Digitising Medicines, Transforming Care: A case-study from Malawi
How systems like the Malawi eMMS can transform medicines management in LMICs
by Dr Helena Rosado, Research and Evaluation Lead
Healthcare systems around the world are under increasing strain. An ageing global population, rising rates of chronic disease, and the growing complexity of patient care – often involving multiple co-morbidities – are placing immense pressure on health services.Â
In high-income countries, digital transformation is underway to help manage these challenges, with investments in electronic health records, clinical decision support tools, and integrated data systems. However, this transition is far from straightforward, involving navigating complex legacy systems, ensuring interoperability and safeguarding data security and privacy.
These challenges are even more pronounced for low- and middle-income countries (LMICs) like Malawi. While grappling with many of the same demographic and clinical complexities, LMICs often lack the foundational infrastructure, workforce capacity, and financial resources needed to support digital health transformation.Â
The Commonwealth Pharmacists Association’s Surveillance and Prescribing Support for Antimicrobial Stewardship Resource Capacity Building (SPARC) programme – in collaboration with the Southern African Programme on Access to Medicines and Diagnostics (SAPAM) – is working with the Malawian government to address these issues by developing a new electronic medicines management system (eMMS).
Why digital systems matter in medicines management
Many health facilities in LMICs rely on paper-based records, manual inventory systems, and fragmented information flows in their management of medicines. Without digital systems to track prescriptions, monitor stock levels, and analyse usage trends, healthcare providers struggle to ensure equitable access to high-quality medicines, reduce waste, and counter supply chain disruptions. These gaps compromise patient outcomes and weaken the ability of health systems to plan, respond, and adapt, particularly in the context of public health threats.
By integrating electronic tools into existing infrastructure, health systems can:
- Improve data accuracy and availability at the patient, facility, and national levels;
- Support adherence to treatment guidelines;
- Optimise supply chain operations to reduce stockouts and waste; and
- Empower healthcare workers with timely, actionable information.
Several LMICs have already begun this journey, introducing digital systems such as DHIS2 for health data management or Open Source Electronic Logistics Management Information System (OpenLMIS) for logistics.Â
But a critical gap remains: integrated, patient-level systems that bring together clinical and supply data in real time, both at the hospital level and in community settings, would offer LMICs an opportunity to further address inefficiencies and build more resilient, responsive health systems.
Transforming medicines management in LMICs: the Malawi eMMS
Malawi offers a compelling example of how digital innovation can begin to close this gap. Despite notable progress, its healthcare system has long struggled with fragmented systems, limited interoperability, and a persistent reliance on paper-based tools and analogue processes. As a result, clinicians often operate with incomplete information, hampering efforts to enforce prescribing and treatment guidelines, manage inventory efficiently, and generate reliable data to inform policy. These issues contribute to widespread challenges such as stockouts and poor resource allocation and lead to inefficiencies in patient care.
Recognising these gaps, the Malawian government, supported by development partners, has set out to strengthen its digital health infrastructure, as articulated in the Malawi Digital Health Strategy 2020–2025. A key initiative formed as part of this strategy is the Malawi eMMS.
The Malawi eMMS aims to tackle persistent bottlenecks and is designed to digitise key aspects of prescribing and inventory management, with a strong emphasis on real-time data, clinical usability, and integration into Malawi’s existing digital health ecosystem.
Key features of the eMMS include:
- Interoperability with existing systems, Malawi Health Information Systems (MaHIS) and OpenLMIS, through Application Programming Interfaces (APIs)
- Electronic prescribing and dispensing tools, in conjunction with MaHIS, to reduce reliance on manual charts
- Inventory tracking to support timely reordering and minimise stockouts
- Data dashboards for monitoring consumption patterns and prescribing behaviour
- Clinical decision support aligned with national treatment guidelines
“In many LMICs, the journey from paper-based systems to real-time, data-driven medicine management is both urgent and transformative.
“The Malawi eMMS reflects this shift – built locally, integrated with national health architecture, and designed to solve real bottlenecks from prescription to dispensing.
“For SAPAM, the eMMS represents more than just a digital tool – it’s a practical step toward sustainable, sovereign health systems that can respond to antimicrobial resistance, supply chain challenges, and patient needs in real time.”
Yunus Mohammed
Executive Director, SAPAM & Project Manager (Malawi eMMS), CPA SPARC
As part of SPARC, the eMMS is being piloted in selected hospitals in Malawi, with a phased approach that includes contextual analysis, training of healthcare workers, usability testing, and impact evaluation. Early findings show promise, with improvements in workflow efficiency, data quality, and clinical decision-making.
Malawi’s experience illustrates the broader potential of digital medicines management systems in resource-constrained settings. As more LMICs explore the shift from analogue to digital, locally developed and context-aware solutions like the eMMS can play a central role in driving systemic change.
Looking ahead, the eMMS has the potential to be scaled nationwide, expanded to manage other drug categories, and extended to the community. Its integration into Malawi’s broader digital health ecosystem positions it as a cornerstone of future healthcare reforms, with the added benefit of informing similar efforts across LMICs.
Digital transformation isn’t just about technology. It’s about creating systems that serve people better. The future of healthcare in LMICs depends not only on more resources but on smarter approaches.Â
The Malawi eMMS is showing how innovation – when grounded in context and collaboration – can bring real, measurable improvements to healthcare delivery. It’s a powerful reminder that even in resource-limited settings, the digital transformation of medicines management may prove to be one of the most powerful tools we have.
Dr Helena Rosado
Research and Evaluation Lead
About the author
Helena is a registered pharmacist in the UK and Portugal with over 20 years of experience in the health sector, working for not-for-profit, academic and private organisations as both a generalist and a specialist. She holds a degree in Pharmaceutical Sciences and a PhD in Medical Microbiology with postdoctoral fellowships in pharmaceutical and medical microbiology, policy, and practice.
Her key interests include global public health, the use of healthcare data for strategic decision-making, education and equity.
About SPARC and the Fleming Fund
Led and implemented by the Commonwealth Pharmacists Association, the SPARC programme is supported through a grant from the Department of Health and Social Care’s Fleming Fund, a UK aid programme supporting up to 25 countries across Africa and Asia to tackle AMR, managed by Mott MacDonald. The Fleming Fund invests in strengthening data surveillance systems through a portfolio of country grants, regional grants, fellowships and global projects managed by partners.