Abstract
This chapter reports the results of a study that evaluated the impact of an mHealth system named Cstock on the supply chain management of medical supplies in village clinics of Mangochi district in Malawi. The study found that Cstock was used for requesting health products, supply, and resupply from healthcare facilities. In terms of quality, it was reported that the system was fast, easy to learn, and rarely displayed error reports. Cstock mHealth also yielded positive impacts through time and cost savings, improved communication, and availability of essential medical stocks at all levels of the supply chain and improved data visibility for decision-making. However, poor network coverage, lack of power source for charging phone batteries, absence of monetary incentives, lack of technical support compromised the effective utilisation of the system. The chapter offers insights to policy makers, implementers, and research practitioners on how to build resilience in the management of medical supply chain in a primary healthcare setting through the use of innovative mHealth technology.
TopProblem Statement
Having reliable and available health commodities is fundamental to diagnosing and treating illnesses in primary healthcare settings. Health commodities include medicines, vaccines, diagnostic consumables and other health supplies (Binyaruka & Borghi, 2017). In Malawi like other developing countries, mHealth is increasingly being adopted to manage health commodity supplies in primary healthcare settings (Nyemba-Mudenda & Chigona, 2018). This is aimed at improving data visibility, decision-making, and reducing instances of shortages of essential health commodities.
To this effect, in 2016, the Malawi government through the Ministry of Health and other development partners deployed a Cstock mHealth logistic management system in at least 18 out of 28 districts of the country (Malanga, 2017; Shieshia et al, 2014). The objective of this mHealth intervention was to ensure effective supply chain management of essential medical supplies, especially in primary healthcare settings, where transport infrastructure remains a problem(Shieshia et al, 2014). However, since its deployment, there are few studies that have evaluated whether this mHealth intervention is a success or a failure.
Prior studies on Cstock mHealth system so far have looked at feasibility, implementation and acceptability of the technology using health indicators as theoretical foundations (SC4CCM, 2018; Friderichs, Foh, & Gathinji, 2014; Shieshia et al, 2014). Due to the complex nature of information technology (IT) implementation such as mHealth, using health indicators to conduct impact evaluation has been criticized as being limited. Some scholars have suggested the integration of information system metrics to potentially achieve a holistic approach to measure the impact of IT such as mHealth on healthcare systems (Pankomera, & van Greunen, 2018). Thus, the cited studies aforementioned have shown the negligible impact of Cstock mHealth on supply chain management of medical supplies particularly in primary healthcare settings.
Key Terms in this Chapter
MHealth: Refers to the provision of health services and information through mobile technologies such as mobile phones, Personal Digital Assistants, and mobile tablets.
Healthcare Supply Chain Management: Involves obtaining health resources, managing health supplies, and delivering them to health providers and patients.
Cstock mHealth: Is a rapid Short Message Service (SMS) and web-based reporting and resupply system that is used by community health workers to report stock data through mobile phones.
Primary Healthcare: Is the first level of contact for individuals, family, and the community with the national health system in addressing main health problems, providing health promotion, rehabilitative, and curative health services.
Information and Communication Technology: Consists of hardware, software, networks, and media for collection, storage, processing, transmission, and presentation of information (voice, data, text, images).
Mobile Technology: Refers to mobile phones, smartphones, Portable Assistant Devices (PDAs) that facilitate the performance of tasks.
Information and Communication for Development (ICT4D): Is the practice of utilising ICT to support socio-ecomic growth and well-being of poor and marginalised people in developing communities.