Assessment of the implementation process of the electronic health commodity management information system in Lusaka district health facilities.

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Date
2023
Authors
Simpungwe, Gamariel James
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The University of Zambia
Abstract
Over the past decade, the Ministry of Health (MOH) in Zambia has experienced health commodity inventory management challenges that resulted in stock outs, expiry and pilferage of life-saving medicines. A weak Logistics Management Information System (LMIS) was cited as a major factor causing the inability of Supply Chain (SC) users to make sound data-based SC decisions. An evaluation of the paper-based LMIS attributed the lack of accurate, goodquality data captured and reported at Service Delivery Points (SDPs) to the laborious nature of the paper-based manual processes that required human resources, time and stationery. To address this challenge, the recommendation was to automate the system by implementing the electronic Logistics Management Information System (eLMIS). The eLMIS was envisaged to ease the data capture and reporting processes at SDP leading to an increase in data visibility, access and data-based SC decision making. The SC managers would at the press of a button have readily available supply status updates to aid aversion of stock imbalance and be equipped to plan re-supply. Currently, the facility level eLMIS is rolled out to 51% (1,643/3200) of public health SDPs while the central edition is rolled-out countrywide. While the reporting rates are in the ninetieth percentile, SDPs continue to experience stock imbalances, expires and instances of pilferage (eLMIS reports, 2023). A key question: Working on the assumption that the design of the LMIS is ideal, how effective was the rollout process of the eLMIS executed? Otto et. al., (2015) in a discussion paper focused on Africa, explains the five pillars of health systems noted to have a direct impact on the success of ICT innovation implementation in Africa. These foundational elements are infrastructure, governance, healthcare financing, supply chain management, and human resources for health. Building on the five pillars, to successfully establish and scale up an automated LMIS, the critical prerequisites are data and interoperability standards, local capacity, policy and regulatory environments, an appropriate business model, alignment of partnerships and priorities, and monitoring and evaluation. While some prerequisites are crosscutting, there is a need for further refinement of other prerequisites depending on the specific country context. This study set out to establish if the implementation process for the eLMIS is yielding the desired system and end-user outcomes. The study evaluated the prerequisites outlined by Otto et. al., (2015) by engaging key stakeholders at all levels of the SC in managing health commodities and supporting implementation. While the findings noted important successful attributes, several significant issues include threats to sustained operations resulting from leadership and policy implementation gaps, limited dissemination of critical information among stakeholders, lack of clarity of roles among eLMIS stakeholders, funding resource challenges, and donor dependence.
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Thesis of Masters in Business Administration
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