2009 Partners In Hope

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2009 Partners In Hope

  1. 1. Building Sustainable Strategic Information Systems in Low-Resource Countries Bobby Jefferson Senior HMIS Advisor AIDSRelief project Futures Group International LLC Presenting on behalf of Lanette Burrows, Pat Bass, Ian Wanyeki
  2. 2. AIDSRelief Overview • PEPFAR Track 1.0 Initiative – Catholic Relief Services – Prime (CRS) – University of Maryland Institute of Human Virology (IHV) – Futures Group – Catholic Medical Mission Board (CMMB) – Interchurch Medical Association (IMA) • 5-year project focused on increasing access to high quality HIV care and treatment
  3. 3. AIDSRelief Overview • Implemented in 9 countries: – Guyana, Haiti, Kenya, Nigeria, Rwanda, South Africa, Uganda, Tanzania, Zambia, Ethiopia (April 2009) • Focus on building capacity for quality HIV care and treatment – lab, pharmacy, clinical services, M&E • More than 212 local partner treatment facilities (LPTF) – Small Rural Health Centers – Rural Health Clinics – District Hospitals – Mission Hospitals – Urban High Volume hospitals
  4. 4. Where we work 7 29 212 ART Treatment 18 Facilities (Clinics) 10 25 + 122 satellite Sites + 288 78 3 PMTCT sites 18 24
  5. 5. Futures Group Overview • Futures Group provides strategic information (SI) capacity building and focuses on: – Improved data demand and information use (DDIU) – Enhancing/implementing patient monitoring and management (PMM) systems that meet local requirements – Enhancing Data quality for better services and clinical outcomes – Using local experts to build capacity at partner sites
  6. 6. Regional Software development teams in Kenya, Rwanda, South Africa, India
  7. 7. Strategic Information • Committed to collecting only information essential for clinical management and quality improvement • Capacity building (local ownership) • Committed to feeding back information to the local partner treatment facility (Clinic) to address gaps in program and services
  8. 8. • To offer a library of tools and solutions built around adaptive management, high quality data, and sustainability • Freely available software, no licensing fees • User , Admin Training, and In-country Programmer or Database Training available • To develop requirements through practical field experience and lessons learned • To take a collaborative approach using local experts throughout the development process
  9. 9. Patient Management and Monitoring Typical Hospital Records Center
  10. 10. Finding patient information in the past
  11. 11. Key Features • Stability and ease of use – A browser-based, easy-to-use software tool with robust underlying SQL database – No Internet access required to use system • Facility and Patient Dashboards • Real Time data entry and reporting • Custom reports
  12. 12. Monitoring our programs through IQSolutions Demonstrate outputs and outcomes – Clinics ability to hit set targets – Trend analysis – CD4 count changes – Mortality & Lost-to-follow-up rates Case studies demonstrating outcomes Using data collected on a routine basis for: – Life table analysis – Defaulter tracking – Quality of life analysis
  13. 13. “After successful assessment, the IQ Care system developed and supported by the Constella Futures Group and Catholic Relief Services came up top in terms of overall features (technical and non technical) and also in terms of largest number of installations “ “From the above data, IQ Care comes out strongly ….recommended for medium to large ART centres.” WHO and CDC sponsored EMR Assessment Report , Kenya May 2009
  14. 14. Implementing Number of Number of IQCare Sites Patients Kenya 28 65,500 Uganda 20 63,000 Nigeria 27 60,000 Total 75 188,500
  15. 15. What does it provide us with? ARV Pickup Report Missed ART > 20 days in August- December 2008 per LPTF Local Partner August September October November December Hospital # 1 78 21 12 4 3 Hospital # 2 51 23 5 0 0 Hospital # 3 25 22 7 5 5 Hospital # 4 17 19 13 1 1 Hospital # 5 5 0 0 0 0 Hospital # 6 5 1 0 0 0 Hospital # 7 2 0 1 1 2 Hospital # 8 1 1 0 0 0 Hospital # 9 0 0 0 0 0 Hospital # 10 0 0 0 0 0 Hospital # 11 0 0 1 0 0 TOTAL 184 87 39 11 11
  16. 16. What does it provide us with? Close monitoring of the ART pick up habits over time at LPTFs has helped ensure that fewer patients miss collecting their ARTs on time All sites 200 180 184 160 140 120 100 87 80 60 39 40 11 20 11 0 August September October November December
  17. 17. Reporting • ARV Pickup Report • CDC Track 1.0 Quarterly Report • Monthly TRAC MOH reports • Custom user and Data quality reports • Cohort mortality report • Display on screen or export to Excel
  18. 18. Three sites showing the sub-districts they service
  19. 19. # Defaulters per village – Green <5, Yellow 5-10, Red >10
  20. 20. Capacity Building and decision making • Identify defaulters per village or sub-district – Deploy adherence counselors to follow-up • Identify trends – Link defaulter data to average distance travelled or average time taken reach the site • Provide supplemental services (transport) • Open field service centers
  21. 21. Select a village to see the defaulter list and HCW assigned
  22. 22. Other Developments • Electronic first (E-First) data entry • Paperless Clinics – Pilot in Kenya – Pilot in Nigeria Clinic • Wireless at Clinics – Security, Use of HTTPS, – OpenSSL
  23. 23. # Defaulters (red) vs avg distance travelled to reach site (blue) Thank you

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