Managing ARV Supplies

Created November 7th, 2008 | Modified February 24th, 2012 | Posted by gmc

Dr. Sarah Chuchu examples ARV drug stocks in a Nairobi health center. HIV/AIDS is one of Kenya’s most pressing health concerns and offering Antiretroviral Treatment ART is a key component of the government’s strategy to reduce HIV/AIDS-related morbidity and mortality. However, health care workers in resource limited settings face serious challenges in the management of pharmaceutical and patient records. The Nairobi Provincial Medical Office, in collaboration with Qualcomm’s Wireless Reach™ initiative, Telkom Kenya, Communications Commission of Kenya, Axesstel, Dell, RTI International have implemented a project to reduce the administrative burden on healthcare workers and improve patient care by strengthening pharmaceutical management systems for ART utilizing 3G technology.

Solution

Based on the needs expressed by the Provincial Medical Office and health center pharmacists, the project has developed an integrated ART patient and ARV pharmaceutical supply management system called Zcore - Daily Activity Register software (Zcore-DAR or DAR). The DAR software is based on the RTI-designed Zcore open source software platform . There are no recurrent software licensing fees and the software may be adapted in Kenya as needed in the future. This replaces the manual data entry and report compilation for 16 health centers in Nairobi that provide ART treatment and are supplied by the Kenya Medical Supplies Agency (KEMSA) with ARV pharmaceuticals. The software has the potential to be used by all health centers that are supplied by KEMSA.

Screen display showing dispensing of ARV pharmaceuticals.

Pharmacists in health centers use the Zcore-DAR software to:

Keep records of medications dispensed to individual patients on given dates (history of all ART related drugs dispensed to patients)
Keep basic demographic information about each patient including: Surname, Forenames, Sex, Client ID number, Birth Date/Age
Select drugs from drop down menus for any drug regimen
Track patient conditions such as weight over time
Track ART regimen for each patient
Produce a Daily Activity Report which displays a list of patients and the drugs/counts dispensed
Provide reports for the PMO by health center (site) and date and provides easy export of data to Excel
Automatically generate monthly reports for Logistics Management Unit (LMU) at KEMSA based on data entered.

Data entry forms and fields can be easily updated through a web-based user interface (no programming is required). This enables the software to be easily updated as drugs, reports, and other elements change.

The software improves the timeliness and accuracy of information about the supply, consumption, stock, and loss of pharmaceutical supplies used in ART. The software also reduces the amount of time spent by health center pharmaceutical technicians and pharmacists on maintaining and reporting this information, providing health center pharmaceutical technicians and pharmacists more convenient access to information about pharmaceuticals and pharmaceutical supplies used in ART (e.g. dosages, side effects, etc.). Finally, the software improves medical staff capacity to monitor patient ART adherence.

Managing ARV Pharmaceutical Supplies in Nairobi, Kenya

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As the diagram above shows, each health center pharmacy has a computer supported by a Uninterruptible Power Supply (UPS) battery backup device and small laser printer. The Communications Commission of Kenya (CCK) and Dell, USA have donated the computers for the project. The computer is equipped with a wireless router (provided by Axesstel) that uses Qualcomm 3G EV-DO Rev A wireless technology to connect to the Internet via Telkom Kenya's Orange™ broadband wireless network.

How is the Zcore-DAR being Used?

Health center pharmacy staff use the DAR software to enter patient data, drugs dispensed and stock inventory and compile monthly reports for submission to the LMU at KEMSA, as well as to the PMO. Each health center then transmits monthly reports to the LMU using Qualcomm 3G EV-DO Rev A wireless technology over the Telkom Kenya Orange™ wireless broadband network. The LMU uses these electronic reports to calculate drug usage and to determine drugs needed for re-supply to each health center. The PMO and District Pharmacists provide quality assurance by reviewing data submitted by health centers and providing supportive supervision. Any health center with the DAR software and access to the Telkom Kenya Orange™ advanced wireless broadband network could use this system to manage ARV pharmaceutical supplies and transmit reports to the LMU.

The software has been designed to enable pharmacists to use it to manage any pharmaceutical supplies, not just ARV supplies. Several Nairobi health centers are already using it to manage all of their pharmaceutical supplies.