Engaging Communities in Commodity Stock Monitoring Using Telecommunication Technology in Primary Health Care Facilities in Rural Nigeria

  • Health Services Research and Managerial Epidemiology, Volume 2, Year 2015

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Study Justification:
– The study aims to address the challenges of frequent stock-out, pilfering, collection of user fees, and poor community engagement in the delivery of health services at the primary health care level in rural Nigeria.
– By utilizing telecommunication technology, the study seeks to engage members of the community in commodity stock monitoring, increase utilization of services, and promote accountability and community ownership.
Study Highlights:
– The pilot study involved 8 primary health care facilities in rural Nigeria.
– Telecommunication technologies were used to exchange information on stock monitoring.
– Data validation was done through cross verification from ward development committee members, officers-in-charge of the facilities, and beneficiaries.
– Results showed increased activity and cooperation between the ward development committees and officers-in-charge in monitoring commodity stock levels.
– There was a decline in the collection of user fees and a rise in overall access to free health care services by beneficiaries.
– The study demonstrates the effectiveness of mobile phones and telecommunication technologies in engaging communities to monitor primary health care stock levels and reducing user fees collection and pilfering of commodities.
Study Recommendations:
– Expand the use of telecommunication technology for commodity stock monitoring to more primary health care facilities in rural Nigeria.
– Strengthen the collaboration between ward development committees and officers-in-charge for effective monitoring.
– Advocate for policies that promote the reduction or elimination of user fees for health care services.
– Promote community ownership and accountability in the delivery of health services.
Key Role Players:
– Ward development committee members
– Officers-in-charge of primary health care facilities
– Beneficiaries (health facility users)
– Call center operators for data collection and analysis
Cost Items for Planning Recommendations:
– Telecommunication technology infrastructure and maintenance
– Training and capacity building for ward development committee members and officers-in-charge
– Data collection and analysis resources
– Advocacy and awareness campaigns for policy changes
– Monitoring and evaluation activities

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Background: With several efforts being made by key stakeholders to bridge the gap between beneficiaries and their having full access to free supplies, frequent stock-out, pilfering, collection of user fees for health commodities, and poor community engagement continue to plague the delivery of health services at the primary health care (PHC) level in rural Nigeria. Objective: To assess the potential in the use of telecommunication technology as an effective way to engage members of the community in commodity stock monitoring, increase utilization of services, as well as promote accountability and community ownership. Methods: The pilot done in 8 PHCs from 4 locations within Nigeria utilized telecommunication technologies to exchange information on stock monitoring. A triangulated technique of data validation through cross verification from 3 subsets of respondents was used: 160 ward development committee (WDC) members, 8 officers-in-charge (OICs) of PHCs, and 383 beneficiaries (health facility users) participated. Data collection made through a call center over a period of 3 months from July to September 2014 focused on WDC participation in inventory of commodities and type and cost of maternal, neonatal, and child health services accessed by each beneficiary. Results: Results showed that all WDCs involved in the pilot study became very active, and there was a strong cooperation between the OICs and the WDCs in monitoring commodity stock levels as the OICs participated in the monthly WDC meetings 96% of the time. A sharp decline in the collection of user fees was observed, and there was a 10% rise in overall access to free health care services by beneficiaries. Conclusion: This study reveals the effectiveness of mobile phones and indicates that telecommunication technologies can play an important role in engaging communities to monitor PHC stock levels as well as reduce the incidence of user fees collection and pilfering of commodities (PHC) level in rural communities.

The pilot study utilized a cross-sectional survey of 3 subsets of respondents predicated upon the use of telecommunication technologies. Eight PHCs were selected from 4 locations through a cluster sample of facilities with good access roads and strong telecommunication signal and a systematic random sample of high- and low-performing facilities from each location. Two facilities (1 low and 1 high client load) within 3 states and the Federal Capital Territory (FCT) participated. Twenty WDC members from each of the 8 facilities totaling 160 WDC members; 1 OIC from each facility, totaling 8 OICs; and 383 beneficiaries participated in the study. In summary, a total of 551 persons participated in the study. This pilot study was carried out in Enugu, Kano, and Lagos states including the FCT Abuja. Two primary health facilities were selected from each state, and the pilot study spanned for 3 months from July to September 2014 (Figure 1). Pilot study locations. The following indicators were established to guide the data collection process over a period of 3 months from July to September 2014. Data on stock and consumption levels of (tracer) drugs and commodities were retrieved from the WDC chairman and OICs biweekly, while beneficiaries data primarily verified commodities received, user fees paid, and satisfaction checks on services received (Table 1). Tracer Drugs/Commodities. A data recording template was developed on Excel spreadsheet to record data collected by call operators from each participant, and analysis was done using Microsoft Office Excel. Data were entered and analyzed for each category of respondents along with the key indicators being assessed by the study. Descriptive statistics were employed in reporting the findings.

