Transforming Patients' Fortunes with SCSA

A patient receiving medicine from a pharmacist at Nthondo Health Centre in Ntchisi district. Photo by GHSC-PSM

Date

November 8, 2022

Malawi’s health sector is embarking on a progressive digital transformation where technology will be the heartbeat for improvements in the delivery of quality medicines from manufacturers to patients. The revolution has been initiated with the launching of the Supply Chain Systems Architecture for commodity tracking and tracing (SCSA) developed by the Ministry of Health in collaboration with the USAID Global Health Supply Chain Program-Procurement Supply Management (GHSC-PSM) project in September 2022.

The innovation allows all health information systems in the country to start sharing data. On the one hand, this fulfills one of Malawi’s Health Sector Strategic Plan II objectives of harmonizing all routine data systems. It also resonates with Master Supply Chain Transformation Plan (MSCTP) which seeks to improve systems automation, data quality, systems operability, and overall end-to-end visibility. On the other hand, this system’s connectivity will provide real-time data from local and global locations required for improved supply chain decision-making.

However, there is one challenge. These systems are mostly working in isolation. Therefore, they limit the benefits that digital technology brings to the health sector. According to the SCSA report, “a digital ecosystem is realized when advanced automation-driven supply chain processes are integrated to interoperate with each other and other ecosystems. SCSA thus ensures availability of real-time data providing end-to-end visibility and enhanced decision making.”

Currently, the Ministry of Health has several systems and processes for supply chain, health management, and regulation that use digital technology. When ordering and reporting medical commodities, facilities have used a web-based logistics management information system called OpenLMIS since 2017. The ministry also uses DHS 2 a health management information system as a national repository for health aggregated data since 2012. Further, in 2021 the Ministry developed the National Product Catalogue (NPC)- a web-based product catalog service used to enter, validate, store, maintain and share all health commodities data in one platform.

SCSA holds the key that allows the exchange of information between applications, databases, and other computer systems in the health supply chain management sector.

Currently, the Ministry of Health has integrated OpenLMIS data with DHS 2 data using the interoperability layer. This allows a better analysis of caseload to commodity consumption and related analytics to better support evidence-based decision-making and logistics planning.

“We are able to download data from DHS 2 and determine the number of cases that were suspected, tested, and confirmed. Then we take that data and check it against the commodities that are going out through the OpenLMIS. For facilities where we see that there is a big gap, there are a lot of medicines going out, the number of cases is small, then, that informs our monitoring activities,” says Elias Mwalabu, GHSC-PSM Malaria Coordinator.

Potential Benefits

While this is a notable highlight, systems that will have automated processes will offer more benefits to the supply chain and quality health service delivery. Real-time data for consumption based on dispensing will be readily available in the system. It will not require downloading DHS 2 data and then having it compared with data from OpenLMIS.

According to the SCSA report, “inventory data will be based on warehouse management, orders coming into warehouses will be based on procurements. This real-time data on inventory, procurements, shipments, and consumption will help generate accurate and reliable demand and supply plans.” This will improve forecasting and planning accuracy.

Patients will be major beneficiaries as they will be accessing genuine medicines at the right time, in adequate quantities, at the right place, and at the lowest cost as intended by the SCSA. This will be made possible with real-time data accurately determining quantities at all levels during forecasting. The Central Medical Stores Trust (CMST) will identify and order quality health products. There will be real-time consumption data captured once pharmacists give out medicines in health facilities.

A further benefit for patients is receiving high-quality commodities. Not expired, substandard or falsified products. Their safety will be certain as SCSA will allow them to verify a product’s authenticity. With the adoption of NPC in 2021 and aligning Malawi to Global Health Standards 1(GS1), patients can get details of the product manufacturer and expiry date. This will be done by scanning the product’s barcode on medical products using a mobile phone.

The alignment to GS1 requires the SCSA to adopt global standards so that data from global organizations are easily incorporated and understood by local data sources and sources. This provides the ability to trace, track and verify products along the supply chain.

Political Will

The government of Malawi has shown commitment to utilizing technology as the remedy to fix gaps in the health sector supply chain. It has put in place a Master Supply Chain Transformation Plan (MSCTP) to digitalize supply chain operations and strengthen processes to improve overall efficiency, service, and health outcomes. There is also the Digital Health Division to centralize and streamline ICT operations and initiatives across the health sector.

Deputy Minister of Health, Enock Phale stresses that digitization is a ‘worthy investment’ for the public health sector to ably provide quality health services to the citizens. He adds that an excellent system is required to promote accountability, transparency, and assurance of quality health products. Further, the deputy minister calls for mindset change against those resisting the surge of technological innovations.

“The choice Malawi has made to implement E2E tracking and tracing, is the only right one, given the challenges the supply system is facing. It is a fact that the choice is ambitious because it requires time and a lot of other resources to build. However, it holds the potential to be the magic wand for Malawi to save and alleviate the suffering of many lives resulting from thefts and shortages of health commodities in health facilities,” says Mphale.

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