Owning the Process: How Sarah Baartman District Adopted and Utilized SVS to Maintain Exceptional Medicine Availability

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Date
November 9, 2020
Lead Paragraph/Summary

The South African National Department of Health (NDoH) and the United States Agency for International Development (USAID)-funded Global Health Supply Chain Program – Technical Assistance (GHSC-TA) are working together to introduce systems and processes to help improve medicine availability for all South Africans. However, systems are only as good as the people who utilize them. What does it take to implement and institutionalize a new system to help ensure that medicine availability is realized at hospitals, community health centers, and clinics?

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For Lesley Welman, Sub-district Pharmacy Manager in the Camdeboo Sub-district of the Sarah Baartman District in the Eastern Cape, it takes commitment, a shared vision, and walking the talk to ensure that systems work effectively. Sarah Baartman has a population of 530,252 (2019), covers seven local municipalities, and surrounds Nelson Mandela Bay. It has 15 hospitals, of which five are district hospitals; one is a specialized psychiatric hospital, and four are tuberculosis (TB) hospitals. The remaining five are district community hospitals. There are 63 primary health care facilities, which include three community health centers. These facilities are staffed by 41 pharmacists, nine pharmacists doing pharmaceutical community service, 50 pharmacists’ assistants (post-basic), and four pharmacists' assistants (basic).

Since the introduction of reporting to the National Surveillance Centre (NSC), the district has managed to report medicine availability consistently and has the highest reporting compliance in the Eastern Cape – meaning that more accurate data is displayed on the NSC dashboards, enabling better decision making. The NSC has helped the country’s hospitals and clinics understand stock-on-hand reporting and facilitate re-distribution of stock between health establishments based on need.

Reporting by clinics is done using Stock Visibility System (SVS), a mobile application and web-based management tool introduced in 2016. SVS is used by health practitioners to capture and monitor medicine availability. Larger facilities report using RxSolution, an electronic transaction inventory management system (introduced in the district prior to 2014) that is used to record medicine transactions such as stock movement into and from a pharmacy.

The GHSC-TA provincial support team is working with provinces to use the NSC’s reports to understand and monitor medicine availability at the health establishment level.

“We currently [September 2020] have a reporting compliance of 98.4 percent in terms of reporting on medicine availability to the NSC. [Reporting on] medicine availability in our hospitals is at 93 percent, clinics is at 94 percent, and the personal protective equipment is above 90 percent,” said Lesley.

For the NSC to be useful, health care workers on the ground must input data regularly to ensure that the system has accurate data and information. In some instances, districts have struggled to implement this successfully. So, what makes Sarah Baartman District different?

For Lesley, it was essential that there was total buy-in for the system. Once the vision for regularly inputting data to the NSC was shared with stakeholders, it was crucial to ensure effective implementation. The first step was to get all stakeholders into the habit of inputting data and reporting. This helped them to become familiar with the system. Once this stage was successful, the district committed to ongoing training so that all stakeholders understood what they needed to do to use the system. It was also essential to ensure that some frontline workers at each health facility knew how to use the tool, especially in cases where there were no pharmacy staff at the facility. The district also provided regular encouragement to health care workers for uploading accurate data, emphasizing that the more accurate the data, the more successful the system would be.

“We walk the talk and are committed to make sure that the ordering system works well”. – Lesley Welman, Sub-district Pharmacy Manager, Camdeboo, Sarah Baartman District

The NSC has helped the Sarah Baartman District team to understand what is happening at pharmacies across the district. As the Covid-19 pandemic hit the world, Lesley celebrated how having effective reporting systems and the NSC made her work so fulfilling. “Over the last six months, I have been forced to stay behind my desk [because of Covid-19]. The NSC dashboard has brought information to our fingertips. We can see how our clinics are doing and having all this information has helped to make our work believable. Our staff are happy because they can track that they are doing their job well,” said Lesley.

Sarah Baartman District stands out for its reporting compliance. With support provided by GHSC-TA, the ability to track and monitor medicine availability has guaranteed that stock outs are minimal in the district, thus helping to make sure that patients in this rural district have access to life-saving medicines including antiretrovirals, products used to treat TB, and other essential medicines.

“The success that we have realized must be attributed to the phenomenal teamwork in the district. There is pure ownership of the work that we do, and everyone plays their part to contribute and support.” – Lesley Welman