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The recommendation to improve access to maternal health in rural Nigeria is to engage communities in commodity stock monitoring using telecommunication technology in primary health care facilities. This recommendation is based on a pilot study conducted in 8 primary health care facilities in rural Nigeria.

The objective of this recommendation is to increase utilization of services, promote accountability, and community ownership. By utilizing telecommunication technology, members of the community can actively participate in monitoring commodity stock levels, reducing the incidence of user fees collection, and pilfering of commodities.

The pilot study involved the use of mobile phones to exchange information on stock monitoring. Data was collected through a call center over a period of 3 months. The study included 160 ward development committee members, 8 officers-in-charge of primary health care facilities, and 383 beneficiaries.

The results of the pilot study showed that all ward development committees involved became very active in monitoring commodity stock levels. There was also a strong cooperation between the officers-in-charge and the ward development committees. The collection of user fees declined, and there was a 10% increase in overall access to free health care services by beneficiaries.

This study demonstrates the effectiveness of mobile phones and telecommunication technologies in engaging communities to monitor primary health care stock levels and improve access to maternal health services in rural communities.

The publication where this recommendation and pilot study were reported is “Health Services Research and Managerial Epidemiology,” Volume 2, Year 2015.
AI Innovations Description
The recommendation to improve access to maternal health is to engage communities in commodity stock monitoring using telecommunication technology in primary health care facilities in rural Nigeria. This recommendation is based on a pilot study conducted in 8 primary health care facilities in rural Nigeria.

The objective of this recommendation is to increase utilization of services, promote accountability, and community ownership. By utilizing telecommunication technology, members of the community can actively participate in monitoring commodity stock levels, reducing the incidence of user fees collection, and pilfering of commodities.

The pilot study involved the use of mobile phones to exchange information on stock monitoring. Data was collected through a call center over a period of 3 months. The study included 160 ward development committee members, 8 officers-in-charge of primary health care facilities, and 383 beneficiaries.

The results of the pilot study showed that all ward development committees involved became very active in monitoring commodity stock levels. There was also a strong cooperation between the officers-in-charge and the ward development committees. The collection of user fees declined, and there was a 10% increase in overall access to free health care services by beneficiaries.

This study demonstrates the effectiveness of mobile phones and telecommunication technologies in engaging communities to monitor primary health care stock levels and improve access to maternal health services in rural communities.

The publication where this recommendation and pilot study were reported is “Health Services Research and Managerial Epidemiology,” Volume 2, Year 2015.
AI Innovations Methodology
The methodology used to simulate the impact of the recommendations in this abstract on improving access to maternal health would involve the following steps:

1. Selection of study sites: Choose a representative sample of primary health care facilities in rural Nigeria that have similar characteristics to the ones used in the pilot study. Ensure that these facilities have good access roads and strong telecommunication signals.

2. Sample selection: Use a cluster sampling technique to select the facilities, ensuring a mix of high- and low-performing facilities from each location. Select a predetermined number of facilities from each state, including the Federal Capital Territory (FCT).

3. Participant selection: Identify and recruit participants from the selected facilities. This should include ward development committee (WDC) members, officers-in-charge (OICs) of the primary health care facilities, and beneficiaries (health facility users). Aim for a similar number of participants as in the pilot study.

4. Data collection: Develop a data recording template similar to the one used in the pilot study. Collect data on stock and consumption levels of drugs and commodities from the WDC chairman and OICs on a regular basis. Also collect data from beneficiaries on commodities received, user fees paid, and satisfaction with services received.

5. Data analysis: Enter and analyze the collected data using Microsoft Office Excel or a similar software. Calculate descriptive statistics to report the findings, similar to the pilot study.

6. Comparison of results: Compare the findings from the simulated study with the results of the pilot study. Look for similarities and differences in the level of community engagement, cooperation between OICs and WDCs, collection of user fees, and access to free health care services.

By following this methodology, researchers can simulate the impact of engaging communities in commodity stock monitoring using telecommunication technology in primary health care facilities in rural Nigeria. This will help assess the potential benefits and challenges of implementing these recommendations on a larger scale and further improve access to maternal health services.

Statistics:
Citations: 2
Authors: 8
Identifiers:
DOI: 10.1177/2333392815609143
Research Areas:
Community Interventions, Health System and Policy, Maternal and Child Health, Quality of Care, Social Determinants, Technology and Innovations
Study Countries:
Nigeria
Study Design:
Cohort Study, Cross Sectional Study, Grounded Theory
Study Approach:
Quantitative
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