Case Study: Expanding Availability of Healthcare Services

SMS for Life, Novartis International AG

Objectives

Maintaining adequate antimalarial medicine supplies at public health facility level is exceptionally challenging in rural sub-Saharan Africa, and can mean life or death for patients. Part of the problem is poor visibility of what stock is left, and when stocks run out (‘stock-outs’), it often takes months to refill. SMS for Life, a public-private partnership led by Novartis, is the first scalable solution addressing this problem. The system tracks drug supplies in public health facilities in Africa, through the use of existing mobile phone and electronic mapping technology. Since its inception, SMS for Life has greatly improved healthcare delivery by ensuring malaria patients can access treatment in a timely fashion.

Lesson Learned

Several insights and critical success factors have been identified since the inception of the program, including:

  • Such projects require collaboration, expertise and resources from many public and private partners.
  • Government commitment at the highest level is essential to ensure the system is workable and sustainable, and that its use is mandatory.
  • Mobile telephone coverage within an acceptable distance is a necessary prerequisite to the program's long-term sustainability.
  • Health workers must use their personal mobile phones, with which they are familiar and for which maintenance is not the responsibility of the project.
  • A free number for sending stock information is mandatory since messages can still be sent if the telephone has no credit.
  • Training sessions for healthcare workers (bringing a personal mobile telephone) are essential.
  • The system needs to be flexible, scalable and compatible with any mobile telephone network, and implemented in any country with minimal tailoring. Tracking of tuberculosis and leprosy medicines, and RDTs has been added as well as health surveillance data.

Results to Date

  • After a successful six-month pilot in Tanzania in 2009-10 (during which the percentage of facilities with no Novartis antimalarial treatment shrunk from 26% to 1%), SMS for Life expanded to over 5000 health facilities in Tanzania.
  • Tracking of tuberculosis and leprosy medicines as well as Rapid Diagnostic Tests (RDT) were also added to the program.
  • In Kenya, upon a successful pilot in 87 health facilities with 38% reduction in antimalarial stock-outs, a full country scale-up to 4700 health facilities was completed and included malaria surveillance data.
  • In Ghana, after a successful pilot in 6 districts, a full country scale-up in 5500 health facilities is ongoing in collaboration with the Ghana Health Service. In addition to antimalarial medicines and RDTs, it includes antibiotics and blood products.
  • In Cameroon, with support from NORAD, a full country scale-up to 3300 health facilities is ongoing with, in addition to malaria medicines, the collection of patient surveillance data on the use of RDTs.
  • Expansion to 1245 health facilities in the Democratic Republic of the Congo is planned later in 2013.

More Information

www.malaria.novartis.com/innovation/sms-for-life