PMTCT data management and reporting during the transition phase of implementing the rationalised Registers in Amathole District, Eastern Cape Province, South Africa

Background: The National Department of Health, in March 2015, launched the implementation of Rationalisation of Register, aimed at reducing the amount of time invested in completing the registers and collecting data. Therefore, the number of registers used in the South African healthcare facilities was reduced from 56 to 6. Objectives: This study explored the effect of the rollout of Rationalisation of Register on the documentation and reporting of Prevention of Mother-to-Child Transmission (PMTCT) programme data with the existing source documents during the transitional period, especially with routine data collected and reported at various health care system levels

Promoting Awareness of the Role of the District Clinical Specialist Team in the Amathole District, South Africa: A Valuable Specialty in Improving Healthcare Access and Quality

INTRODUCTION: This study explored the understanding of healthcare professionals on the role of the District Clinical Specialist Team (DCST) and how the team works together with the district personnel at different management levels to improve and strengthen the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme performance across four sub-districts in the Amathole district of the Eastern Cape Province, South Africa. METHODS: An interpretive qualitative case study was used to understand the role played by the DCST in improving PMTCT programme performance in the district. We used a purposive sampling method to select eight participants involved in providing technical assistance to support the implementation of the quality improvement programme. We conducted in-depth interviews with all the participants; all were females in their mid-forties. Data were analysed thematically by identifying themes and reporting patterns within the data. FINDINGS: Most interviewees were females in their mid-forties and had been at their respective facilities for at least five years. The findings were discussed based on three themes: capacity building, programme performance oversight and monitoring, and technical support. The DCST significantly enhances the staff's clinical skills, knowledge, and work performance to care for and manage the mother and baby pair. In addition, the DCST plays a vital role in providing programme oversight and complements the technical support provided by the Department of Health (DoH) managers and the quality improvement programme support by the South to South (S2S) team aimed at improving and achieving the PMTCT programme's desired outcomes. The DCST also provided additional support for data verification to identify gaps in the PMTCT programme. CONCLUSION: The role of DCST is essential in improving the quality and service provision of the PMTCT programme and is critical to assist the team at different levels in addressing challenges encountered and training and mentoring the needs of the staff. In addition, DCST's responsibilities cannot be fully achieved without a good working relationship with the quality improvement and district health teams because they work better together to ensure that the programme is performing optimally. TAKE-HOME MESSAGE: This study showed that the District Clinical Specialist Team is vital for improving the quality and service provision of the PMTCT programme and it is essential for addressing challenges encountered by healthcare facilities and the staff providing PMTCT services

Promoting Awareness of the Role of the District Clinical Specialist Team in the Amathole District, South Africa: A Valuable Specialty in Improving Healthcare Access and Quality

Introduction: This study explored the understanding of healthcare professionals on the role of the District Clinical Specialist Team (DCST) and how the team works together with the district personnel at different management levels to improve and strengthen the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme performance across four sub-districts in the Amathole district of the Eastern Cape Province, South Africa. Methods: An interpretive qualitative case study was used to understand the role played by the DCST in improving PMTCT programme performance in the district. We used a purposive sampling method to select eight participants involved in providing technical assistance to support the implementation of the quality improvement programme. We conducted in-depth interviews with all the participants; all were females in their mid-forties. Data were analysed thematically by identifying themes and reporting patterns within the data. Findings: Most interviewees were females in their mid-forties and had been at their respective facilities for at least five years. The findings were discussed based on three themes: capacity building, programme performance oversight and monitoring, and technical support. The DCST significantly enhances the staff’s clinical skills, knowledge, and work performance to care for and manage the mother and baby pair. In addition, the DCST plays a vital role in providing programme oversight and complements the technical support provided by the Department of Health (DoH) managers and the quality improvement programme support by the South to South (S2S) team aimed at improving and achieving the PMTCT programme’s desired outcomes. The DCST also provided additional support for data verification to identify gaps in the PMTCT programme. Conclusion: The role of DCST is essential in improving the quality and service provision of the PMTCT programme and is critical to assist the team at different levels in addressing challenges encountered and training and mentoring the needs of the staff. In addition, DCST’s responsibilities cannot be fully achieved without a good working relationship with the quality improvement and district health teams because they work better together to ensure that the programme is performing optimally. Take-home message: This study showed that the District Clinical Specialist Team is vital for improving the quality and service provision of the PMTCT programme and it is essential for addressing challenges encountered by healthcare facilities and the staff providing PMTCT services

PMTCT Data Management and Reporting during the Transition Phase of Implementing the Rationalised Registers in Amathole District, Eastern Cape Province, South Africa

Background: The National Department of Health, in March 2015, launched the implementation of Rationalisation of Register, aimed at reducing the amount of time invested in completing the registers and collecting data. Therefore, the number of registers used in the South African healthcare facilities was reduced from 56 to 6. Objectives: This study explored the effect of the rollout of Rationalisation of Register on the documentation and reporting of Prevention of Mother-to-Child Transmission (PMTCT) programme data with the existing source documents during the transitional period, especially with routine data collected and reported at various health care system levels. Methods: A mixed-method research approach was used, and three source documents, namely: Tally sheet, Antenatal care (ANC) register, and Tick register used for collecting and reporting PMTCT data, were reviewed. An in-depth interview was conducted with healthcare workers in four sub-districts of the Amathole district, Eastern Cape province of South Africa. Results: All selected facilities completed the three source documents. The facilities consolidated their PMTCT data monthly before reporting to the District Health Information System (DHIS). Less than half of the facilities had already started using the rationalised registers. However, they did not transition entirely because they still use other registers, especially the ANC register. Reasons for not displaying facility performance include clinicians not properly completing the clients’ information, and a shortage of staff to collect, report, and analyse data. Conclusions: PMTCT data management and reporting were challenging during the transitioning phase of implementing the rationalised registers because of different timelines instituted in the facilities and non-availability of source documents in some facilities. Capacity of the clinic staff involved in data collection should be built on programme care pathways, data monitoring, data capturing into the Routine Health Information System and complemented with coaching, mentoring, and supportive supervision for improved programme outputs and outcomes