Abstract
BackgroundIn resource-poor countries access to essential medicines, suboptimal prescribing and use of medicines are major problems. Health workers lack updated medical information and treatment support. Information and Communication Technology (ICT) could help tackle this. The impact of ICT on health systems in resource-poor countries is likely to be significant and transform the practice of medicine just as in high-income countries. However, research for finding the best way of doing this is needed. We aimed to assess current approaches to and use of ICT among health workers in two rural districts of Tanzania in relation to the current drug distribution practices, drug stock and continuing medical information (CME), as well as assessing the feasibility of using ICT to improve ordering and use of medicines.MethodsThis pilot study was conducted in 2010–2011, mapping the drug distribution chain in Tanzania, including problems and barriers. The study was conducted in Bunda and Serengeti districts, both part of the ICT4RD (ICT for rural development) project. Health workers involved in drug procurement and use at 13 health facilities were interviewed on use and knowledge of ICT, and their attitudes to its use in their daily work. They were also shown and interviewed about their thoughts on an android tablet application prototype for drug stock inventory and drug ordering, based on the Tanzanian Medical Stores Department (MSD) current paper forms.ResultsThe main challenge was a stable supply of essential medicines. Drug supplies were often delayed and incomplete, resulting in stock-outs. All 20 interviewed health workers used mobile phones, 8 of them Smartphones with Internet connection. The Health workers were very positive to the tablet application and saw its potential in reducing drug stock-outs. They also expressed a great need and wish for CME by distance.ConclusionThe tablet application was easily used and appreciated by health workers, and thus has the potential to save time and effort, reduce transportation costs and minimise drug stock-outs. Furthermore, the android tablet could be used to reach out with CME programs to health care workers at remote health facilities, as well as those in towns.
Highlights
In resource-poor countries access to essential medicines, suboptimal prescribing and use of medicines are major problems
In resource-strained countries, in sub-Saharan Africa (SSA), weak health systems are challenged by a disease burden that is high compared to the rest of the world [1]
Several studies indicate that the impact of Information and Communication Technology (ICT) on health systems in resource-strained countries will be significant and will transform the practice of medicine just as it has done in high-income countries [1,6,7]
Summary
In resource-poor countries access to essential medicines, suboptimal prescribing and use of medicines are major problems. The impact of ICT on health systems in resource-poor countries is likely to be significant and transform the practice of medicine just as in high-income countries. Up to 65% of health care costs in resourcepoor countries are spent on medicines, compared to 7-30% in rich countries [2], poor access to life-saving essential medicines, counterfeit drugs as well as suboptimal prescribing and use of medicines are major problems [3,4]. Information and Communication Technology (ICT) could help tackle such problems, but to apply existing ICT and decision support systems from high-income countries in resource-strained countries may not achieve the required results [5]. Several studies indicate that the impact of ICT on health systems in resource-strained countries will be significant and will transform the practice of medicine just as it has done in high-income countries [1,6,7]. Mobile phone penetration passed 40% in SSA already in 2010 and continues to increase rapidly [11], offering other possibilities for introduction of ICT tools in both rural and urban settings
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