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.
Serving governments to improve the availability of life saving drugs and supplies in public health facilities
OpenLMIS Community Manager
Clinton Health Access Initiative (CHAI)
Empower School of Health
John Snow Inc. (JSI)
United States Agency for International Development (USAID)
Bill & Melinda Gates Foundation
2014 - 2019
Health System Manager, Data Services Provider
Leadership and Governance, Strategy and Investment, Standards and Interoperability, Infrastructure
Supply Chain Management
Governments need accurate, timely logistics data from their health facilities to make decisions about procurement and supply of medical commodities; however, too often this information is inaccurate or simply not available. As a result, health systems in many countries continue to experience stockouts of essential medicines, leaving people vulnerable to treatable illness and diseases. OpenLMIS is a state-of-the-art, open-source electronic Logistics Management Information System (LMIS) solution, which automates logistics processes and promotes visibility, timeliness, and accuracy of supply chain data. This data is essential to reducing stockouts, managing waste and losses, and operating an effective supply chain.
The OpenLMIS Initiative’s mission is to make powerful LMIS software available in low-resource environments—that is, providing high-quality logistics management to improve health commodity distribution in low- and middle-income countries (LMICs). OpenLMIS increases data visibility, helping supply chain managers identify and respond to commodity needs, particularly at health facilities where lack of data significantly impacts the availability of key medicines and vaccines.
The OpenLMIS software is currently used to manage logistics processes at more than 11,000 health facilities across eight geographies in Africa, providing ordering, reporting, and inventory management for a mix of health programs including for vaccines (EPI) as well as HIV, malaria, TB, family planning, and essential medicines. OpenLMIS is used across many health areas, and is not disease- or health area-specific.
OpenLMIS is a web-enabled, enterprise class electronic LMIS solution that facilitates the resupply process for medicines and health supplies in LMICs. Its main function is to automate the process of routinely restocking hospitals and clinics with the supplies they need, replacing paper-based logistics systems, which rely on manual calculations and data entry by hand. The result is more complete, accurate, and timely data for decisionmaking—essential for reducing stockouts, managing waste and losses, and operating an effective and efficient supply chain.
OpenLMIS was designed by a community of countries and international stakeholders who believe in working together to solve common challenges. Countries and donors pooled resources to create a non-proprietary product built on shared user requirements across countries. The end result is a more flexible and powerful information system than what any one country or organization could create individually. The OpenLMIS software is an open source software, available free of charge. Enhancements made by individual countries are contributed back to the community for others to use. Since its inception in 2011, OpenLMIS has evolved from a collaboratively developed open source software to a best-in-class electronic LMIS and a true “global good.” OpenLMIS is now the leading digital platform powering LMIC health supply chains for more than 11,000 health facilities across 10 country implementations and is a certified global good (Global Goods Guidebook, Digital Square 2019).
The impact of OpenLMIS impact can be seen across multiple program areas, including improving access to family planning medications and supporting decision-makers with the data they need to keep family planning products sufficiently stocked across national supply chains. OpenLMIS improves the availability of medicines and family planning products for patients by reducing stockouts at hospitals and clinics, as has been repeatedly demonstrated with evidence from past implementation experiences. As reported by a 2014 VillageReach survey in Mozambique on SELV (Sistema Electronico de Logistica de Vacinas), stockout rates prior to SELV deployment were 19 percent, and were significantly reduced to just 5 percent after SELV was implemented. In Zambia, JSI conducted an analysis of Zambia’s stockout rates before and after OpenLMIS implementation, and noted significant decreases in both stockout incidence and stockout duration (see illustration).
There is growing evidence to demonstrate OpenLMIS’ potential to increase staff efficiency by reducing the time spent on manual calculations, thereby simplifying reporting and leaving more time available for patient care and other duties. A survey conducted by VillageReach in 2014 concluded that the time taken by healthcare workers to perform ordering calculations was reduced from three hours to just one minute with OpenLMIS (see illustration). Furthermore, OpenLMIS reduces the time for data to reach central levels and decisionmakers, improving supply chain visibility and performance.
The OpenLMIS approach emphasizes the use of human-centered design and getting frequent feedback from the users during the requirements-gathering and development stages. As a result, user satisfaction is a success that we have seen across multiple country implementations. In Malawi, the system was deemed “easy to use” and a majority of users confirmed that it provides them with all the services that they want (OpenLMIS Malawi User Satisfaction Survey, 2018).
Critical success factors are summarized as follows.
The OpenLMIS community has grown immensely in recent years, reaching new geographical areas and transforming the software into a state-of-the-art system that can serve a range of country- and program-specific needs. Our pool of engaged community partners continues to grow year by year, expanding our geographic footprint and incorporating new expertise to our initiative. With 10 deployments under its belt and multiple implementation opportunities, upgrades, and study tours planned for 2020, it is evident that OpenLMIS continues to fill a crucial market niche by supporting governments to digitize and streamline their public health supply chain data.
In 2020, our plans are focused around finding a sustainable business model that will allow the product and community to grow, continuing to serve its public health purpose, without a strong reliance on donor funding. To achieve this end, the initiative is seeking a public-private partnership to transition management of OpenLMIS to an external entity. Throughout 2020-21, OpenLMIS will closely collaborate with community partners to identify a suitable handover partner and guide the OpenLMIS initiative through a transition, while ensuring that it adheres to key community values, principles, and staying true to our mission of strengthening health systems.