TABLE 2.

Four Key Supply Chain Solutions Designed for Community Health, 2 Counties in Kenya

Supply Chain SolutionOld SolutionProblems Addressed
1. Paper-based stock record: redesigned to be highly visual, with circles for tallying, illustrations of the product and disease/conditionPaper-based stock record used in Siaya County, Kenya, that was in English with no illustrations

  • CHVs' low literacy levels

  • CHVs verbally reporting to supervisors

  • CHVs incorrectly recording data

  • Lack of standardized tool used by all communities to report on logistics data

2. cStock smartphone application: Redesign of the application that includes simplified navigation, context appropriate language, audio prompts, and visual cuesOriginal cStock smartphone application designed for Siaya County, Kenya

  • CHVs' illiteracy and language barriers

  • CHVs' lack of understanding of supply chain terms and concepts

  • CHVs' login challenges/user friendliness

3. CHV supervisor smartphone application: New cStock application for the CHV supervisors designed to be used to enter data for low literacy CHVs and to validate data plus allow for alternative supply arrangements during migrationInformal processes already in place

  • CHVs' with low tech capacity and low literacy levels had difficulty with data entry and data quality monitoring

  • Supervisors previously reporting on CHVs' behalf but in a nonsystemized way

4. USSD reporting system: Hybrid USSD and SMS reporting structure to be used by CHVs to report on supply chain data via a feature phone, eventually reiterated to be only USSD reportingSMS only system used in Siaya County, Kenya

  • Some CHVs lacking smart phones

  • CHVs' challenges entering symbols for structured SMS option

  • CHVs' difficulty with case-sensitive SMS structure

  • USSD only option has a time-out feature

  • Abbreviations: CHV, community health volunteer; SMS, short message service; USSD, unstructured supplementary service data.