Afghanistan: Establishing a Logistics Management Information System for Improved Decision Making on Medicines and Commodities

{Doctors visit patients in Rabia Balkhi hospital, Kabul Afghanistan. (Photo Credit: Afghan Eyes/Jawad Jalali)} Doctors visit patients in Rabia Balkhi hospital, Kabul Afghanistan. (Photo Credit: Afghan Eyes/Jawad Jalali)

Since 2003, with the support of international donors (namely the US Agency for International Development [USAID], World Bank, and European Union), Afghanistan’s Ministry of Public Health (MoPH) has worked with NGOs to implement two key health packages: the Basic Package of Health Services (BPHS), covering primary care services, and the Essential Package of Hospital Services (EPHS), covering secondary care needs. The implementing NGOs have produced internal pharmaceutical logistics reports for the commodities they deliver to their catchment provinces. However, a mechanism to coordinate the collection and dissemination of this data across the public sector has been lacking, leading to inconsistencies and information gaps regarding procurement, distribution, and consumption of medicines.  

To provide the MoPH with better information to aid in decision making, the USAID-funded Strengthening Pharmaceutical Systems Afghanistan Associate Award project, implemented by Management Sciences for Health, assisted the MoPH and implementing NGOs to develop a Pharmaceutical Logistics Information System (PLIS). This was carried out through a coordinated procurement and distribution system in which the implementing NGOs and other BPHS/EPHS stakeholders worked as a team to strengthen BPHS/EPHS services. This system, based in Microsoft Access, keeps track of the value and volume of medicines flowing through the supply chains of implementing organizations.

The PLIS allows the MoPH to track stock status, consumption patterns and costs, encouraging better centralized planning. For example, an ABC analysis generated from PLIS data in the fourth quarter of 2014 showed that around 10 percent of the medicines accounted for 80 percent of consumed value, while around 77 percent of medicines accounted for just 5 percent of the consumed value. This information has helped the government identify and better track the flow and use of the most expensive or most consumed commodities.

A number of challenges remain until the PLIS can be fully effective—reporting quality is often inconsistent; NGOs operating in Afghanistan have high turnover, resulting in the need for more staff training; and internet connections are sometimes lacking, preventing implementing organizations from delivering information in a timely manner.  

The establishment and implementation of the PLIS is, however, a significant step in the right direction. By allowing the MoPH to better track commodities as they move along the supply chain, medicines can be redistributed when needed, stock-outs can be prevented, and the government can better predict its future procurement and budget needs.