Indonesia Goes Mobile to Manage its Family Planning Commodities

July 8th, 2020 | Viewpoint

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Since World Population Day was designated in 1987, there have been great advancements in ensuring reproductive health and rights of women and girls around the world. Access continues to be a challenge, however, especially in lower- and middle-income countries (LMICs) that have limited health systems. 

Indonesia, home to more than 270 million people with diverse preferences and needs, had one of the most successful family planning (FP) programs, with a distribution network comprising 17,000 clinics supported by 34 provincial and more than 500 district warehouses. But in the last 10 years, the contraceptive prevalence rate has stagnated. With almost half the population living in rural areas across more than 17,000 islands, access to contraceptives has been inconsistent. The COVID-19 pandemic is further jeopardizing access to FP services and supplies. 

COVID-19 has disrupted and exposed inefficiencies in public health supply chain systems across the globe. With many LMICs still using paper-based systems, data visibility is low and/or delayed, causing supply chains to be slow and rigid. LMIC governments must build digital ecosystems that can make supply chains and other health system-strengthening building blocks more agile and resilient.

Through the My Choice project, led by the Johns Hopkins Center for Communication Programs, JSI has been supporting Indonesia’s National Population and Family Planning Board (BKKBN) supply chain system since 2014. JSI collaborated with stakeholders to design and implement a package of data-centric supply chain interventions to fill critical system gaps and improve data visibility, quality, and use for continuous improvement and, ultimately, contraceptive availability. JSI has developed an Android application called Stokku (‘My Stock’) to digitize warehouse management processes. The new system focuses on strengthening organizational efficiency through improved data visibility and accuracy, and better compliance with warehouse management processes.

The need for digital transformation

The FP supply chain system cuts across multiple decentralized levels, while functioning within each level cuts across multiple departments. Each of these levels and departments often works in silos, which curtails system responsiveness and efficiency. The digital tools break down these silos and integrate the supply chain across multi-level stakeholders, standardizing processes and increasing visibility and transparency in operations. This results in a supply chain that can anticipate and adapt to changes in demand, ensuring that people have consistent access to the contraceptives of their choice.

The existing paper-based warehouse management process requires staff to spend considerable time filling multiple records, resulting in data entry errors. In Indonesia’s decentralized health system, lack of standardized processes has resulted in poor reporting rates and data quality, which has led to large stock imbalances across the country. 

Over the past four years, the project has strengthened the use of stock cards and deployed an Excel-based tool to support the use of logistics data for developing distribution lists, which has improved stock management. Now leveraging the high smartphone penetration in Indonesia, the Stokku mobile application builds on these improved processes and streamlines reception, storage, distribution, and tracking of contraceptives at each level of the supply chain. Managers now have real-time data visibility that can accelerate response times for making resupply decisions and improve forecasting and quantification.

Features

Stokku has been deployed in almost 100 district warehouses across four provinces. The application digitizes all processes for receiving and distributing products, recording and reporting stock, and tracking deliveries and orders. Features include:

  • Digital records and reports: The warehouse manager can log problems, receipts, physical counts, and stock data directly into the mobile application. All records including delivery notes and stock registers are auto-generated and printed directly from the application. Stokku tracks expiry dates, ensuring the warehouse staff follow first-expiry, first-out when issuing products.
  • Real-time data visibility: Warehouse staff and higher-level managers have access to real-time stock status. These stock levels are updated automatically when the warehouse receives or issues products. This allows for quick decision making for emergency supplies or reallocations.
  • Inter-level communication: Users between levels can communicate through the application, which automatically sends requests, alerts, and reminders to users when stock is short, there is oversupply, reports are due, etc. In addition, the application is linked to the JSI-developed Inventory Management and Monitoring (MIM) tool that enables the warehouse manager to receive delivery orders automatically.
Impact

The introduction of a mobile application at province and district warehouses has provided the FP supply chain program with a solid foundation to operate in the digital world. Stokku is being used to manage and distribute more than 15 FP products to 2,300 health facilities. It has allowed warehouse managers to achieve high standards, resulting in better customer service and a more efficient supply chain. By using Stokku, FP staff can spend more time on other critical supply chain tasks such as distribution, conducting supportive supervision, and monitoring. Purworejo District in Central Java Province has been using Stokku and made this video describing its distribution process.

Following the success of the pilot implementation, in July 2020, BKKBN, with support from the My Choice project, is scaling up the deployment of the digital tools countrywide to more than 500 district and 34 provincial warehouses. In addition, a health facility application that will provide end-to-end visibility of the supply chain across all levels is being developed. The two applications–mobile-based Stokku and web-based MIM–form a comprehensive digital supply chain system for the FP program known as SIRIKA, which in June was featured on CNN Indonesia. In the interview, BKKBN Head Hasto Wardoyo said “SIRIKA would reduce the overall warehouse operational workload, including recording and reporting. The quality of the data and level of reporting will also improve, thereby accelerating and strengthening the accuracy of calculating the contraceptive needs of the community. Program performance will also improve because the visibility of product access data and supply chain performance can be clearly seen so as to encourage the achievement of program targets.”

The FP program in Indonesia contributes to the Family Planning 2020 (FP2020) global movement that supports the rights of women and girls to decide freely and for themselves whether, when, and how many children they want to have. FP2020 is based on the principle that all women, no matter where they live, should have access to life-saving contraceptives. 

Achieving the FP2020 goal is a critical milestone to ensuring universal access to sexual and reproductive health services and rights by 2030, as laid out in Sustainable Development Goals 3 and 5. A strong and dynamic contraceptive supply chain system that provides universal availability of a full range of contraceptive methods is critical to achieving this goal.

As Indonesia works toward universal health coverage for all its citizens, the public sector is mandated to provide a full range of contraceptives to both public and private service providers. A supply chain system that can adapt to the changing method-mix and support the needs of an increasing number of new users is critical to meeting this mandate. 

Written by: Barbara Lamphere & Omar Balsara

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