Reducing stock-outs of life saving malaria commodities using mobile phone text-messaging: SMS for life study in Kenya

PLoS One. 2013;8(1):e54066. doi: 10.1371/journal.pone.0054066. Epub 2013 Jan 17.


Background: Health facility stock-outs of life saving malaria medicines are common across Africa. Innovative ways of addressing this problem are urgently required. We evaluated whether SMS based reporting of stocks of artemether-lumefantrine (AL) and rapid diagnostic tests (RDT) can result in reduction of stock-outs at peripheral facilities in Kenya.

Methods/findings: All 87 public health facilities in five Kenyan districts were included in a 26 week project. Weekly facility stock counts of four AL packs and RDTs were sent via structured incentivized SMS communication process from health workers' personal mobile phones to a web-based system accessed by district managers. The mean health facility response rate was 97% with a mean formatting error rate of 3%. Accuracy of stock count reports was 79% while accuracy of stock-out reports was 93%. District managers accessed the system 1,037 times at an average of eight times per week. The system was accessed in 82% of the study weeks. Comparing weeks 1 and 26, stock-out of one or more AL packs declined by 38 percentage-points. Total AL stock-out declined by 5 percentage-points and was eliminated by the end of the project. Stock-out declines of individual AL packs ranged from 14 to 32 percentage-points while decline in RDT stock-outs was 24 percentage-points. District managers responded to 44% of AL and 73% of RDT stock-out signals by redistributing commodities between facilities. In comparison with national trends, stock-out declines in study areas were greater, sharper and more sustained.

Conclusions: Use of simple SMS technology ensured high reporting rates of reasonably accurate, real-time facility stock data that were used by district managers to undertake corrective actions to reduce stock-outs. Future work on stock monitoring via SMS should focus on assessing response rates without use of incentives and demonstrating effectiveness of such interventions on a larger scale.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Antimalarials / therapeutic use
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins / therapeutic use*
  • Cell Phone / statistics & numerical data*
  • Drug Combinations
  • Ethanolamines / therapeutic use*
  • Fluorenes / therapeutic use*
  • Health Facilities / statistics & numerical data
  • Humans
  • Kenya
  • Malaria / diagnosis
  • Malaria / drug therapy*
  • Malaria / prevention & control
  • Public Health / methods
  • Public Health / statistics & numerical data
  • Reproducibility of Results
  • Text Messaging / statistics & numerical data*
  • Time Factors


  • Antimalarials
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins
  • Drug Combinations
  • Ethanolamines
  • Fluorenes