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Use of Google Group Applications Technology to Enhance Commodity Security in Health Facilities: Experiences from Eastern and Central Kenya by: David Wasambla 1 , Moses Kitheka 1 , Stephen Mutwiwa 1 , Pascal Mutie 2 , Danson Macharia 1 , Mark Kabue 1 , Mildred Mudany 1 and Isaac Malonza 1 affiliate: 1 Jhpiego, an affiliate of Johns Hopkins University/Kenya, 2 ICAP/Kenya Background: APHIAPLUS KAMILI Project n APHIAPLUS KAMILI is a 5-year, USAID- funded project n Country-owned, Government-led in Eastern and Central Regions, Kenya n Supports Integrated Health Services: n Reproductive Health/Family Planning/ Maternal, Neonatal and Child Health n HIV Services (ART, HTC, PMTCT) n Social Determinants of Health n Community Health Strategy and Prevention n Monitoring and Evaluation n Has 9 consortium implementing partners, led by Jhpiego Description: A 4-Step Process Description n Google Groups Innovation involves use of closed user group mailing system. n Beginning in September 2011, the MOH pharmacist was supported to initiate a closed Google Groups email connecting other district pharmacists. n The simple yet interactive Internet- based innovation is also accessible via Internet-enabled mobile phones. n One focal person maintains the email group dubbed: [email protected]. n The innovation was adopted by health records and information officers (HRIOs). n Currently, the network consists of more than 150 pharmacists and 50 HRIOs, covering over 1,800 health facilities. n To date, over 600 messages have been exchanged – 75% from pharmacists. n Information shared includes redistribution of commodities, knowledge exchange and general updates. n Drugs redistributed range from ARVs to general antibiotics, antifungals, mental health drugs and multivitamins. How Innovation Has Improved Practice 1. Reduced chance of drugs expiring in facility and district stores 2. An effective communication platform for facilities 3. Short-term solution: Addressed acute shortages 4. Long-term solution: Led to targeted on-the-job training 5. Innovation has been adopted by other District Managers: Laboratory Technologists, Health Records and Information Officers, Reproductive Health Coordinators 6. Regional spread beyond project coverage and incorporated National Commodity Management Agencies Other Application of the Innovation n Dissemination of updates, e.g., non- standard ART regimen updates n Case management support n District Health Information System (DHIS) peer support to improve reporting Lessons Learned n The pharmacists expressed enthusiasm and the value of the innovation: “Google Groups has just made it easy for us to communicate and share resources … it’s convenient and no investments are necessary.’’ – District Pharmacist “Pharmacists can now share not only drug redistribution, but also other information like devolution and technical updates.’’ – County Pharmacist n Key barriers to commodity security: n Poor communication networks between the facilities n Lack of technical skills in quantification and forecasting of commodities n Key success factors: n MOH ownership (guaranteed buy-in) n This simple, inexpensive and easily accessible technology has improved commodity security in the short term n Effective feedback Next Steps n Integrating use of simple technology with effective commodity management systems at facility, regional and country levels. n Providing the opportunity to tailor local innovations for local solutions – key to a participatory, problem-solving approach. This poster is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under award number AID-623-A-11-00008. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID or the United States Government. Background n Commodity insecurity poses a major challenge in health programming and hampers quality health service delivery in Kenya. n The project and the Ministry of Health (MOH) invest in mentorship as a long- term strategy, but in the short term provide communication avenues for redistribution to minimize commodity spoilage and expiry. KITUI MAKUENI MACHAKOS MERU THARAKA - NITHI NYANARUA NYERI KIAMBU EMBU MURANG’A User group email defined Closed user group email developed Invitations by email Group Administrator Acceptance and use by closed user group members Stock-outs noted and Google Groups solution proposed Main Triggers to the Innovation n Lack of a communication forum for pharmacists to share commodity status at facility level, leading to: n Commodity stock-outs in some facilities n Commodity excesses in other facilities n Short-expiry drugs in excess at some facilities and stock-out of the same in other facilities n Inadequate commodity management skills How Innovation Has Improved Practice (cont.) BEFORE AFTER National Commodity Agency National Commodity Agency District Pharmacist District Pharmacist District Pharmacist Health Facility Health Facility Health Facility Health Facility
