Uptake of electronic logistic management information system of anti-tuberculosis commodities at public health facilities in Kilimanjaro region, Tanzania

Abstract

ABSTRACT Background: Efficient management of Anti-TB commodities is crucial for sustaining an uninterrupted supply chain. Utilizing an electronic health system like the Electronic Logistic Management Information System (eLMIS) is essential for improving supply chain performance, ensuring adequate quantities, and enhancing healthcare outcomes. Tanzania has recently adopted eLMIS for managing Tuberculosis (TB), aiming to address challenges of the conventional paper-based system by enhancing data visibility and quality. However, there's limited literature on its uptake in healthcare facilities. Objective: This study aimed to assess the uptake of the Electronic Logistic Management Information System (eLMIS) for anti-TB commodities in public health facilities within the Kilimanjaro region of Tanzania. Materials and methods: This cross-sectional study utilized both quantitative and qualitative methods. For quantitative analysis, the study targeted public health facilities in Kilimanjaro specifically dedicated to managing TB. The focus was on assessing the uptake of eLMIS, crucial for inventory tracking and stock monitoring of anti-TB commodities. For qualitative insights, pharmacists and laboratory technicians directly involved in anti-TB commodity management and eLMIS utilization were interviewed. Data collection was done using data abstraction form and interviewer guide. Quantitative data was analyzed using stata 18, and for qualitative, step by-step content qualitative analysis approach was utilized. Results: A total of 19 public health facilities were included in the analysis. All the surveyed facilities had established eLMIS, however only 37% of the facilities utilized eLMIS for both pharmacy and lab commodities management, while 63% only used it for lab commodities. The findings from this study indicated varying degrees of availability of anti-TB commodities across pharmacy and laboratory items, with notable stock outs observed within 12 months, particularly for essential medications like Isoniazid (INH) 100mg and Gene Xpert MTB/RIF. The study on factors affecting the uptake of the eLMIS for anti-TB commodities in Public Health Facilities

(PHF) at the study site identified several significant challenges. These challenges included system disturbances, technical issues like poor internet connectivity and data input errors, inadequate user training, integration system challenges, and user perceptions and attitudes. Conclusion: The study revealed that while a considerable proportion of public health facilities in the Kilimanjaro region have adopted the eLMIS for anti-TB commodities management, its utilization remains suboptimal. The availability of anti-TB commodities varied across pharmacy and laboratory. Challenges affecting the uptake of eLMIS included system disturbances, technical issues such as poor internet connectivity, inadequate user training, integration system challenges, and user perceptions. Variability in availability of Anti –TB commodities may have caused low detection of TB patients also emerging of Multi drug resistance Tuberculosis due to stock outs of anti TB commodities. Addressing these challenges is imperative for enhancing system functionality and optimizing inventory management in public health facilities, thereby ensuring the consistent availability of anti-TB commodities for effective tuberculosis management.