Evaluating the Impact of the SMS for Life 2.0 Stock Visibility System on Antimalarial Medicine Stock-Outs in Togo: A 2018 Analysis of 100 Health Facilities

Stock-outs of essential antimalarial medicines at primary health facilities remain a significant barrier to effective malaria control in sub-Saharan Africa. Digital stock visibility systems, such as SMS for Life, have been deployed to improve supply chain management, but evidence of their impact in routine settings is limited. This study evaluated the effectiveness of the SMS for Life 2.0 system in reducing stock-out rates of key antimalarial medicines in public health facilities in Togo. A retrospective analysis was conducted using routine stock data from 100 health facilities participating in the SMS for Life 2.0 programme. Weekly stock reports for artemisinin-based combination therapies (ACTs) and rapid diagnostic tests (RDTs) were analysed over a one-year period. Stock-out rates were calculated and compared across facility types and regions. System implementation was associated with a reduction in stock-out incidence. The overall stock-out rate for first-line ACTs decreased by approximately 40% compared to the period prior to rollout. Stock visibility improved, enabling more timely replenishments. Challenges with consistent reporting from remote facilities persisted. The SMS for Life 2.0 system contributed to a decrease in antimalarial medicine stock-outs in the studied facilities, demonstrating its utility for strengthening supply chain visibility and management. Programme sustainability requires continued investment in health worker training and mobile network infrastructure. Future iterations should integrate the system with broader national health management information systems and explore automated data capture to reduce reporting burdens. stock-outs, antimalarials, supply chain, digital health, mHealth, Togo, health systems strengthening This study provides empirical evidence from routine programme data on the impact of a scalable, low-cost digital tool for improving antimalarial commodity availability.