Lesotho’s Electronic Reporting and Requesting (RnR) System Improves Supply Performance and Planning

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Ensuring Lesotho’s health clinics are stocked with essential supplies is no easy task in the rugged and mountainous nation known as the “Kingdom in the Sky.” Long distance and poor road networks between central warehouses and remote facilities make delivering supplies difficult. These challenges are compounded by supply chain management issues, such as inaccurate calculations by facilities due to lack of supply chain personnel, cumbersome financial processes for ordering medicines, and poor coordination among programs and partners. These challenges can lead to stockouts of medicine and pose a threat to patients’ health in the nation with the second highest HIV prevalence in the world.

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Optimizing the Health Commodity Supply Chain

The USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project supports local partners to strengthen the country’s health commodity supply chain. In collaboration with the Ministry of Health and Columbia University’s ICAP, the project is expanding electronic data collection and helping build an increasingly optimized health commodity supply chain, including commodity forecasting, inventory management, and planning and distribution.

One of the program’s most impactful activities has been the expansion of the reporting and requesting (RnR) or “informed push” tool nationwide, which uses electronic data to manage Lesotho’s health commodity supply chain. With this automated system, health facility staff use electronic tablets to upload information about current stock levels, expiry dates, quantity expired or damaged, and quantities received from the central warehouse. These data points from health facilities inform resupply quantities from the central level that are pushed to facilities. In addition, district logistics officers (DLOs) use the data to identify supply risks and help facilitate stock transfers between health facilities and districts.

Lesotho Electronic Reporting and Requesting System Inline Image 1

The system connects to the National Ministry of Health’s web-based platform (DHIS2) for health records and automatically calculates health facility resupply quantities for DLOs who, through the click of a button, can ensure a continuous supply of critical health commodities and minimal waste of unused supplies. This reduces the burden on often understaffed facilities to manually enter stock data into paper-based records and to forecast supply needs.

The web-based supply request system improved data clarity and helped shorten delivery times to increase commodity availability in last-mile storage sites. Additionally, the electronic system enhances data visibility and transparency at all levels of the supply chain during reporting periods – an improvement that can reduce overall cost and help health officials at the central, district and facility levels to analyze supply chain data for decision-making. Over several years, the GHSC-PSM project has provided technical support to expand the RnR system and train users at additional government facilities, non-profit facilities run by the Christian Health Association of Lesotho and private clinics.

Lesotho Electronic Reporting and Requesting System Inline Image 2

Currently all health facilities (228 ART sites) nationwide use the tablet-based system to upload supply chain data. The electronic informed push system saves these facilities valuable time (eight hours) by automatically calculating the average monthly consumption of commodities – a previously time-consuming and error-prone exercise that was done manually with a calculator for each of a facility’s approximately 100 items ordered.

In the coming years, GHSC-PSM will continue supporting supply chain data visibility in Lesotho. Working hand in hand with central and district health officers and facility health workers, the program will promote the tools and processes needed to ensure patients have access to vital health supplies.

Lesotho Electronic Reporting and Requesting System Inline Image 3