IntraHealth improving lives
Residents of the Kavango East Region have seen a change in service delivery with the help of IntraHealth International, in collaboration with the US embassy, through the infant tracking system and SMS printing of results.
After the implementation of the Early Infant Diagnosis Programme by IntraHealth International with assistance funding from the US government and support from the Ministry of Health and Social Services, Nyangana Catholic Hospital in the Nyangana district in the Kavango East Region has moved to sufficiency through the infant diagnosis tracking system.
Dr Eric Hamani Sidile, senior medical officer at the hospital, testified to the benefits of the tracking system and its successful implementation. “With the help of the nurse mentors, we have seen a positive change within our service delivery towards the community. We work hand in hand with the nurses and this has been a very good arrangement,” said Sidile. The nurse mentors work together with registered nurses and midwives to avoid sending back patients when doctors are not available, as nurses in most situations are not authorised to conduct certain tests or put patients on treatment without the go-ahead from a doctor. “The help of nurses after they go through the mentorship was a good concept as we have now increased manpower and we can attend to more patients,” said Rightwell Zulu, nurse mentor of Nyangana Catholic Hospital.
After its establishment in 2015, preventing HIV transmission from mother to child has been successful. Zulu explained that it is the goal of every country to eliminate mother-to-child transmission of HIV, but without any form of records, it has proven to be difficult as the health facility did not have any numbers to fall back on. “The government has put up a lot of tools to make sure we eradicate Aids, but with no system in place, it was impossible to see how many babies have been exposed to the virus,” he explained.
“We have decided to put up a register, but there was no system set up to see how many babies have been tested so it was very challenging to measure our performance.”
Testing babies
The system involves testing babies from birth until they are said to have “graduated” from the programme. Graduation of these tested babies means that after the tracking has been done a baby has tested negative. Before the establishment of the tracking system, only a recorded number of 24% of babies had graduated from the programme, but after its implementation, the performance of Nyangana distract went up to 94% between April to June 2016. “Every mother that is on treatment after testing positive for HIV that gives birth in this distract is filed in our distract register. All mothers attending counselling from our community counsellors are educated on the importance of testing their babies and taking care of them and upon discharge these mothers are referred to one of our eight clinics for follow-ups. In addition, we compile a list with the names of the mothers which is sent to the clinics so that we can have record of all the mothers we are tracking,” Zulu continued to explain.
Namibian Sun was also informed that the health extension workers are given the responsibility to remind the mothers as the babies should be tested at six weeks, nine months and 18 months after delivery, depending whether the mother was breastfeeding the baby or not. “We also experience cases where some mothers are not near clinics so we go the extra mile of referring them to the closest health centres,” he said.
“HIV can pass from mother to child during pregnancy, childbirth and breastfeeding, but when effective medication is taken, the risk of transmission is significantly reduced and children are born and remain HIV negative, even when an HIV positive mother is breastfeeding her HIV negative baby.”
SMS results
There are 39 Short Message System (SMS) printers currently operational in the Kavango East and West, and Mashare clinic is one of the 232 clinics throughout the country that currently uses these printers. Nurses at Mashare demonstrated how the printer works - it involves inserting a SIM card into the machine and requesting for the results of a certain patient.
Collaboration
Through a collaborative partnership with Namibia Institute of Pathology (NIP), and funding from the US President's Emergency Plan for AIDS Relief (Pepfar), the Centre for Disease Control and Prevention Namibia (CDC) has supported the provision to have access to these SMS printers. “The use of these printers improves service delivery by reducing the time it takes for the results of a blood test to get back to a patient,” said Alphons Dikuua, nurse in charge at Mashare.
In the past, the only way results reached the clinic was through NIP's regional office sending the results by post to the district hospital. These results were then collected by the primary healthcare team and delivered to the respective clinics. Instead of having to wait for results to be delivered to clinic, NIP is able to send the results direct.
Dikuua also explained that the benefits of receiving results of patients earlier mean a much quicker response to a diagnosis. “The use of printers is helping people to get treatment much faster which allows healthcare providers to correct treatment regimens that are failing and to help make sure that patients continue to adhere to their treatment schedules and remain in the system.” Cases have been experienced in the past where it could take weeks or even months for results to reach a patient. In some situations results were also said to be lost and this creates a challenge for patients to be followed up.
Matilde (not her real name) says her encounter with the SMS printer was earlier this year in April when she came to the Mashare clinic for a pregnancy test. “I came here feeling sick one day and the nurse suggested I take a pregnancy test,” says Matilde who lives about three kilometres from the clinic. After conducting a traditional pregnancy test on her, Matilde could not be told if she was pregnant as her urine was not indicating any sign of pregnancy. “The nurse then had to take my blood for the test and the next day I was informed of my results,” she told Namibian Sun.
