A cross-sectional pilot study assessing needs and attitudes to implementation of Information and Communication Technology for rational use of medicines among healthcare staff in rural Tanzania

Abstract

BackgroundIn resource-poor countries access to essential medicines, suboptimal prescribing and use of medicines are major problems. Health workers lack updated medical information and treatment support. Information and Communication Technology (ICT) could help tackle this. The impact of ICT on health systems in resource-poor countries is likely to be significant and transform the practice of medicine just as in high-income countries. However, research for finding the best way of doing this is needed. We aimed to assess current approaches to and use of ICT among health workers in two rural districts of Tanzania in relation to the current drug distribution practices, drug stock and continuing medical information (CME), as well as assessing the feasibility of using ICT to improve ordering and use of medicines.MethodsThis pilot study was conducted in 2010–2011, mapping the drug distribution chain in Tanzania, including problems and barriers. The study was conducted in Bunda and Serengeti districts, both part of the ICT4RD (ICT for rural development) project. Health workers involved in drug procurement and use at 13 health facilities were interviewed on use and knowledge of ICT, and their attitudes to its use in their daily work. They were also shown and interviewed about their thoughts on an android tablet application prototype for drug stock inventory and drug ordering, based on the Tanzanian Medical Stores Department (MSD) current paper forms.ResultsThe main challenge was a stable supply of essential medicines. Drug supplies were often delayed and incomplete, resulting in stock-outs. All 20 interviewed health workers used mobile phones, 8 of them Smartphones with Internet connection. The Health workers were very positive to the tablet application and saw its potential in reducing drug stock-outs. They also expressed a great need and wish for CME by distance.ConclusionThe tablet application was easily used and appreciated by health workers, and thus has the potential to save time and effort, reduce transportation costs and minimise drug stock-outs. Furthermore, the android tablet could be used to reach out with CME programs to health care workers at remote health facilities, as well as those in towns.

Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso

“…Designing a CDSS without considering the user perspective fails to provide interest, and can raise resistance to their use in daily practice (7,(9)(10)(11). The benefits of CDSS systems are ensured if they have a specific purpose, are "easy to use" and are adapted to the workflow at the healthcare facility (3,6,7,12,13).…”

“…One strategy to assist HCWs in rural Africa in undertaking skilled decisions is to give easy access to guidelines and information at the "point-of-care" by using a computerized clinical decision support system (CDSS) (6,7). Unfortunately, CDSS systems are commonly designed without a clear strategy for understanding the needs of end-users and their working conditions (3,9).…”

Developing a Challenges Landscape Relating to Drug Safety, Provision, and Distribution in Resource-Limited Settings for the Case of Hiv/Aids

“…Furthermore, when limited amounts of ART are available, ethical issues often arise about how the medication should be prioritised for different patients [23]. Delays in drug delivery in resource-limited settings are often caused by poor infrastructure such as poor roads and by financial burdens such as a lack of funding for fuel [37], [40]. The challenges posed by poor drug supply involve all aspects of the supply chain, from ordering systems to the storage and distribution of drugs.…”

“…The WHO defines a drug stock-out as the total absence of a medication that has been identified as essential at the point of service delivery [49]. Drug stock-outs are often the result of poor infrastructure and insufficient human resources [40], [50]. Although alternative ARTs are often provided in the case of a stock-out, it still poses the threat of drug resistance, as it might cause suboptimal drug levels [34].…”

Initiative to progress research on medicine utilization in Africa: formation of the Medicines Utilization Research in Africa group

“…Jaran Eriksen presented a number of drug utilisation studies he has been involved with including optimizing dosing regimens for ARVs in children and adults in Uganda (https://openarchive.ki.se/xmlui/handle/10616/41587); mHealth projects in pregnant women with HIV and their newborns (South Africa); algorithms for optimizing treatment in critical care (Tanzania) as well as studies assessing needs and attitudes to the implementation of information and communication technology (ICT) for rational use of medicines among healthcare staff in rural Tanzania (12).…”