Tulane University School of Public Health, USA
Dr. Julie Hernandez received her PhD from the University of Paris X Nanterre in 2010. She currently is a Research Assistant Professor with the Tulane School of Public Health in New Orleans, LA. Dr. Hernandez is a Geographic Information System / Digital Data Collection specialist with 10+ years of experience in developing user – friendly, participant mapping and surveys initiatives and early warning systems in resource – constrained environments. She serves as Co-Investigator on several DFID, Gates Foundation and Packard Foundation funded projects in DR Congo to improve access to Family Planning services.
In Kinshasa, D.R. Congo, unmet need for modern contraception is extremely high (31.3% in 2013), while access to primary healthcare facilities remains difficult. Community – based contraceptives distribution is a possible solution to increase FP use. However, evaluations conducted with Community – Based Distributors (CBD) revealed that they were stocked out of contraceptives about 70% of the time. Quarterly resupply circuits were insufficient to meet the demand. In addition, routine healthcare services reporting in Kinshasa is mired with completeness, accuracy and timeliness issues. In order to strengthen contraceptive logistics, Tulane developed a text – message based reporting system to track contraceptive distribution at the community level. This system (“sms4bPF”) is linked to a web base capable treating routine data and alerting suppliers of imminent stock outs. We evaluated the technical and systemic feasibility of this platform based on feedback from 150 DBC users and quality analysis of the pilot database. While this text-message based reporting system shows promising results in terms of strengthening ADBCs involvement in community-based activities and FP service reporting, the pilot phase revealed in particular that, while some of the issues encountered with this reporting system stem from its technical design, most barriers to its effectiveness are rooted in the same communication and logistics issues plaguing the contraceptive supply chain in Kinshasa. With electronic data collection and mHealth increasing popularity for strengthening global health systems, this presentation will endeavor to look beyond the “techno fix” approach and highlight systemic hurdles to scaling up and sustaining these initiatives in challenging programmatic environments.