C. Fan-Osuala

C. Isah

N. Sam-Agudu

O. Adeyemi

Annals of Global Health

Directory of Open Access Journals

Health Systems and Human Resources A n n a l s o f G l o b a l H e a l t h , V O L . 8 3 , N O . 1 , 2 0 1 7J a n u a r y eF e b r u a r y 2 0 1 7 : 1 8 – 5 836Program/Project Purpose: A pediatric HIV-focused non-profit(Pedi-HIV) sent its first cohort of US-trained physicians to provideHIV/AIDS care and treatment in clinics throughout sub-SaharanAfrica in 2005. A study conducted by BIPAI five years afterprogram implementation found that 11% of physicians reportedfeelings of depression during and after their placements. Contrib-uting factors to these feelings have been identified as dealing withlarge-scale death encountered in resource-limited areas (RLAs),long work hours in countries with a lack of trained, local medicalprofessionals, and adapting to a new culture in both work and socialsettings.Structure/Method/Design: The health, safety and well-being ofstaff should be as important as that of the communities served byhealth care delivery programs. In response to the study findings,Pedi-HIV sought to improve the pre and in-service trainingsprovided to physicians serving in global locations. New physiciansattend a month-long orientation and training course designed toenhance their ability to provide effective, high-quality care for chil-dren and their families in RLAs. In addition to sessions on HIV/AIDS and tropical medicine, the p;hysicians also attend sessionson the practicalities of working in RLAs, coping with grief afterdeath, as well as reflective practice and leadership.Outcome & Evaluation: Addressing the mental and emotionalhealth needs of long-term staff in RLAs requires a strategic approachwhich should begin during recruitment and continue through to thetermination process. Pre-service sessions are useful preparation forpotential challenges, but they are not sufficient to address the ongoingneeds of staff. Supplemental strategies identified by BIPAI include:formal in-country orientation with current physicians; site visits bythe Pedi-HIV headquarters staff; quarterly GHC performance evalu-ations and “check-in” calls and exit survey calls.Going Forward: Development of effective support systems forfield-based staff is an important component of human resourcesplanning. Although there is consensus that the emotional andmental health of staff has a tangible impact on program outcomes,there remain very few resources to help employees develop andmaintain efficient coping strategies. Pedi-HIV will continue todevelop and implement activities to support the mental andemotional well-being of Pedi-HIV staff working in RLAs.Source of Funding: Funding is provided by the non-profit.Abstract #: 1.041_HHRQuality Assessment of PMTCT Data Documentation amongUser and Non-User Data Clerks in a Nigerian PMTCT ProgramC. Fan-Osuala1, O. Adeyemi1, C. Isah1, N. Sam-Agudu2; 1Institute ofHuman Virology Nigeria, Abuja, Nigeria, 2University of MarylandBaltimore, Baltimore, MD, USABackground: High-quality routine data is needed to track progressand identify gaps in national PMTCT programs. In many resource-limited settings like Nigeria, the quality of data obtained from healthfacilities (HFs) has been poor. One of the major challenges is thedocumentation workload, in addition to non-utilization of datagenerated at the HF level. During the roll-out of a large PMTCTimplementation research study, we piloted a comprehensiveMother-Infant pair (MIP) register at study sites. Data quality ofMIP records was assessed by type of data clerk (DC) (User vsNon-User) documenting the data.Methods: The MIP register was adapted from multiple pre-exist-ing registers used to capture PMTCT data. We piloted the registerat 20 rural HFs and retrospectively reviewed records collected overan 18-month period. At 10 of the HFs, the register data wasroutinely used to provide patient care; at the other 10, the datawas only collected for reporting. Data documentation for 20 pre-defined indicators (10 maternal and 10 infant) was assessed for 10randomly-selected clients at each HF. A score of 1 and 0 wereassigned for complete and incomplete documentation, respectively.The level of completeness between the two groups was comparedusing proportions and t-test at p¼0.05.Findings: Of 20 indicators assessed, “Client Name” had the high-est level of completeness for both User and Non-User DCs, at 97%and 98% respectively. Level of completeness for most indicatorsalong the PMTCT cascade were all higher for User DCs vs Non-User DCs, respectively: “Maternal ART start date”: 81% vs 71%;“Infant feeding option”: 72% vs 28%; “Delivery Date:” 84% vs38%; “Date Infant Nevirapine given”: 77% vs 31%. Overall, themean score was significantly higher for User DCs than Non-UserDCs [73.40 (SD14.94) vs 47.35 (SD 4.94); p¼0.002.].Interpretation: The quality of documented PMTCT data washigher among DCs who routinely used the data. This suggeststhat registers developed for manual documentation should also befunctional with respect to delivery of care. Simplifying PMTCTdata collection tools and making them user-friendly for casemanagement is likely to improve the quality of data reported.Source of Funding: INSPIRE MoMent grant funded by WHOand Global Affairs, Canada.Abstract #: 1.043_HHRBarriers and Facilitators of Data Quality and Use in Malawi’sHealth Information SystemK. Finnegan1, M. Marx2, E. Kaludzu3, B. Malunga4, R. O’Hagan1,S. Yosefe5, I. Dambula5; 1Johns Hopkins Bloomberg School of PublicHealth, Baltimore, Maryland, USA, 2Johns Hopkins Bloomberg Schoolof Public Health, Baltimore, USA, 3Ministry of Health, Lilongwe,Malawi, 4National Statistical Office, Lilongwe, Malawi, 5Ministry ofHealth, Malawi, Lilongwe, MalawiBackground: The Malawi Ministry of Health’s health informationsystem (HIS) documents utilization of the health system, resourceavailability, and disease burden. Data are reported by MOH facili-ties to the central level monthly and stored in the HIS for reportingand program planning purposes. However, very few program plan-ners use these data. We used qualitative methods to understand keybarriers to use and perceptions of the quality of HIS data.Methods: We purposively selected specific cadres of health systemsactors to solicit their experiences and opinions about collecting andreporting data through the HIS, as well as data quality and use.Specifically, we conducted (4) focus group discussions with clinic-based data clerks and (4) key informant interviews (KII) withdistrict-based HMIS. KIIs were also conducted with (5) national

Quality Assessment of PMTCT Data Documentation among User and Non-User Data Clerks in a Nigerian PMTCT Program

http://www.annalsofglobalhealth.org/articles/10.1016/j.aogh.2017.03.078/galley/346/download/

Quality Assessment of PMTCT Data Documentation among User and Non-User Data Clerks in a Nigerian PMTCT Program

Abstract

Similar works

Full text

Available Versions

Directory of Open Access Journals