SMS for Life: An RBM initiative
What is it?
The SMS for Life initiative is a new 'public-private' project that harnesses everyday technology to eliminate stock-outs and improve access to essential medicines in sub-Saharan Africa.
A solution to the longstanding problem of stock-outs at the remote health facility level is now available
Maintaining adequate supplies of anti-malarial medicines at the health facility level in rural sub-Saharan Africa is a major barrier to effective management of the disease. Lack of visibility of anti-malarial stock levels at the health facility level is an important contributor to this problem.
"It's simple. If there are no malaria treatments, someone will die. It is very likely to be a child. Reducing stock-outs saves lives."
Prof. David Mwakyusa , Former Minister for Health & Social Welfare, Tanzania, April 2010
Tanzania was the pilot country where 20 regional managers from PSI plus Ministry IT personnel have now been trained in how to implement the system.
The 21-week pilot study, 'SMS for Life', was undertaken during 2009-2010 in three districts of rural Tanzania, involving 129 health facilities, covering a population of 1.2 million. Undertaken through a collaborative partnership between Novartis, the Roll Back Malaria Partnership, IBM, Vodafone and the Ministry for Health of Tanzania, SMS for Life used mobile telephones, SMS messages and electronic mapping technology to facilitate provision of comprehensive and accurate stock counts from all health facilities to each district management team on a weekly basis.
The system covered stocks of the four different dosage packs of artemether-lumefantrine (AL) and quinine injectable. The data captured through the SMS stock count messages was available through a secure reporting website. The website was then accessed via the internet on a computer or a Blackberry or other smart mobile phone. Access to the website was granted through a unique User ID and password allocated at the group level and was been granted to the following groups:
- The District Medical Officer and his staff in each district
- The Regional Medical Officer and his staff in each region affiliated with the chosen Districts
- The Project Team
- The National Malaria Control Program in the Ministry of Health
- The Medical Stores Department (including the Zonal Stores affiliated with each district)
Stock count data was provided in 95% of cases, on average. A high response rate (≥93%) was maintained throughout the pilot. The error rate for composition of SMS responses averaged 7.5% throughout the study; almost all errors were corrected and messages re-sent. Data accuracy, based on surveillance visits to health facilities, was 94%. District stock reports were accessed on average once a day. The proportion of health facilities with no stock of one or more antimalarial medicine fell from 78% at week 1 to 26% at week 21. In Lindi Rural district, stock-outs were eliminated by week 8 of the pilot with virtually no stock-outs thereafter. During the study, AL stocks increased by 64% and quinine stock increased 36% across the three districts.
The SMS for Life pilot provided visibility of anti-malarial stock levels to support more efficient stock management using simple and widely available SMS technology, via a public-private partnership model that worked highly effectively. The SMS for Life system has the potential to alleviate restricted availability of anti-malarial drugs or other medicines in rural or under-resourced areas.
Overall, the SMS for Life system was built to be a generic and highly scalable solution that can be leveraged to support any medicine or product, and can be implemented in any country with minimal tailoring. Additionally the system could also be utilized for disease surveillance.
"I'm grateful for what you are doing for my country – I loose a child every five minutes which is a waste from a disease that is completely preventable. This is a great project and an innovation that I support very much, it's exciting to me."
Prof. David Mwakyusa , Former Minister for Health & Social Welfare, Tanzania, April 2010 when presented with the "SMS for Life" Pilot results