilities will see their stocks replenished much faster, suffer fewer stockouts, and, most importantly, witness improvements in health outcomes for Zambians across the country.
“If 75 percent of facilities use eLMIS, we can improve our pace, and deliveries [to health facilities] will improve,” said Felistus Banda, an order processing clerk at MSL.
Felistus and Joseph are thrilled with the new system and look forward to the promise it has to continue improving the availability of health commodities for Zambians.