Managing ARV Supplies
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 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.
Based on the needs expressed by the Provincial Medical Office and health center pharmacists, the project 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 used and adapted by other organizations. This software was designed to replace the manual data entry and report compilation for health centers in Nairobi that provide ART treatment and were supplied by the Kenya Medical Supplies Agency (KEMSA) with ARV pharmaceuticals.
Pharmacists in health centers used 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.
The software improved the timeliness of information about the supply, consumption, stock, and loss of pharmaceutical supplies used in ART. The software also reduced 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 improved the ability of medical staff to monitor patient ART adherence.
As the diagram above shows, each health center pharmacy was provided with 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 donated the computers for the project. The computers were equipped with a wireless router (provided by Axesstel) that used 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 used 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 transmited monthly reports to the LMU using Qualcomm 3G EV-DO Rev A wireless technology over the Telkom Kenya Orange™ wireless broadband network. The LMU used these electronic reports to calculate drug usage and to determine drugs needed for re-supply to each health center. The PMO and District Pharmacists provided quality assurance by reviewing data submitted by health centers and providing supportive supervision. Any health center with the DAR software and access to the Internet could use this system to manage ARV pharmaceutical supplies and transmit reports.The software has been designed to enable pharmacists to use it to manage any pharmaceutical supplies, not just ARV supplies..