Using mobile phones to keep track of medicines and notify superiors when more are needed

What is the aim of this review?

In this Cochrane Review, we aimed to assess if health workers would have better access to medicines and other supplies, if they used mobile phones or other mobile devices to keep track of the amount of supplies they had available, and to notify superiors when they needed more supplies. We also described how health workers are currently using these mobile systems, and what factors influence their use.

Key messages

We do not know if using mobile phones to keep track of medical supplies gives primary healthcare workers better access to these supplies. This is because the certainty of the available evidence was very low. However, the evidence does point to several factors that could influence the implementation of these systems. These include the sharing of data across all levels of the health system; reliable access to electricity and the internet; easy‐to‐use and functional phones and systems; good technical support; and sufficient training and supervision. Well‐functioning digital systems will only succeed if medical supplies are actually available.

What was studied in the review?

Healthcare workers need medicines, vaccines, syringes, and other supplies to do their jobs properly. But many healthcare settings, particularly in poor countries, often lack supplies because governments cannot afford to buy them, or because they do not have good systems for distributing them to the right places at the right time.

To address some of these problems, managers and health workers can use mobile phones to keep track of supplies, decide how much more to order and when, and let people at higher levels of the system know when supplies are running low.

The main aim of our review was to find out if health workers who use these mobile systems had better access to supplies than health workers using other systems, or no systems at all. We also looked at how these mobile systems are being used in primary healthcare settings, and the factors that influences their use.

What are the main results of the review?

We found one study from Malawi that measured the effect of mobile phone systems on access to medicines and supplies in health facilities. However, we do not know whether these systems improve access or not, because the certainty of this evidence was very low.

We found 16 studies conducted in African and Asian countries, in which study authors identified several factors that could help to set up systems successfully.

‐ Study authors suggested that allowing healthcare officials at all levels of the healthcare system to see the data could help them to respond on time and avoid supply shortages (low confidence).

‐ Study authors highlighted how poor access to electricity and internet could make it difficult for health workers to charge phones and send data (moderate confidence).

‐ Study authors pointed to the importance of user‐friendly systems, built with user participation (moderate confidence); access to technical experts to develop and maintain the system (low confidence); proper support and supervision for health workers (moderate confidence); and training of health workers in how to use the mobile system itself (moderate confidence).

‐ One author suggested that adding phone credits to health workers’ mobile phones for their personal use, could motivate them, and improve their use of the system (low confidence). Study authors also suggested several mobile phone functions that could be helpful to health workers using these systems. These included phones that could take pictures and map geographic locations, systems that allowed toll‐free text messaging, two‐way communication, and easy sharing of information (low confidence). But study authors also suggested that health workers might find it easier to use basic phones and maintain their own personal phones (low confidence).

‐ Study authors emphasised that digital notification systems will only give health workers better access to supplies if the supplies are actually available at the district or national level (low confidence).

How up‐to‐date is this review?

We searched for studies that had been published up to August 2019…more