This document proposes using DHIS 2 Tracker to track mother-infant pairs across PMTCT services in order to reduce loss to follow up. Currently, high rates of loss to follow up occur when women do not complete preventive treatment or infants do not receive necessary testing. The DHIS 2 Tracker could track progress through the PMTCT cascade regardless of service location, track referrals, and link mother and infant data to improve infant monitoring. It would generate appointments, mark their completion, and issue alerts for missed appointments. This would allow programs to better monitor the PMTCT cascade and improve outcomes.

1. Tracking Mother-Infant Pairs
across the Cascade of the Prevention
of Mother-to-Child Transmission of HIV
Using DHIS 2 Tracker
Cristina de la Torre, DSc
MEASURE Evaluation
ICF
May 7, 2018
USAID Meeting

2. High loss to follow-up (LTFU) among clients of
prevention of mother-to-child transmission of
HIV (PMTCT) services
• Women not adhering to preventive treatment
• HIV-exposed infants not getting the testing and
care they need
• Poor linkages across services
Problem Statement (1)

3. Information systems are unable to track
clients across clinics or providers when:
• Referrals are made
• Clients self-transfer to a new clinic
Problem Statement (2)
• The full spectrum of
services is not available
in the antenatal care
(ANC) clinic: e.g.,
antiretroviral treatment
(ART), labor and
delivery, and early
infant diagnosis (EID)

4. https://www.measureevaluation.org/resources/publications/ms-18-
127
• DHIS 2 Tracker: Designed to
track people or events
longitudinally
• DHIS 2 is an open source
solution
• Many countries have local
capacity to work with DHIS 2
• Guidance designed to use DHIS
2 Tracker as-is:
• Requiring no additional
programming

5. Purpose of the Proposed
DHIS 2 PMTCT Tracker
• Track progress of a mother-infant
pair along the PMTCT cascade,
regardless of where they obtain
care
• Track referral completion
• Link mother and infant data to
improve monitoring of HIV-exposed
infants
• Alert providers when appointments
are missed
• Generate longitudinal data for
monitoring of PMTCT cascade

6. Functions of the PMTCT
Tracker
• Generate one off or recurring appointments
for the mother and/or child
• Any clinic can create an appointment
• Any clinic can mark it as completed
• Monthly ART visits, delivery, and infant
testing have due dates and generate alerts
when missed or not confirmed
• Upon delivery, prompts to create a linked
record for child(ren)
• Monthly reports generated to show all
clients who are overdue

7. PMTCT Tracker not an EMR
• Track only key milestones along continuum
of care
• Minimum data to monitor completion of
prevention measures
• DHIS 2 does not have the same data
security as EMR systems.

8. Guidance Document (1)
• Assessing the Environment
• PMTCT program and context in which it operates
• Existing monitoring tools
• Infrastructure, data policies, information technology
(IT) capacity (central- and facility-level)
• Planning for Tracker Development
• Intended for PMTCT program managers
• Define scope and requirements
• Data needs
• Tools and reporting structure
• Assigning unique identification numbers
• Governance to oversee development and
implementation
Content Overview

9. Guidance Document (2)
• System Design and Configuration
• Intended for technical staff
• Describes DHIS 2 tracker structure and
implications for a patient tracker
• Proposes an overall structure for the PMTCT
Tracker
• Detailed guidance for configuration
• Defining program stages, setting up
repeatable programs, enabling different
facilities to open and close appointments,
generating prompts, notifications, reports,
analytics, linking mother and infant records
etc.
• Handling dates
Content Overview

10. Guidance Document (3)
• System Design and Configuration
• Setting up organization hierarchy
• Data security and protecting confidentiality
• Data entry options (web-based, mobile, etc.)
• Hosting
• User roles and permissions
• Data Sharing
Content Overview
Source:Shutterstock
Much of this guidance is
relevant to any patient tracker

11. Global, five-year, $232M cooperative agreement
6 partners, led by the University of North Carolina at Chapel Hill
Strategic objective:
Strengthen capacity in developing countries to gather,
interpret, and use data to improve health

12. Local partners and
capacity building are key
 Prime: UNC-CH and partners:
 ICF
 John Snow, Inc.
 Management Sciences for Health
 Palladium
 Tulane University
 MEASURE Evaluation works with more than
72 smaller sub-awardees in over 27
countries
 Over 26 percent of project funding goes
back to minor sub-awardees

13. Global footprint (more than 40 countries)

14. This presentation was produced with the support of the United States
Agency for International Development (USAID) under the terms of MEASURE
Evaluation cooperative agreement AID-OAA-L-14-00004. MEASURE
Evaluation is implemented by the Carolina Population Center, University of
North Carolina at Chapel Hill in partnership with ICF International; John
Snow, Inc.; Management Sciences for Health; Palladium; and Tulane
University. Views expressed are not necessarily those of USAID or the United
States government.
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