MIS Innovations for Last Mile Health System Advancement

More than 4 billion people live in remote communities in developing countries with extremely poor service infrastructure. Today these communities account for a disproportionate share of the 2.4 million annual deaths worldwide, many from vaccine preventable diseases. Examining the lessons learned across many types of management information system projects in developing countries, various themes emerge: • Need for technology that is appropriate for the environment; • Need to greater information transparency in real time; and • Need for aggregation of regional- and country-level data as an outcome, not a primary goal. The reliable presence of medical supplies and trained healthcare workers greatly improves health system functioning. However, outside of a few small pilot projects, no systems have effectively supported the health workers in rural health centers. Central to its logistics platform for health systems strengthening at the last mile, VillageReach developed an MIS that provides for monitoring and analyzing medical supply chain logistics, cold chains, and outcome tracking. Working with the Mozambique Ministry of Health, VillageReach conducted a health system strengthening program, leveraging the WHO Expanded Program on Immunization (EPI). The Village Reach technology intervention covers: - medicine/supply transportation and delivery; - cold chain (refrigeration) management; - inventory management; VillageReach employs SMS forms on mobile phones, centralized web-based reporting, and desktop data entry in offline modes. VillageReach applied formal business process mapping in collaboration with stakeholders to determine optimal information flows and visualization of reported results. The project strengthened vaccine logistics by creating a comprehensive delivery system, based in part on improving the flow of information. It dramatically increased vaccination coverage; improved the quality of health services and access to vaccines by reducing stock-outs; directly improved the cold chain; and among communities served by health facilities benefiting from the project, cultivated greater trust in, and use of, health services.