Ivan Ngoboka It’s just five months since the Ministry of Health started rolling out a new system of distributing medicines to various health facilities country wide. The web-based method called the Electronic Logistics Management Information System (eLMIS) is out to cut red-tape and ensure more efficiency in as far as delivery of medicines to health units is concerned. As I write this article, all 42 district hospitals, 30 district pharmacies, five referral hospitals and over 400 health centres have been hooked onto the system, using passwords. Obviously, the paper-based format that was in use formerly was dotted with not only inaccuracies but delays too. Senior health official can attest to this.With the electronic system, an officer at the ministry headquarters, for example, can know which district hospital or pharmacy is under or over stocked by simply logging onto the network. This has not only removed the bureaucratic paperwork involved in requisitioning, but also help officials in planning for constant supply, says Joseph Kabatende, the head of pharmaceutical services and logistics management. The system that cost over $ 1million is a worthwhile investment because it will certainly reduce losses, since it has an alerting system about expiry dates, therefore helping medics or logistics officers identify drugs that should be given out for consumption first. There is more to it. The application also has an in-built tracking system that for instance monitors transportation of drug consignments to various destinations, minimising incidents of theft or fraud. The format limits human labour yet creates a sense of urgency as far as ordering and delivery of medical supplies is concerned. It is timely as well. In the past, officials say, it would take about two weeks to get deliveries from the central medical store to a health unit, say, in Bugesera District. It now takes only two days. Clement Rurangwa, the director of Bugesera District pharmacy, has confirmed this. The new efficient delivery system seems to have been reinforced by the commissioning of a multi-million state-of-art central medical store, an important element in health logistics. The mega structure, located in the Kigali Special Economic Zone in Masoro, is not only spacious but also fashioned to allow mechanisation and technological development, resulting less human contact with medical supplies. The establishment that took a year to build at a cost Rwf 1.4billion, covers 24,000 cubic metres in space, and has seen the total number of main medical ware houses country wide reduce from 10 to 3. Officials say that before, mobilising of medical batches from 10 different ware houses scattered around Kigali for shipment to various districts, was not only time-consuming, exhausting, but also gave chance to error. The world class structure is also armed with ample natural ventilation, removing the need to spend on costly air conditioners. The eLMIS is not the only innovation of the kind by the ministry. Earlier on in 2005, TRACnet, an application that allows storage, access, and sharing of vital information on HIV/AIDS patients by medics was rolled out. The home-made system for instance enables practitioners involved in anti-retroviral (ARV) treatment programmes to submit or receive reports electronically as soon as they are processed by dialing a particular number or logging onto a bilingual website (English and French). TRACnet was designed for use with all types of technology and information systems, but today, 90 percent of the system’s users access it through mobile phones, rather than more expensive and less reliable computers and Internet connections. During the same year, tele-medicine, the use of ICT where distance is critical by health-care professionals to evaluate, diagnose and treat patients was introduced. The system includes use of a growing variety of applications and services, for instance a two-way video, email, smart phones, wireless tools and other forms of telecommunication. The aim is to reduce the number of patients from different parts of the country being referred to specialised hospitals. This is already happening between King Faisal, the university teaching hospitals of Kigali and Butare. More about electronic migration, about four years ago, the rapid SMS system, a phone application that helps in monitoring; maternal and child health was introduced by the ministry. The method for instance, automatically notifies a community based health worker about the date a particular pregnant mother in their area is supposed to report to the health centre for routine check-up, helping them remind the patient hence-force. The writer is journalist specialising on health
