Digitization at the Last Mile: A case study of 2 leading approaches to integrating supply chain, service delivery and health financing data

Supply chains are the backbone of health service delivery, yet last-mile visibility on commodity availability and consumption remains elusive in many health systems that operate with fragmented, outdated data—undermining effective planning and accountability.

Digitization offers a transformative solution: by linking supply chain, service delivery, and health financing data, systems can shift from reactive management to predictive, integrated planning that delivers visibility and accountability all the way to the last mile. The question is no longer whether digitization is needed, but how to implement it effectively.

In fragmented health systems where governments struggle to maintain visibility across diverse last-mile health facilities, digitization offers a pathway to achieving supply chain stewardship—enabling governments to plan, coordinate, and hold actors accountable across all distribution and service delivery channels. 

This case study, “Digitization at the Last Mile: A Case Study of Two Leading Approaches to Integrating Supply Chain, Service Delivery and Health Financing Data”, aims to highlight the advantages offered by last-mile digitization solutions in capturing transactional or encounter-level information for supply chain decision-making. It examines two distinct approaches to digitizing last-mile facility data: 

1. Adopting a unified platform | Use case: Elephant Operating System, Enugu, Nigeria 
   Elephant-OS integrates and analyzes inventory, clinical and payments data across 120+ public health facilities in Enugu within a single platform to guide planning and decision-making by state government officials. Over 87,000 patients have been registered since deployment, and nearly 450 health workers have been trained. The system is fully funded by user fees, with annual micropayments of less than $1 per user—an approach well suited to health systems where few or no digital systems are in place.   
    
2. Aggregating independent solutions | Use case: Rural Health Operating System, Rwanda 
   RHOS employs a collection of tools to integrate and analyze supply chain, clinical, payments and operations data from independent solutions deployed across 126+ health posts. About 700,000 patients have been served, and nearly 820 health workers have been trained. The system is fully funded by donors, with plans to transition to a self-sustaining operating model, making this approach ideal for health systems with multiple existing digital platforms.