Taking mHealth to Scale: Governing Tanzania’s Private Drug Outlets

Taking mHealth to Scale: Governing Tanzania’s Private Drug Outlets

 {Photo credit: Rachel Lieber/MSH.}ADDO owners and dispensers in Mafia Island, Tanzania, learn to use the mobile applications developed by SDSI. The applications allow ADDO personnel to access an SMS-based Pharmacy Council helpline, send service utilization reports to the Pharmacy Council, and to pay annual licensing fees via mobile money.Photo credit: Rachel Lieber/MSH.

Cross-posted with permission from mHealthKnowledge.org.

In the private sector, Tanzania has more than 1,000 pharmacies, 2,500 pharmaceutical personnel, 6,000 accredited drug dispensing outlets (ADDOs), and more than 18,000 ADDO dispensers. The Pharmacy Council of Tanzania has overseen these facilities and personnel since 2011, but lacked a comprehensive system to manage regulatory information. Without such a system, basic facility and personnel information was inaccessible, the locations of rural ADDO facilities were unclear, and tracking business and professional licensing status, including fees collection, was difficult. Furthermore, the Pharmacy Council had no way to efficiently communicate directly with the outlets.

Developing a user-driven mobile solution

MSH’s Sustainable Drug Seller Initiatives (SDSI) project partnered with the Pharmacy Council and Tanzania’s Invention and Technological Ideas Development Organization to develop a web-based information system with interoperable mobile applications. The system manages information on facility registration, personnel qualifications and certifications, inspections, and licensing fee payment status for retail outlets.

The complementary mobile technology applications include mobile money fee payment and SMS-based reporting and communication modules, including an automated response line based on keywords and a helpline to query the Pharmacy Council on issues such as trainings and licensing status. 

SDSI employed a user-driven approach, tasking ADDO personnel and Pharmacy Council staff to drive the design phase by identifying priority features and requirements for the technology. Such stakeholder input on the system design has helped ensure sustainability and scalability. The solution was developed using JAVA-based open source software to ensure affordability and adaptability. The mobile applications work with the basic mobile phones that the vast majority of ADDO personnel already own, which prevents the need to purchase smartphones and helps ensure the applications’ accessibility.

[ADDO owners and dispensers in Kibaha district, Tanzania learn to use the mobile applications developed by SDSI.] {Photo credit: Rachel Lieber/MSH.}ADDO owners and dispensers in Kibaha district, Tanzania learn to use the mobile applications developed by SDSI.Photo credit: Rachel Lieber/MSH.

SDSI held numerous working sessions with Pharmacy Council and ADDO personnel to ensure that the modules accurately reflected existing processes, envisioned improvements, and staff capacity to implement and manage the system. Moreover, by using open source technology and installing the necessary hardware, SDSI ensured that the Pharmacy Council has the infrastructure in place to maintain the system after the launch. By partnering with ADDO personnel and Pharmacy Council staff from the beginning, SDSI adapted industry best practices to meet both parties’ needs and simultaneously built local ownership into the system.

Early success indicates potential for scale-up

The system is being tested in pharmacies in Dar es Salaam and ADDOs in Pwani region with strong positive results–more than 75 percent of ADDOs successfully reported for the first 5 months. Between July and August, approximately 70 percent of the ADDOs in the pilot site paid their annual renewal fee of 18 USD per outlet per annum via the mobile money application totaling TZS 3,0 million (1,800 USD). Using the mobile money feature streamlined the fee collection process and saved time and money for both district staff and ADDOs, who no longer had to travel to submit or collect payments. Encouraged by these results, Tanzania is accelerating the wider roll out of the system. Pharmaceutical regulatory agencies in other countries have already expressed interest in adapting and implementing the technology.