mTrac: Using technology to improve health operations in Uganda
Only a few months ago, Mukono Health Centre IV was hampered by drug shortages, an inefficient information system, and a lack of personnel. Helpless patients lined the hallways and for Esther Mbambu, a nursing assistant at the centre, it was painful to turn away sick people in their hour of need.
As she contemplated resignation, things changed for the better with the introduction of mTrac, a new SMS-based technology connecting hospitals to the national drug chain. "mTrac has changed everything," says Mbambu, adding that, the health centre used to take almost a month without drugs which forced them to turn away patients.
mTrac has standardized drug management and operations. Cathy Mugisha, a Medical Records Officer at Mukono Health Center, observes that with mTrac, replenishment of depleted drug stocks is only a click away. “We don’t have to spend money on fuel to drive to National Medical Stores just to inquire about drugs. We simply SMS and this triggers an immediate response that culminates in delivery of medicines to the health facility.” She says that with the stable availability of medicine more patients are being treated at the center.
mTrac is one of the leading government-led mobile health initiatives that is taking advantage of growing mobile phone ownership rates in Uganda to complement the existing Health Management Information System (HMIS).
Through the toll free mTrac SMS Hotline (8200), any community member can report health service-related issues, including stock-outs of essential drugs in hospitals. Currently, more than 10 million mobile subscribers are capable of engaging with the government in monitoring of health services through mTrac using free SMS messages. It is a service that is rapidly gaining popularity among low income families that do not have access to computers, but own phones.
The mTrac Community Outreach Coordinator, Lilian Nabunnya is urging all mobile users in Uganda to start using it to demand for better health care. Using artemisinin-based combination therapies (ACTs) as an entry point, the system will generate real time information that will facilitate planning and accountability for medicines.
“Through mTrac, we will be able to monitor and track malaria death rates, and the availability of ACTs from the national level down to the community,” says Dr Eddie Mukooyo, Assistant Commissioner Health Services at the Ministry of Health.
Currently, researchers are still grappling with efforts to make innovations such as mTrac sustainable and efficient. The Ministry of Health is training Ugandan software programmers to be able to maintain and continuously improve the mTrac solution geared towards improving quality of health care. In addition, health workers are using simple, non-expensive mobile phones to send weekly reports, which minimize the previous paper based method of reporting related costs. Consequently, districts spend less than USD $2 to run mTrac per month, significantly less expensive than ferrying paper reports on motorcycles in the past.
UNICEF mTrac Coordinator, Sean Blaschke, says that by capturing real-time data throughout the continuum of care, bottlenecks can be immediately identified and addressed while accountability at all levels is strengthened. Over 57 districts have received mTrac training so far and over 1,000 health facilities are submitting data via mTrac. These numbers are expected to rise quickly, with plans to complete national scale-up due before December 2012.
The Ministry of Health and her partners - National Medical Stores, the Medicines and Health Services Delivery Monitoring Unit, UNICEF, WHO and DFID - have prioritized nationwide awareness campaigns to empower stakeholders and the general public to stimulate action in health facilities at all levels.