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13h32 lise Presentation Transcript

  • 1. 1
    INS
    New technologies experience in Mozambique- Health Sector
  • 2. 2
    Challenge: how to implement new technologies to improve health care in resource limited setting
    Country Context Mozambique: Population 21 million
    • HR: oneofthelowest ratios ofhealthcareworkersperpopulation vs othercomparablesubsaharancountries
    • 3. Access: geographicallylargecountry, limitedinfrastructuremakingaccess to a 60% rural populationchallenging
    • 4. HIV representsapprox 45% ofpatientstreated – taxingalreadyoverburdenedHCW’sandsystem.
    Response to addressingchallengesandmeetingMDG’s 4+5
    • Introducednew mobile technologiesin 2009 for HIV programs
    • 5. Nationalexpansionin 2010
    • 6. Labourandneonatalcomplicationspilotingtechnologies- 2011
  • 3
    Mobile technologies in Mozambique
    Mobile devicescurrentlyinhealthfacilitiesandusedbymobile outreachteams:
    CD4: patientcanreceivetestresultsin 20 minutes
    SMS printers: testresultsfromlabsprintin real timeathealthfacilities.
    Hemocue I: testresultsin 2 minutes for hemoglobin
    Evaluationphase 2011:
    PCR/ViralLoaddevice
    Hemocue II: resultsofwhitebloodcellcount
    SMS- mobile phone: textmessaging to ANC and HIV+ womenfor followup – withnewguidelines
    TB mobile testingdevice
  • 7. Objectives ofthePointofCaredevices
  • 8. Expedited Results System (ERS)
    INS
    Server saves data and sends to printers, results only deleted once confirmed receipt from the printer
    Data codified when sent via GPRS with no possibility of erroneous transmission
    Admin sends results using automated software, saving precious tech time
    Server
    GPRS Wireless Network
    Internet
    Printer simple “black box” so HCWs only need to plug in and await their results
    Real-time stats
    Printer in Health Center
    Lab Database (LIS)
    Lab manager can monitor results transmission and know if printers are functioning or not
    5
  • 9. “Real-time” Statistics for Program Monitoring
    INS
  • 10. ExpeditedResultsSystem: Impact
    Result Ready
    Result to Patient
    Sample Collection
    Result to Site
    Sample at Lab
    Patient Enrolled C&T
    Todayover 40% of sites receiveresultsin 28 days
  • 11. INS
    Mobile CD4 ResultsfromPhase 1
  • 12. POCT: Mobility and Capacity for hard to reach areas
    Community Health Care workers like Martins visit communities by foot in order to deliver ARVs and to monitor CD4.
    During 2010 this unit produced more than 360 CD4 results for patients in northern Lago district. This compares to only 30 CD4 tests performed in 2009 (samples sent to reference laboratory.)
  • 13. Mobility for hard to reach areas: mobile testing to 35 communities with no road access in North Niassa.
  • 14. Patient Benefits
    Mr. J. – Cobue
    Needs to walk 8 hours to get to the health post. Visited the site on this day to pick up his ARV refill. Since his last CD4 was 8 months ago, the community HCW performed a CD4 and the doctor reviewed the result on the same day.
    Mrs. A. – Metangula
    “It will help me a lot not to come too many times to the health center since I live 4 hours away by foot. Some times I have come to my consultation just to be told that my CD4 result has not come back yet from the [reference] lab in Lichinga”
  • 15. 12
    AcknowledgementsandPartners
    NationalInstituteofHealth
    MinistryofHealth
    Provincial DirectoratesofHealth
    UNITAID
    ARK – AbsoluteReturn for Kids
    UNICEF
    IrishAid
    CDC
    Sequoia Technologies
    Mcell Mobile Company
    Alere