Electronic Pharmaceutical Management Improves ART Service in Lesotho

Mr. Sello Lechesa, a pharmacy technician and RxSolution user in the ART pharmacy at Maluti Adventist Hospital. {Photo credit: MSH staff/Lesotho}Photo credit: MSH staff/Lesotho

Lesotho’s pharmaceutical sector faced two formidable challenges: the unreliable supply of essential medicines and the unknown quality of medicines circulating in the country. Inefficiencies within the supply chain system were at the root of both problems, specifically weak information management systems that did not support decision-making in the supply chain. This resulted in the Global Fund to Fight AIDS, TB & Malaria (Global Fund) setting a condition precedent that had to be addressed for the country to qualify for further disbursement of a round of funds: the establishment of a robust and functional management information system for the antiretroviral therapy (ART) program.

The Ministry of Health (MOH) established the Pharmaceutical Management Information System (PMIS) to provide information to drug supply management staff through scheduled and on-demand reports for management control and to facilitate informed decision-making and strategic planning.

The RxSolution system helps MOH implement PMIS. Data from this electronic tool are used to meet all the reporting requirements for PMIS. The World Health Organization (WHO) early warning indicators can also be tracked using the system at ART sites. RxSolution was produced by the USAID-funded Systems for Improved Access to Pharmaceuticals and Services’ (SIAPS) predecessor, the Strengthening Pharmaceutical Systems program.

The Global Fund supply chain specialist from Geneva, along with SIAPS, visited Maluti Adventist Hospital, where RxSolution is used for ART pharmaceutical management, and conducted data quality checks. The pharmacy technician in charge of the ART pharmacy, Mr. Sello Lechesa, reported that since implementing RxSolution, the hospital has been able to calculate average monthly consumption for adults on ART. The hospital uses that information, in turn, to accurately determine the number of people currently on ART during the reporting period. 

“All RxSolution needs is for you to understand how it works,” Mr. Lechesa explained. “Use it, and it will work for you and for your ART clinical management solutions.”

The RxSolution intervention has improved the quality of data generated from sites. Errors—especially transcription errors—have been minimized. The visiting team confirmed that RxSolution is a remarkably helpful tool to measure consistency and accuracy between the recorded data and reported information. Ninety-two percent of information from sites using RxSolution is accurate compared to 78 percent before RxSolution’s introduction. Such high-quality data dimensions help ensure accurate quantification of needs and procurement of antiretrovirals in the country.

So far, RxSolution has been implemented in 11 hospitals as the scale-up of the system continues. Ongoing on-the-job trainings during supportive supervision and mentoring visits ensure that the system is sustainable not only in maintenance but also as a continued effort to build capacity among health care workers.

Ultimately, the goal is better health outcomes—and that goal was at the core of the SIAPS program’s work in support of MOH. Data generated from sites will feed robust and comprehensive information up the chain to complete the pharmaceutical management framework, ultimately curbing the countrywide inefficiencies that once plagued Lesotho’s pharmaceutical sector.;