As low- and middle-income countries transition from paper to digital systems, family planning programs can benefit from unprecedented opportunities to improve services. Investments in digital health tools have expanded exponentially, but information on what works—and what does not— remains limited and scattered. As investments have increased, digital applications and data fragmentation have proliferated, but stakeholders are moving towards more coordinated efforts to scale digital health solutions, support countries’ digital health infrastructure, and share evidence-based learnings.
This Digital Health Compendium enables users to explore case studies across a range of digital health technologies used to enhance family planning programs mainly in sub-Saharan Africa, but also in other regions of the world. Digital health applications in family planning programs can be broadly classified as those affecting demand generation, service delivery, supply chain management, and the policy and enabling environment. In many low- and middle-income countries, digital health innovations were adopted earlier in other health sectors, including HIV/AIDS, maternal and child health, and noncommunicable disease prevention and response. As a result, much of the impact evidence is likewise restricted to those sectors. To advance greater adoption of digital technology in family planning programs, more data and information on the challenges, opportunities, scalability, and results are needed. This compendium aims to consolidate emerging information and data on applications of digital technology in family planning programs to inform adoption and scale-up of successful approaches.
All of the case studies were submitted by the implementing organizations and include a description of the digital health intervention, program context, and, if available, important findings and lessons learned through rigorous evaluations or program data. The compendium facilitates a quick search for case studies based on the target user for digital health intervention, building block for the digital health enabling environment, family planning program classification, and country location. The case studies give policy and program decisionmakers insights on real-world applications of digital health, promising practices, challenges, and other lessons that can be applied to current and future programs.
Senior Health Information Systems Advisor
John Snow, Inc
The information below appeared in the original case study.
Tanzania Ministry of Health and Social Welfare
John Snow, Inc.
USAID, under the USAID | DELIVER PROJECT
Chief of Party
USAID | DELIVER PROJECT
Health Care Provider
Services and Applications
Supply Chain Management
This case study was originally published in the mHealth Compendium Volume , developed by the African Strategies for Health project, implemented by Management Sciences for Health with support from the U.S. Agency for International Development (USAID). Updates to the original case study, submitted by the implementing organization in March 2021, appear in the final section of this case study.
Health programs succeed when the supply chain delivers a reliable, continuous supply of essential commodities to clients, so they can choose, obtain, and use these products when and where they are needed. The USAID | DELIVER PROJECT, a U.S. Agency for International Development (USAID) funded project, improves essential health commodity supply chains by strengthening logistics management information systems, streamlining distribution systems, identifying financial resources for procurements and supply chain operations, and enhancing quantification and procurement planning.
Implemented by John Snow, Inc., the project designs, develops, strengthens, and, upon request, operates safe, sustainable, and reliable supply systems that provide a range of affordable, quality essential health commodities, including drugs, diagnostics, and supplies, to clients in country programs. The project’s technical support strengthens all aspects of in-country supply chains, including quantification, procurement, distribution, management information systems, quality assurance, storage and infrastructure, and medical waste disposal.
The USAID | DELIVER PROJECT has worked with the Tanzanian Ministry of Health and Social Welfare (MOHSW) to establish the ILSGateway, a mobile logistics system that supports the Integrated Logistics System (ILS). In Tanzania, obtaining high quality logistics data has been a challenge for the health care system. Without this data, decision makers have difficulty managing the supply chain, leading to the possibility that patients won’t receive the medicines they need. Before 2005, the health care system in Tanzania was made up of a number of parallel systems for restocking health care facilities with the supplies needed. The growing number of systems was uncoordinated; each cluster of facilities had separate procedures for ordering supplies from the Medical Stores Department (MSD). However, the successful implementation of an integrated logistics system (ILS) by the MOHSW, with technical support from the USAID | DELIVER PROJECT, addressed the duplicative processes by integrating them into one system with a single set of procedures. In 2010, the USAID | DELIVER PROJECT designed the ILSGateway, a mobile system to be used at the lowest level health facilities as a means of enhancing information visibility of key logistics data from the ILS. This new system allows real-time visibility into existing stock levels of crucial medicines.
Created to enhance supply chain decision-making, the ILSGateway is a mobile health alert and reporting system designed to increase the visibility of logistics data and improve product availability. The system was developed with an eye on sustainability, requiring health facility personnel to use personal cell phones to send logistics data via text message (SMS) to a toll-free number. This data is then transmitted to a website that analyzes and displays the information.
The project conducted a quantitative review in addition to a qualitative review that was attended by users from the facility, district, and central levels to evaluate system functionality, usability, and impact. Of the 29 facility users that responded to the survey, 93 percent felt that ILSGateway improved their diligence in conducting a stock count on time. In addition to that, 93 percent indicated they are more likely to submit their ILS report and requisition forms to the district on time as a result of the alerts provided by the ILSGateway. Eighty-eight percent of 17 district respondents said the tool has increased attention to the management of a list of 20 essential medicines, including reproductive health commodities, in their districts. A majority of the district users surveyed (94 percent) responded that ILSGateway has improved the timeliness with which they receive report and requisition forms. Overall, 45 percent of facilities indicated an increase in tracer product availability through the use of ILSGateway.
In the post-pilot phase, the USAID | DELIVER PROJECT and the MOHSW are working to instill a data culture and build requisite computer skills among health workers, particularly at the district level to improve their ability to access data generated in the ILSGateway. Moving forward, the project and partners hope to link this mobile health logistics system to other automated health systems being developed by the MOHSW with the USAID | DELIVER PROJECT and its partners. As the visibility of logistics data improves, decision makers and health workers at all levels will be able to improve the availability of health commodities in Tanzania.
Using mobile phones, the ILSGateway improves the flow of information from facilities to central medical stores, thereby facilitating more timely decision-making and ultimately improved product availability at service delivery points.
The Integrated Logistics System (ILS) Gateway filled the gap in ILS in Tanzania but is no longer active due to changes in the Ministry of Health and Social Welfare’s reporting structure. Prior to 2017, health facilities reported and requested health commodities from central medical stores on just a quarterly basis. The ILSGateway supported facilities with monthly reporting to track the status of 20 tracer commodities as an early warning system for stockouts. After a holistic supply chain review in 2017 led the Ministry of Health and Social Welfare to move from quarterly to monthly reporting, and bi-monthly ordering/requisitioning, the ILSGateway was no longer needed.
USAID | DELIVER PROJECT, Task Order 4: http://www.jsi.com/JSIInternet/IntlHealth/project/display.cfm?ctid=na&cid=na&tid=40&id=7801
The ILSGateway: Mobile phones improve data visibility and lead to better commodity availability in Tanzania: http://www.jsi.com/JSIInternet/Features/article/display.cfmthisSection=Features&thisSectionTitle=Features&thisPage=stories&ctid=na&cid=na&tid=20&id=414
AIDSTAR-Two: The Use of Information and Communication Technology in Family Planning, Reproductive Health and Other Health Programs: A Review of Trends and Evidence: