CLICK TO ADD TITLE The 5th Global Health Supply Chain Summit Twenty Lessons from SMS for Life pilot Peter Ward November , 2012 Kigali, Rwanda

© Peter Ward, All rights reserved Agenda Brief description of project and results Twenty lessons References and links

© Peter Ward, All rights reserved Brief description of project and results

© Peter Ward, All rights reserved SMS for Life pilot project overview Dar es Salaam Lindi Rural Ulanga Kigoma Rural A public-private team –Novartis, IBM, Vodafone, Ministry of Health, Roll Back Malaria Focused on raising visibility of stock levels of malaria drugs in health facilities –Thus permitting actions to reduce stock-outs Pilot project ran in 3 districts “SMS for Life: a pilot project to improve anti-malarial drug supply management in rural Tanzania using standard technology”, Barrington, Wereko-Brobby, Ward, et al. Malaria Journal 2010, 9:298

© Peter Ward, All rights reserved SMS for Life pilot project sample Google map

© Peter Ward, All rights reserved SMS for Life pilot project results Lindi rural Ulanga Kigoma rural Graphs are % facilities with stock-outs Colours represent the 4 types of drug Downward trend in all districts over the 5-month pilot period

© Peter Ward, All rights reserved Twenty lessons from SMS for Life

© Peter Ward, All rights reserved Lessons 1 of 4: prerequisites 1)You need strong sponsorship –We had a hands-on senior Novartis executive committed to success 2)You need strong and committed partners –Each one committed for their own reasons and contributing well 3)You need good project management –Experienced, with good yet flexible processes 4)Ensure your objectives are clear up-front –Ours was “provide visibility of stock levels” which we could deliver, not “reduce stock-outs” which we couldn't

© Peter Ward, All rights reserved Lessons 2 of 4: the way to work 5)You need to build good relationships with your Ministry –Most projects fail and Ministries know this –Ours improved during the project as our professionalism was visibly maintained 1)You need to be aware of other initiatives in the same department –Sensitivity is required 7)Make sure you work with, not “do to” –Sense of respectful partnership required 1)Factor in a full recce before finalising your plans –Don't assume you know –We identified several requirements and value- add opportunities

© Peter Ward, All rights reserved Lessons 3 of 4: application basics 9)Design the field user interface for phone, not laptop –Phones are ubiquitous –But not smartphones! 1)Keep UIs simple –Any processing complexity should be in the central server 2)Carefully consider where to site the central server –Out-of-country may provide better service 12)Be aware of end user capabilities –Some staff had previously never sent an SMS message 1)Be prepared to donate smartphones and data packages for senior regional staff –To avoid using laptops for web access 2)Be aware of bandwidth requirements/availability

© Peter Ward, All rights reserved Lessons 4 of 4: on the ground 15)You must keep engaged throughout the pilot period –It keeps everyone focused 1)Be aware of your project adding workload to overworked staff –Compensate them! 2)Ensure you understand ministry staff's per diem expectations for training –Even senior regional staff may expect it 18)Provide guidance simply –We provided a poster 1)Plan travel carefully –Road conditions vs. rainy season, even with 4x4 –Safety of certain roads –Flights may be preferable –Build contingency into travel plans 2)Take opportunities to add value during the project –Education

© Peter Ward, All rights reserved References and Links

© Peter Ward, All rights reserved References and links 1 of 2 Project press release: 03.ibm.com/press/us/en/pressrelease/29022.wsshttp://www- 03.ibm.com/press/us/en/pressrelease/29022.wss Malaria Journal: IBM Icons of Progress: 03.ibm.com/ibm/history/ibm100/us/en/icons/medicineon- demand/ 03.ibm.com/ibm/history/ibm100/us/en/icons/medicineon- demand/ IBM Smarter Planet blog: lives.html lives.html UK Guardian article: saving-lives-malaria?newsfeed=true saving-lives-malaria?newsfeed=true

© Peter Ward, All rights reserved References and links 2 of 2 SMS for Life on Roll Back Malaria website: Project summary report: pdf pdf Project detailed report: WSJ 2011 award for Health-Care IT: html html ComputerWorld 2011 Laureate in Health: /?& /?&