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Improving patient care through improved patient tracking


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Use and applications of the WHO HIV care and ART patient monitoring system

Use and applications of the WHO HIV care and ART patient monitoring system

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    • 1. Improving patient care through improved patient tracking Use and applications of the WHO HIV care and ART patient monitoring system
    • 2. The need
      • Context: Universal Access; the Three Ones; chronic care, ~ 7 million in need of ART, ~2 m have access (end 2006) 1
      • Simple, scalable, harmonized patient monitoring systems that facilitate management of patients and monitoring of programs
      • Increased demand for accountability
      • Decision making based on evidence at all levels of the health system
      1 World Health Organization (WHO). Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector. Progress Report. Geneva, WHO, April 2007.
    • 3. The MEASURE Evaluation activities
      • Support to WHO for HIV care/ART patient monitoring activities
      • TA for HMIS strengthening in Cote d’Ivoire
      • TA to Nigeria’s National Reporting and Information System (NNRIMS)
      • Global Fund TA, Togo
      • Data Quality Assessments
    • 4. Results
      • The guidelines and training materials
      • Hundreds of program managers, M&E specialists and clinicians trained
      • Countries supported
    • 5. Results (continued)
      • In the process of adaptation/implementation:
      • Ghana
      • Haiti
      • Nigeria
      • Moldova
      • Mozambique
      • Myanmar
      • Namibia
      • Nepal
      • Sri Lanka
      • Swaziland
      • Tanzania
      • Ukraine
      • Zimbabwe
      • Adapted and in use:
      • Côte d’Ivoire
      • Djibouti
      • Ethiopia
      • Guyana
      • India
      • Indonesia
      • Kenya
      • Lesotho
      • Senegal
      • Somalia
      • Sudan
      • Uganda
      • Viet Nam
      • Yemen
      • Zambia
    • 6. Ethiopia- Patients accessing treatment (September 2006) Source: Overview of ART PM, Eleni Seyoum, M&E Officer, WHO/MOH Ethiopia, presentation at the Harare AFRO anglophone patient monitoring training, September 2006
    • 7. Cote d’Ivoire- June 2007 Source: Rapport Semestriel VIH- Janvier-Juin 2007, Cote d’Ivoire
    • 8. Cumulative number of patients ever started on ART Source: Dr Abdoulaye S. WADE et collaborateurs, Division Sida/IST, report to the COMITE INTERNE DE LUTTE CONTRE LE SIDA, 04/01/2008
    • 9. India- August 2006 6 months (n=5,241) 12 months (n=2,248) 24 months (n=388) Treatment outcome of patients at 6, 12 and 24 months after start of treatment Alive on ART 81% Alive on ART 84% Alive on ART 73% Died 6% Died 8% Died 13 % Lost 8% Lost 13% Lost 9% Stopped 2% Stopped 1% Stopped 2% Source: Effectiveness of India’s Public Sector Antiretroviral Treatment Programme Khera A., Dharamshaktu N.S.,Rewari B.B., Tassie J, Chan P., Mahanty B., Garg R., August 2006, Contact: 1 National AIDS Control Organization, New Delhi, India, 2 World Health Organization, Regional Office, New Delhi, India, 3 World Health Organization, India Office, New Delhi, India
    • 10. Challenges
      • Simplification needed to decentralize to the primary health care level
      • Paper  Electronic continuum
      • Need to evaluate implementations of the system
    • 11. Challenges (continued)
      • Linkages- PMTCT, TB, <5, community-based interventions
      • Supportive supervision
      • Data quality
    • 12. Special thanks to the overwhelmed, understaffed but very motivated health workers providing care and support to PLHAs From Frank Lule, MoH Uganda