Rural health facilities in Tanzania use mobile and electronic mapping technology to save lives; "SMS for Life" pilot increases availability of malaria treatments threefold at participating health facilities1
Geneva/New York, 21 April 2010: In a report presented this week to the Tanzanian Ministry of Health and Social Welfare, the Roll Back Malaria (RBM) Partnership unveiled the results of the "SMS for Life" pilot in Tanzania. The project used mobile and electronic mapping technology to track and manage the delivery and stock levels of antimalarial drugs to health facilities in rural locations. At the start, 25% of all health facilities did not have any artemisinin-based combination therapies (ACTs) in stock, but by the end, 95% had at least one ACT dosage form in stock.2 In addition, 888,000 people in the three pilot districts had access to all malaria treatments at the close of the pilot, versus 264,000 people at the start, which helped to reduce the number of deaths from malaria.
Accurately monitoring the amount of medication, such as ACTs and quinine injectables, available in a given location reduces the risk of running out of stock and ensures that treatments are available to malaria patients, even in the most remote areas, where and when they are needed.
The pilot, which is the result of a public-private partnership involving the Roll Back Malaria Partnership, Novartis, Vodafone, IBM and the Tanzanian Ministry of Health and Social Welfare, ran from September 2009 to February 2010. Three districts in Tanzania - Lindi Rural, Kigoma Rural and Ulanga - were involved, covering 129 health facilities and 226 villages, representing 1.2 million people. "The use of mobile phones to keep everyone informed of the stock position of anti-malarial medicines has prompted the supply chain to replenish those medicines on time and thus avoid stock-outs," said Professor David Mwakyusa, the Tanzanian Minister of Health and Social Welfare. "The outcome has been hundreds of lives saved in the districts where the pilot was implemented."
The "SMS for Life" system sends weekly automated SMS messages to staff at participating healthcare facilities, prompting them to check the stock of antimalarial medicines, and reply with an SMS that includes detailed stock levels. These messages are collected in a central web-based system that provides the District Medical Officers and other users with stock level information accessible via the Internet or their mobile phone. This information allows District Medical Officers to re-distribute lifesaving malaria treatments to where they are most needed, as well as coordinate emergency deliveries to health facilities if necessary. A half-day training session for health workers in the participating districts elicited a high response rate, with a measured accuracy of 94%, to weekly SMS request messages.
"In Lindi Rural, stock-outs were completely eliminated in all 48 facilities by week eight of the pilot, a major improvement from 57% of facilities not having all malaria treatments at the beginning. Kigoma Rural increased availability from 7% to 53%, and Ulanga increased availability from 13% to 70%," said Professor Awa Marie Coll-Seck, Executive Director of the Roll Back Malaria Partnership, and Chair of the "SMS for Life" Steering Committee. "The "SMS for Life" pilot is an outstanding example of the tremendous power of partnerships, and what can be achieved by bringing together the competencies of non-profit and for-profit organizations committed to the same goal."
"The pilot has demonstrated that finally we have a solution to the longstanding problem of stock-outs at the health facility level. This solution, which is scalable and available now, can be implemented quickly and at relatively low cost in any country to track any medicines," said Jim Barrington, "SMS for Life" Program Director and former Chief Information Officer at Novartis. "It's rewarding to see how a unique partnership and the innovative use of everyday technologies can positively impact the lives of malaria patients and their families."
"Malaria is a preventable disease but without the right treatment it is life threatening and kills 60,000 to 80,000 people a year in Tanzania because drugs supplies are inadequate. The results of this collaborative program demonstrate that the use of simple technology, such as text messaging, able to reach remote populations via our networks, can stimulate behavioral change, improve efficiencies and quite literally, save lives. I look forward to a time when all clinics will use the system," said Joaquim Croca, Head of Health at Vodafone Group.
"This is an example of a truly innovative solution helping to solve a humanitarian problem," said Peter Ward of IBM, "SMS for Life" Project Manager. "IBM has been committed to making this idea a reality, and our cloud computing technology enabled the "SMS for Life" partners to collaborate across geographies and share critical project information. We expect other countries will also be able to benefit in the future."
The "SMS for Life" report is available online at http://www.rollbackmalaria.org/
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1 Only 29 facilities had all five medicines available at the start of the pilot, and at the end, 96 facilities had all five medicines in stock– approximately three times more, or an improvement of threefold or 300%. At the start of the pilot, 32 health facilities had no ACT of any dosage form in stock, and at the end, 123 facilities had at least one dosage form in stock, an improvement of 380%.