Rhoann Kerh, PhD Student
Demand Sensing and Digital Tracking for Maternal and Child Health in Uganda
99% of maternal deaths today occur in the developing world. Uganda is one of the developing countries with the poor reproductive status. The poor state of reproductive health indicator is associated with ineffective use of service and poor access to healthcare supplies. Maternal health product supply chains in Uganda are fraught with many problems. In particular, capacity of supply chains to forecast procurement and deliver essential medical supplies is the major constraint. Lack of financial and human resources, limited institutional capacity and infrastructure and weak health information systems undermine system’s ability to forecast, procure and deliver the supplies to the last mile point of use. The main core of this study is to improve health outcomes for the pregnant women and their newborns through developing better mechanism to collect the first-mile data and utilize it to the last-mile delivery. System engineering principles and cloud-based smart sync technology will be applied to improve the first mile data collection. Data driven demand sensing and inventory system would be established through triangulating patient data in registries, diagnostic data in laboratories and consumption data captured in stocks. With ambidextrous approaches proposed to address maternal and child health (MCH) supply chain management issues, the distribution and management information systems will be strengthened in place. The proposed system will improve resource allocation and equip health units with adequate supplies to enhance MCH care quality in Uganda.
Every two minutes, a mother dies from preventable causes related to childbirth. 99% of maternal deaths occur in developing countries, and complications from pregnancy and childbirth are leading cause of death among girls age from 15-19. The major cause of this poor reproductive statistics is the fragmented logistics and supply chain system in MCH commodities. To save the lives of pregnant women and their newborns, the UN Commission has identified a list of 13 commodities as shown in Fig1, and it is reported that more than 16 million lives were saved by increasing access to and appropriate use of these essential medicines, medical devices and health supplies.
Fig 1. MCH lifesaving essential commodities defined by UN Commission
The major problem confronted in Uganda’s level IV health facility is the weak responsiveness of MCH supplies with paper-based reporting and requisition systems. From the field study, it is discovered that the bi-monthly supply order preparation is tedious and time consuming, replication and data inconsistency were often found in the paper based register records. Lack of digitalized supply management system has impeded the access to data and make it difficult for decision makers to trigger and predict future orders, thus resulting unusual stock-out or over stock. Fig 2 to Fig 5 demonstrates the problems and the findings from one of the health center IV in Mukuno district, Uganda.
Fig 2. Acquisition form of medical commodities
Fig 3. Paper-based antenatal patient registers
Fig 4. Medication expired in December 2017
Fig 5. Refrigerated medication stock out
A Diagnosis-Based Demand sensing and Digital tracking (DBDD) approach is proposed to analyze the process of information flow and identify critical path of supplies associated with MCH in Uganda health system. Fig 6 demonstrates the cloud based smart sync architecture to digitize and triangulate critical data sets for MCH commodities forecasting.
Fig 6. DBDD Architecture
IV. Preliminary results
Poster Presentation: "Demand Sensing and Digital Tracking for Maternal and Child Health (MCH) in Uganda"
Award: 4th Annual Innovation for International Development (I2D) Lab Exposition Global Good Award
- School of Industrial Engineering, Purdue University
- Global Engineering, Purdue University
- Regenstrief Center for Health Care Engineering, Purdue University
- School of Public Health-Resilient Africa Network (RAN), Makerere University, Uganda
- Management Science for Health, USA
VI. Funding Sources: Bill & Melinda Gates Foundation