Over the last decade, Zambia has invested in a nimbler, more responsive, and efficient supply chain. Funded by USAID and implemented by John Snow Health Zambia (JSH), the electronic supply chain management information system (eSCMIS) project enables the Zambia Medicines and Medical Supplies Agency (ZAMMSA) to move products not just efficiently, but with visibility and strengthened security.
The electronic logistics management information system (eLMIS) is a next-generation digital logistics management system, which equips the Government of the Republic of Zambia to make data-driven supply chain decisions. A safe, secure, reliable, and sustainable supply chain will ensure the availability of essential medicines, laboratory commodities, and malaria, HIV and AIDS, and family planning products at health facilities throughout Zambia. The eLMIS covers the reporting needs and disbursement of medical supply to over 2,600 health facilities across Zambia using electronic data management to capture end-to-end supply and demand data. The results of this innovative supply chain system include reduced wastage from product expiry and increased efficiency in product availability in Zambia.
How did ZAMMSA prevent wastage before introducing batch codes?
In 2015, ZAMMSA was ensuring the delivery of products based on expiry (first to expire, first out to health facilities) – sending out products for immediate use that would soon run through their expiration date. Although this enabled less wastage of medical products across the health system, it resulted in little understanding of how products were used, or where they were in the system once delivered.
“Supplying medical entities with product is not a one-size-fits-all model; it requires transparency to understand where products are, how they are being used, and how they can be shared to improve access” says Mwila Lukonde, Monitoring, Evaluation and Learning Specialist at USAID eSCMIS project “Medical products are also sensitive and temperamental. With some frequency, batches of medical products are recalled, but how can we immediately pull those batches from shelves of thousands of health facilities, if we don’t have clarity around where they are and how many are still out there?”
How has the introduction of batch codes and their incorporation into eLMIS helped?
Queue batch numbering: a subtle adjustment to the eLMIS that entails identifying each batch by code; and tracking those batches through the eLMIS. The eLMIS digital database has been outfitted with an alert system, which sends the eLMIS user a notification when products are close to expiry and where they are. If insufficient use of that product at select health facilities is occurring, the provincial / district supply chain supervisors call the under-consuming health facility to ask if they have enough overage to supply a different facility (one consuming that particular product at higher volume). If the health facility in over-supply agrees to stock another facility with greater potential to use it, an exchange and transport is organized. As soon as that batch is received at the high-consumption facility, it’s batch number is again entered into the eLMIS, updating its whereabouts.
And it works both ways. If a health facility is running low on supply, the system again alerts users that supply shortage is forthcoming, giving the user a chance to reconfigure supply from locations where an overage is occurring. This system has become more adaptable and agile than ever.
“We know with greater accuracy now where products are and how close they are to expiry, or where specific batches are and where we need to pull them from shelves when recalled.” Wendy Bomett, Management Information System Director, USAID eSCMIS project says, “We can now guarantee to health facilities that their products are not too close to expiry and we’re managing and moving them as soon as they are. Expiry assessment used to fall on health providers. Busy clinicians were having to check first if it was okay to use the products they had on hand, but now we can guarantee them that it is and this is no longer time they need to waste”
“Batch number tracking led to better transparency and our digital solution (eLMIS) to monitor them led to greater security” says Lukonde.