Titre du formulaire de participation
Quels changements pensez-vous apporter ?
One of the many problems health workers like ASHA, ANM, nurses and doctors in rural India face is irregular supplies of essential medicines and other supplies.
Apparently, the problem is not intentionally caused by health workers or medicine suppliers. Rather, people associated with supply chain management do not have precise and actionable information on the requirement, amount, time of supplies.
Therefore, this proof-of-concept project intends to verify if information regarding current stock status, estimated demand and order information can be made available through SMS among the stakeholders, this problem could significantly be alleviated.
If this idea proves to be effective, we will disseminate the results and scale-up the project.
Quelles sont les principales activités mises en place par le projet ?
This idea will be tested in a rural community in Orissa, which has one of the lowest health achievements in India and the world. National Rural Health Mission is a pan-India rural health delivery program which provides services in reproductive, maternal, neo-natal, child health, malaria, filaria, blindness and TB. In a cluster of 2 villages with a total of 5000 people, there is one Sub-Health Centre (SHC) and in a cluster of 6 villages (30,000 people) there is one Primary Health Centre (PHC). Details are available here: http://mohfw.nic.in/WriteReadData/l892s/file35-33319850.pdf.
NRHM has provided with essential drugs and supplies list for SHC, PHC and each health workers. However, facilities and health workers do not have an effective mechanism to report stock status and order fresh stocks. Supply store manager (in district headquarter) also does not react to demands effectively. An effective supply management means i) fast and reliable check of stock status, b) fast order for replenishment and c) store manager who acts upon requests. Traditional paper based system can not solve this problem.
3. Solution approach (activities):
i) Mapping the supply requirements: Since in a given community, number of eligible beneficiaries registered under NRHM is finite and predictable, it is also feasible to predict the stock requirement in SHCs and PHCs, in each category of supplies. There could be additional 10% stocks as safeguard. This analysis of requirements could be done using three databases - a) Register of patients maintained at facilities and health workers, b) NRHM-HMIS database - http://nrhm-mis.nic.in which keeps data at SHC and PHC levels and c) community survey.
ii) SMS: We will then develop an SMS system to allow health workers report stock status in all supply categories and place requisition for fresh stocks. The SMS will be done using a small set of English keywords which will be written in a printed and illustrated pocket guide that will be distributed to all concerned people. The SMS method will be implemented using a commercial SMS gateway and short codes and strings will be developed.
iii) Store manager: We will present this data to the district store manager and other stakeholders - Block Health Manager, CMO, among others. We will also send periodic updates (monthly) on stock requirements. Store manager will receive the SMS from health workers and will act upon those requests. If he does not act upon within 3 days, a subsequent alert will be sent to Chief Medical Officer for him to follow up.
iv) Training: Training in SMS reporting will be provided to health workers, store managers and others involved in supply chain management.
v) Community involvement: Despite this intervention, there is a need for the beneficiary to be able to report stock out status. Using the SMS gateway or direct call, they can register complaints. We intend to publicise this intervention and provision of complaints through wall painting. We would also like to distribute a printed list of essential medicines that should be available with the health workers and facilities among the entire population in the project site.
En quoi votre initiative est-elle innovante ? Dans quelle mesure apporte-elle une contribution originale dans son domaine ?
1. Compared to traditional system: There are significant improvements over the traditional systems, in areas of a) near accurate prediction of stock requirements, b) (almost) real time communication of current stock status, c) faster order for fresh stock, d) ability to act upon precise and actionable information for stock manager and health workers, e) supervisors can check and follow up on supplies and f) community can monitor and complaint on non-availability of essential medicines.
2. Compared to other mHealth: Population Service International (PSI-India, Rajasthan) implemented SMS reporting of condom sales and stock status by their sales persons. However, sales persons in private sector are motivated by their incentives. In public sector, motivation does not come automatically, unless there is a proper system to hold one accountable. Therefore, the real innovation is in business process, rather than introduction of the SMS technology.
3. Involvement of community: To our knowledge, there is another initiative called Stop Stock Out (http://stopstockouts.org) in Africa. This works in campaign mode in which community members and NGO workers randomly check medicine availability in stores and report in a web-based forms. In the proposed method, community members can lodge complaints which will directly be sent to the concerned officials.
Comment décririez-vous la population auprès de laquelle vous travaillez ? Parlez-nous, par exemple, de la situation économique, des structures politiques, des normes et des valeurs, de l'évolution démographique, de l'histoire ou des précédentes expériences d'engagement communautaire.
We intend to implement this idea in a rural and tribal community where mobile network is available. The project site will be one of the KbK districts. The members of tribal community are mostly (95%) live in below poverty line and depend upon agriculture, forest, handicrafts for livelihoods.
We are strongly connected through community based organizations (CBOs) and health officers in number of locales in the proposed districts. In the past, we have undertaken several field studies involving health workers in this area and we saw interest among health workers and communities.
Racontez l'histoire du fondateur et ce qui l'a inspiré à démarrer ce projet
The founder has undertaken major research projects in the area of using mobile communication for improving rural health delivery and uptake. He pointed out structural limitations and barriers in the traditional methods of health delivery and promotion, especially in developing countries. He provided with evidence how these barriers can be significantly reduced with the appropriate usage of information and communication technologies. He studied information management and e-Governance from EPFL. He intends to demonstrate this idea for all the stakeholders for further scaling up across societies.
He received Master of Technology in Computer Science with specialization Software Project Management (SPM) from Utkal University (Bhubaneswar, India). He received post graduate degree in business administration with dual specialization of Enterprise resource planning (ERP) and human resources (HR) from Vinod Gupta School of Management, Indian Institute of Technology Kharagpur (Kharagpur, India). He received specialized education in ERP from Indian Institute of Management Ahmedabad (Ahmedabad, India).
He has been working as a freelancer for software design development and deployment in various domains such as education, health care and security for 5 years (2003-2008) and started software development research and Consultancy Company as a proprietor during 2008-2009. This company was registered as private limited company in 2010.