Tanzania Supply Chain Pharmacy Module Database Utilization in addressing AIDS Patients Loss to Follow-Up at Nyamagana MC, Mwanza Region.

Introduction

Loss to follow-up (LTF) for Patients’ on ART is one of the major challenges in AGPAHI supported HIV Care and Treatment Centers. LTF contributes 33% of the total attrition as per the Oct – Dec, 2017 Data at Nyamagana MC in Mwanza.

This study reports the use of Pharmacy Module Database and CTC2 Database in addressing the challenge of LTF.

Figure 1: Programmatic performance of the 3 facilities; Clients Current on ART vs LTF across the 3 Quarters (Oct, 2016 – June, 2017)

Methods

  • Bugando Medical Centre, Sekou Toure RRH and Mwananchi Hospital were selected based on programmatic and supply chain criteria
  • Used the list of existing LTF from the CTC2 Database
  • Used the updated PMD to check if the identified LTF clients have been dispensed with ARVs medication during the same Quarter/Month (Innovative Procedure).
  • Data cleaned False LTF
  • Updated False LTF (Traditional Procedure).Yield (Impact) Evaluation

Methods

  • Bugando Medical Centre, Sekou Toure RRH and Mwananchi Hospital were selected based on programmatic and supply chain criteria
  • Used the list of existing LTF from the CTC2 Database
  • Used the updated PMD to check if the identified LTF clients have been dispensed with ARVs medication during the same Quarter/Month (Innovative Procedure).
  • Data cleaned False LTF
  • Updated False LTF (Traditional Procedure).Yield (Impact) Evaluation

Results

  • 15% were recovered (118 out of 779) as these were not LTF, however 779 clients represent 21% of the cumulative reported LTF (3,753).
  • Oct – Dec, 2016; there were 346 clients reported as New LTF, reviewed 54 (16%), and Not LTF were 11(20%).
  • Jan – March, 2017; there were 352 clients reported as New LFT, reviewed 352 (100%), and Not LTF were 50 (14%)
  • April – June, 2017; there were 374 clients reported as new LTF, reviewed 373 (99.9%), and Not LTF were 57 (15%).

Criteria for Facility Selection for Intervention

  1. Program Criteria;
  • Facility from scale up council
  • Gradual increase of LTF; New LTF greater than 5%
  • Clients current on ART = More than 1,000
  1. Supply Chain Criteria;
  • Availability of Pharmaceutical Personnel at CTC
  • Compliance with Pharmacy Module Database’s Standard Operating Procedure (SOP)
  • PMD Functioning; Greater than 12 Months
  • Best match R&R (PMD) Vs R&R (e-LMIS)
  • Supply Chain Performances; For 12 Months

                  1.Emergency Order = 0

                  2.Reporting Rate (4/4 =100%)

                  3.Timely Submission; (4/4 = 100%)

Figure 2: Summary of the Intervention Yield for the three facilities for 3 Consecutive Quarters

Discussions

Pharmacy module database is the tool that captures the daily attendance of clients at the clinics during ARVs medication dispensing; therefore,

  • The system is the only promising tool to provide evidence based information for the clients attending the facilities and being compared with the CTC2 Databases of the same facilities.
  • Pharmacy Module Database has proved to be the best solution for programmatic challenges.
  • The intervention has improved data quality for the key indicators in the program; Clients current on Care and Clients current on Treatment.

Conclusion

1.The Poor adherence of SOPs in management of Client Files and clients Flow, and Late updating of the CTC2 Files present as major reasons for having False LTF at the facilities.

2.Prompt intervention on monthly basis is an efficient  approach in addressing False Loss to Follow Up at the facilities using appropriate tools such as Pharmacy Module Database.

References

1.Electronic  Logistics Management Information System (e-LMIS) for logistics data

2.NACP CTC2 Database for morbidity data

3.NACP Pharmacy Module Database for logistics data

 

What We Do

  • Provision of Comprehensive HIV Care +

    The purpose of** Boresha Project** is to support comprehensive facility-based HIV testing, care, treatment and support service provision in 9 scale-up and 25 sustained districts in the five lake zone regions of Geita, Mara, Mwanza, Simiyu and Shinyanga. .

  • CIFF Reprogramming +

    Project Goal is to improve health services to prevent HIV transmission, increase identification of adolescents with HIV infection, and improve HIV care and treatment and retention for ALHIV in Tanzania.

  • TB in the Mining Sector Programme +

    TB in mining sector (TIMS) project is funded by Global fund through Development Aid from People to People (ADPP - Mozambique). AGPAHI is a sub-recipient of ADPP Mozambique.The project target is to screen TB to approximately 30,000 mine workers and their families.

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