Q+A: Introducing the USAID eSCMIS Project

A public health supply chain is a network of organizations or actors that ensures the availability of health commodities to the people who need them. A strong supply chain system is key to improving the quality of health services. 

The USAID Electronic Supply Chain Management Information System (eSCMIS) project in Zambia aims to create an efficient and reliable health supply chain using a logistics management information system. eSCMIS is implemented by John Snow Health Zambia, Ltd. (JSH). Partners include John Snow, Inc. (JSI), the Churches Health Association of Zambia, and Zenysis.

JSI spoke with John Chisha Sikasote, chief of party, and Wendy Nicodemus, deputy chief of party, to find out what the project has been doing since beginning in January. 

What is eSCMIS trying to achieve?

Our goals are increased use of health services, decreased burden of disease, and increased quality of life for Zambians. The transformation of the supply chain management information system will ensure appropriate quantities and qualities of health commodities at health facilities to meet patient demand. Our vision for eSCMIS is to create an open-source digital platform that provides end-to-end real-time supply chain visibility. In other words, a platform that supports improved decision-making, accountability, fiscal responsibility, and local ownership, leading to a more efficient and sustainable supply chain, a more effective health system, and better health outcomes. 

Are there specific supply chains you’re focused on in terms of diseases or commodities?

The eSCMIS project is building on the current electronic logistics management information system (eLMIS), implemented previously by JSI. The eLMIS is a cost-effective system to manage health data that ensures greater commodity security and better health outcomes. It focuses on HIV, malaria, reproductive health, essential medicines, and laboratory commodities.

JSH will transform the eLMIS into a next-generation information system in collaboration with the Ministry of Health (MOH), Medical Stores Limited (MSL), the government’s agency focused on procuring, storing, and distributing essential medicines, and other key supply chain partners.

eSCMIS’ early life is taking place during the COVID-19 epidemic. How is the project responding?

We have temporarily closed the office to ensure staff safety. Most of our work requires travel and in-person meetings, but we are conducting as much of our planned activities as possible while working remotely and following government guidelines. 

That said, we are also responding to the COVID-19 situation in Zambia. We have been working with the MOH, USAID, CDC, and Zambia National Public Health Institute to customize a surveillance application to monitor the disease. 

Additionally, JSH is working with JSI projects in Zambia as part of the response. USAID DISCOVER-Health is procuring U.S. Government-approved COVID-19 commodities including sample collection and laboratory supplies and equipment, infection control supplies and equipment, and patient management supplies and equipment. DISCOVER-Health asked JSH to help track the supplies that the U.S Government and other donors have delivered to MSL, including where they are distributed. We are now adapting eLMIS to track COVID-19 commodities and supplies to enable facilities to use them prudently and ensure that they reach the intended beneficiaries. 

We will continue to look for opportunities to collaborate with DISCOVER-Health and USAID Securing an Aids-FREE Era on supply chain matters.

What plans do you have for the coming months, apart from continuing to respond to COVID-19?

We started work on January 14, 2020 and had a kick-off meeting with USAID on January 22. During start-up, the team continued to support the existing 624 health facilities nationwide that have the facility edition (FE) of eLMIS. We’ve been working to improve the FE user interface to manage commodities for HIV testing. The aim is to make it match the modifications that MOH made to the paper-based system. As soon as conditions allow, we plan to rapidly deploy eLMIS FE to 1,000 additional health facilities and will work with MOH to start deploying IMPACT teams to analyze eLMIS data and improve the supply chain. The IMPACT team goals are to improve product availability, reduce wastage, and identify and implement solutions to supply chain problems. 

Why is this the right time for Zambia to upgrade its supply chain MIS?

Since 2015, efforts to automate the supply chain have improved its efficiency and resilience. It’s evident in the improved visibility of certain commodities, like antiretrovirals and HIV tests, and in the reduction of wastage, like expired medicines. Other reasons to continue improving the supply chain MIS are:

• To integrate systems for supply chains and electronic health records.  
• Many systems, including the health MIS, are still siloed. 
• The warehouse information systems, which keep track of supply stocks, need to be able to interface with eLMIS. 
• For end-to-end product traceability across the supply chain. 
• To adopt standards to facilitate information exchange across HISs.
• To enhance data accuracy and transmission of global supply data to a centrally accessible repository for better visibility. The COVID-19 pandemic has highlighted the need for this, as countries rush to supply hospitals with personal protective equipment, tests, and treatment. 

Are there other countries in sub-Saharan Africa with electronic supply chain MISs that serve as models?

Our main references have been Ethiopia and Tanzania. Zambia has been on a similar path to the development of electronic supply chain management systems, and over the past five years, we have continuously worked to learn from each other. Our partner JSI has learned from Tanzania about other supply chain areas, like vaccine management. Many countries are using mobile apps to manage their medical supply chains, but they have major limitations when it comes to managing large volumes of products and capturing detailed transnational data.  

eSCMIS is implemented by John Snow Health Zambia Limited, a new local entity affiliated with JSI. Can you explain JSH’s mission and why it is uniquely positioned to run eSCMIS? 

JSH is staffed by professionals who have vast experience in supply chain management throughout Africa and institutional knowledge and capacity in Zambia. As an affiliate, we benefit from JSI’s extensive knowledge and experience in these areas as well as in eHealth strategy and systems development and implementation to scale. Yet as a local organization, we help projects like eSCMIS become sustainable and truly embedded in the public health system.