Before the implementation of the SMS printers, Matilde said patients would usually pay N$30 to go to the Shambyuu hospital which was a challenge as most of the community members are very poor.
“I am grateful we do not have to wait for weeks to receive our results and action can be taken much faster,” she concluded.
TUNOHOLE MUNGOBA
Dr Eric Hamani Sidile, senior medical officer at the hospital, testified to the benefits of the tracking system and its successful implementation. “With the help of the nurse mentors, we have seen a positive change within our service delivery towards the community. We work hand in hand with the nurses and this has been a very good arrangement,” said Sidile. The nurse mentors work together with registered nurses and midwives to avoid sending back patients when doctors are not available, as nurses in most situations are not authorised to conduct certain tests or put patients on treatment without the go-ahead from a doctor. “The help of nurses after they go through the mentorship was a good concept as we have now increased manpower and we can attend to more patients,” said Rightwell Zulu, nurse mentor of Nyangana Catholic Hospital.
After its establishment in 2015, preventing HIV transmission from mother to child has been successful. Zulu explained that it is the goal of every country to eliminate mother-to-child transmission of HIV, but without any form of records, it has proven to be difficult as the health facility did not have any numbers to fall back on. “The government has put up a lot of tools to make sure we eradicate Aids, but with no system in place, it was impossible to see how many babies have been exposed to the virus,” he explained.
“We have decided to put up a register, but there was no system set up to see how many babies have been tested so it was very challenging to measure our performance.”
Testing babies
The system involves testing babies from birth until they are said to have “graduated” from the programme. Graduation of these tested babies means that after the tracking has been done a baby has tested negative. Before the establishment of the tracking system, only a recorded number of 24% of babies had graduated from the programme, but after its implementation, the performance of Nyangana distract went up to 94% between April to June 2016. “Every mother that is on treatment after testing positive for HIV that gives birth in this distract is filed in our distract register. All mothers attending counselling from our community counsellors are educated on the importance of testing their babies and taking care of them and upon discharge these mothers are referred to one of our eight clinics for follow-ups. In addition, we compile a list with the names of the mothers which is sent to the clinics so that we can have record of all the mothers we are tracking,” Zulu continued to explain.
Namibian Sun was also informed that the health extension workers are given the responsibility to remind the mothers as the babies should be tested at six weeks, nine months and 18 months after delivery, depending whether the mother was breastfeeding the baby or not. “We also experience cases where some mothers are not near clinics so we go the extra mile of referring them to the closest health centres,” he said.
“HIV can pass from mother to child during pregnancy, childbirth and breastfeeding, but when effective medication is taken, the risk of transmission is significantly reduced and children are born and remain HIV negative, even when an HIV positive mother is breastfeeding her HIV negative baby.”
SMS results
There are 39 Short Message System (SMS) printers currently operational in the Kavango East and West, and Mashare clinic is one of the 232 clinics throughout the country that currently uses these printers. Nurses at Mashare demonstrated how the printer works - it involves inserting a SIM card into the machine and requesting for the results of a certain patient.
Collaboration
Through a collaborative partnership with Namibia Institute of Pathology (NIP), and funding from the US President's Emergency Plan for AIDS Relief (Pepfar), the Centre for Disease Control and Prevention Namibia (CDC) has supported the provision to have access to these SMS printers. “The use of these printers improves service delivery by reducing the time it takes for the results of a blood test to get back to a patient,” said Alphons Dikuua, nurse in charge at Mashare.
In the past, the only way results reached the clinic was through NIP's regional office sending the results by post to the district hospital. These results were then collected by the primary healthcare team and delivered to the respective clinics. Instead of having to wait for results to be delivered to clinic, NIP is able to send the results direct.
Dikuua also explained that the benefits of receiving results of patients earlier mean a much quicker response to a diagnosis. “The use of printers is helping people to get treatment much faster which allows healthcare providers to correct treatment regimens that are failing and to help make sure that patients continue to adhere to their treatment schedules and remain in the system.” Cases have been experienced in the past where it could take weeks or even months for results to reach a patient. In some situations results were also said to be lost and this creates a challenge for patients to be followed up.
Matilde (not her real name) says her encounter with the SMS printer was earlier this year in April when she came to the Mashare clinic for a pregnancy test. “I came here feeling sick one day and the nurse suggested I take a pregnancy test,” says Matilde who lives about three kilometres from the clinic. After conducting a traditional pregnancy test on her, Matilde could not be told if she was pregnant as her urine was not indicating any sign of pregnancy. “The nurse then had to take my blood for the test and the next day I was informed of my results,” she told Namibian Sun.
Before the implementation of the SMS printers, Matilde said patients would usually pay N$30 to go to the Shambyuu hospital which was a challenge as most of the community members are very poor.
“I am grateful we do not have to wait for weeks to receive our results and action can be taken much faster,” she concluded.
TUNOHOLE MUNGOBA
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