A pilot study of a novel, incentivised mHealth technology to monitor the vaccine supply chain in rural Zambia

Abstract

Introduction The World Health Organization estimates that up to half of vaccines are wasted, however only a minority of mHealth programs in Africa have been directed at vaccine supply chain optimisation. We piloted a novel mHealth solution dependent only on short message services (SMS) technology that allowed workers in rural health centres in Zambia to report vaccine stock levels directly to an online platform. Small airtime incentives were offered to encourage users to engage with the system, as well as weekly reminder messages asking for stock updates. Methods The primary outcome measured was the percentage-of-doses-tracked, calculated over the study period. Each vaccine box was randomly allocated to offer either a standard or double airtime incentive and either weekly or daily reminders, in a 2 x 2 design; ANOVA was used to calculate if any of these factors affected time-to-reply. Results Over the study period, the total percentage-of-doses-tracked was 39.9%. Within the subset of users who sent at least one message to the platform, the percentage-of-doses-tracked was 93.8%. There was no significant difference in average time-to-reply between the standard airtime incentive and double airtime incentive groups, nor was there a significant difference between the standard reminder and daily follow-up reminder groups. Conclusion This pilot study found that in an active subgroup of health workers, an incentivised mHealth solution was able to collect tracking data for 93.8% of doses. More research is needed to identify methods to encourage healthcare workers to engage in timely stock reporting practices.

Identifying resilience strategies for disruption management in the healthcare supply chain during COVID-19 by digital innovations: A systematic literature review

“…In this research for handling vaccine SC, the researchers concentrated on the advantage of public-private cooperation, which encompasses skills development, technology transfer, localization, and preservation of a valid and well-organized supply chain. Moreover, Lamanna et al [ 75 ] provided an M-Health method based on short message Services (SMS) that permit healthcare workers in rural areas to send vaccine stock amounts to an online platform. The results showed that this method can accumulate follow-up data.…”

“…Healthcare supply chains should be constantly controlled and the pandemic response challenges clarified [ 75 ]. Throughout the COVID-19 pandemic, there has been tremendous scarcity in the materials and pharmaceutical SC, such as personal protective equipment, medicines, testing kits, respirators, gloves, gowns, and other necessities.…”

“…Throughout the COVID-19 pandemic, there has been tremendous scarcity in the materials and pharmaceutical SC, such as personal protective equipment, medicines, testing kits, respirators, gloves, gowns, and other necessities. Based on the literature [ 75 ], there are five essential elements for an immune supply chain system, namely flexibility, traceability, persistence, global independence, and equity. Flexibility requires strategic resource planning for every requirement that might arise during disasters.…”

Assessing technological impact on vaccine supply chain performance

“…Microneedle (or array) patch technology adoption improved vaccine thermostability, reducing its wastage and enhancing its availability in Benin, Mozambique, India and Australia (Bozorgi and Fahimnia, 2021;Wedlock et al, 2019). The use of short message service (SMS) technology using mobile phones and web-based applications established a visibility network to track the supply and stocks of vaccines in Pakistan (Altaf et al, 2021) and Zambia (Lamanna and Byrne, 2019). The effectiveness of a dose-based reporting tool, designed to reduce vaccine wastage at primary healthcare facilities, was assessed by comparing the pre-and post-intervention situation in Delhi, India (Rustagi et al, 2021).…”

“…The use of short message service (SMS) technology using mobile phones and web-based applications established a visibility network to track the supply and stocks of vaccines in Pakistan (Altaf et al. , 2021) and Zambia (Lamanna and Byrne, 2019). The effectiveness of a dose-based reporting tool, designed to reduce vaccine wastage at primary healthcare facilities, was assessed by comparing the pre-and post-intervention situation in Delhi, India (Rustagi et al.…”