13h32 lise


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13h32 lise

  1. 1. 1<br />INS<br />New technologies experience in Mozambique- Health Sector<br />
  2. 2. 2<br />Challenge: how to implement new technologies to improve health care in resource limited setting<br />Country Context Mozambique: Population 21 million<br /><ul><li>HR: oneofthelowest ratios ofhealthcareworkersperpopulation vs othercomparablesubsaharancountries
  3. 3. Access: geographicallylargecountry, limitedinfrastructuremakingaccess to a 60% rural populationchallenging
  4. 4. HIV representsapprox 45% ofpatientstreated – taxingalreadyoverburdenedHCW’sandsystem.</li></ul>Response to addressingchallengesandmeetingMDG’s 4+5<br /><ul><li>Introducednew mobile technologiesin 2009 for HIV programs
  5. 5. Nationalexpansionin 2010
  6. 6. Labourandneonatalcomplicationspilotingtechnologies- 2011</li></li></ul><li>3<br />Mobile technologies in Mozambique<br />Mobile devicescurrentlyinhealthfacilitiesandusedbymobile outreachteams:<br />CD4: patientcanreceivetestresultsin 20 minutes<br />SMS printers: testresultsfromlabsprintin real timeathealthfacilities. <br />Hemocue I: testresultsin 2 minutes for hemoglobin<br />Evaluationphase 2011:<br />PCR/ViralLoaddevice<br />Hemocue II: resultsofwhitebloodcellcount<br />SMS- mobile phone: textmessaging to ANC and HIV+ womenfor followup – withnewguidelines<br />TB mobile testingdevice<br />
  7. 7. Objectives ofthePointofCaredevices<br />
  8. 8. Expedited Results System (ERS)<br />INS<br />Server saves data and sends to printers, results only deleted once confirmed receipt from the printer<br />Data codified when sent via GPRS with no possibility of erroneous transmission<br />Admin sends results using automated software, saving precious tech time<br />Server<br />GPRS Wireless Network<br />Internet<br />Printer simple “black box” so HCWs only need to plug in and await their results<br />Real-time stats<br />Printer in Health Center<br />Lab Database (LIS)<br />Lab manager can monitor results transmission and know if printers are functioning or not <br />5<br />
  9. 9. “Real-time” Statistics for Program Monitoring<br />INS<br />
  10. 10. ExpeditedResultsSystem: Impact<br />Result Ready<br />Result to Patient<br />Sample Collection<br />Result to Site<br />Sample at Lab<br />Patient Enrolled C&T<br />Todayover 40% of sites receiveresultsin 28 days<br />
  11. 11. INS<br />Mobile CD4 ResultsfromPhase 1<br />
  12. 12. POCT: Mobility and Capacity for hard to reach areas<br />Community Health Care workers like Martins visit communities by foot in order to deliver ARVs and to monitor CD4. <br />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.) <br />
  13. 13. Mobility for hard to reach areas: mobile testing to 35 communities with no road access in North Niassa.<br />
  14. 14. Patient Benefits<br />Mr. J. – Cobue<br />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.<br />Mrs. A. – Metangula<br />“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”<br />
  15. 15. 12<br />AcknowledgementsandPartners<br />NationalInstituteofHealth<br />MinistryofHealth<br />Provincial DirectoratesofHealth<br />UNITAID<br />ARK – AbsoluteReturn for Kids<br />UNICEF<br />IrishAid<br />CDC<br />Sequoia Technologies<br />Mcell Mobile Company<br />Alere<br />