scholarly journals Tanzania Health Information Technology (T-HIT) System: Pilot Test of a Tablet-Based System to Improve Prevention of Mother-to-Child Transmission of HIV (Preprint)

2017 ◽  
Author(s):  
Sheana Bull ◽  
Deborah SK Thomas ◽  
Elias C Nyanza ◽  
Sospatro E Ngallaba

BACKGROUND The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries. OBJECTIVE The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania. METHODS We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites. RESULTS Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system. CONCLUSIONS T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more antenatal visits during the pilot intervention compared with a traditional system of paper logs, suggesting potential for improvements in antenatal care for women at risk for HIV.

2012 ◽  
Vol 2 (3) ◽  
pp. 163-172
Author(s):  
Sadandaula R. Muheriwa ◽  
Angela Chimwaza ◽  
Alfred Maluwa ◽  
Martha Kamanga

PURPOSE:To determine knowledge and practices of young women on utilization of prevention of mother-to-child transmission (PMTCT) of HIVservices.DESIGN:A cross-section descriptive study that used quantitative and qualitative data analysis methodologies.FINDINGS:Knowledge of PMTCT of HIV among respondents was universal. All respondents (100%,N= 184) stated that utilization of PMTCT services reduces transmission of HIV from mother to child. Respondents knew that HIV transmission can be reduced with exclusive breastfeeding (93%,n= 172), abrupt weaning at 6 months (44%,n= 81), taking single-dose nevirapine (SD-NVP; 43%,n= 79), and giving NVP to the baby (65%,n= 120). Very few respondents (4%,n= 7) stated that avoiding pregnancy is one way of preventing HIV transmission and that a mother who is HIV positive who has received SD-NVP or antiretroviral (ARV) therapy can still deliver a baby who is HIV positive. Actual practice was very low; only 14% breastfed exclusively and only 3% weaned their babies abruptly. Although all the 184 mothers were given NVP to take at onset of labor, very few respondents (22%) took NVP as recommended. Although it was recommended that all babies take NVP at birth and within 72 hr of birth, only 58% of the babies received NVP as recommended and only 3% of the women avoided pregnancy.CONCLUSION:There was a big discrepancy between knowledge and practice of PMTCT services. Culture was the major barrier because traditionally, babies are expected to be breastfed and supplements are fed to babies, too. Most mothers did not adhere to the taking of NVP at onset of labor. Therefore, there is a need to mobilize communities on PMTCT of HIV. The HIV education programmes should emphasize behavior-change interventions and should focus on both men and women, their partners, and significant others. There is also need to intensify monitoring and evaluation of health workers’ activities to ensure that knowledge is put into practice.


2020 ◽  
Author(s):  
Noel Namuhani ◽  
Hamiliton Kainga ◽  
Olufemi Obafemi ◽  
Adeyemi Adelabu ◽  
Moses Mukuru ◽  
...  

Abstract Background; Despite the adoption of Elimination of mother to child transmission (EMTCT) strategy in 2012, mother to child transmission of HIV remains one of the significant forms of new HIV infections among children in Uganda, accounting for 20% of new infections. However, the implementation of the EMTCT strategy in Uganda remains unclear and an under researched field. This study aimed at assessing the extent of implementation of EMTCT strategy, barriers and constraints in Lira district using the adapted Policy Implementation Barometer (PIB) approach. Methods; This was a cross sectional study that employed both quantitative and qualitative data collection methods. A Policy Implementation Barometer tool developed by a project called Supporting Policy Engagement for Evidence-based Decisions (SPEED) for Universal Health Coverage in Uganda was adopted to assess the extent of implementation of EMTCT strategy. A total of 32 interviews with health facility managers were purposively conducted from a random sample of 20 health facilities offering Antenatal clinic (ANC) services in Lira district. Quantitative data was analyzed using STATA 14. Qualitative data was analyzed using thematic content analysis approach. Results; Majority 17/32 (53.1%) of the respondents were health facility in charges, 14/32 (43.8%) were midwives and half 16/32 (50.0%) had been in service for more than five years. Half of the respondents perceived their facilities to have fully established programs for implementing EMTCT and only 2/32 (6.2%) perceived the EMTCT programs to be functioning optimally. The perceived level of EMTCT implementation was 80%. Almost all the respondents perceived the funding for EMTCT activities to be inadequate, untimely, and not sustainable. Only 4/32 (12.5%) of the respondents believed that the health workforce size was adequate to support EMTCT activities, 13/32 (40.6%) believed that health workers lacked the skills to provide EMTCT services.Conclusion/Recommendation; Overall, the perceived extent of EMTCT policy implementation was high, however slow progress was reported in some of the key policy objectives due to a number of hindrances including inadequate staff and funding. Therefore, there is a need for strategies to increase the number of health workers for EMTCT and solicit for more funding for the implementation of EMTCT strategy.


2020 ◽  
Vol 8 (1) ◽  
pp. 47
Author(s):  
Pina Pudiyanti ◽  
Tuti Afriani

<p><em>People with diabetes mellitus must take responsibility for their own care to improve their quality of life. People with diabetes mellitus often need a set of services and support ranging from glucose monitoring, insulin and other treatment management, psychotherapy and social support, physical activity, nutritional counseling and others. Diabetes mellitus patients can play a more active role in treating their diabetes with health information technology. This literature review uses the PRISMA statement as a guide to search for research articles from two databases, Ebsco and Scopus. The results of the analysis of nine selected research articles indicate that information technology provides patient education and support for patients with diabetes mellitus. Information technology has been used to improve the quality of care for patients with diabetes mellitus, enable health workers to more effectively manage patients and to help patients manage their own illnesses so that research and related publications are needed to improve the care of patients with diabetes mellitus at home.</em></p><p><strong>BAHASA INDONESIA ABSTRAK: </strong>Penderita diabetes mellitus harus bertanggung jawab atas perawatan mereka sendiri untuk meningkatkan kualitas hidupnya. Penderita diabetes mellitus seringkali membutuhkan seperangkat layanan dan dukungan mulai dari pemantauan glukosa, insulin dan manajemen pengobatan lainnya, psikoterapi dan dukungan sosial, aktivitas fisik, konseling gizi dan lain-lain. Pasien diabetes mellitus bisa memainkan peran lebih aktif dalam perawatan diabetesnya dengan teknologi informasi kesehatan. Kajian pustaka ini menggunakan <em>PRISMA statement </em>sebagai panduan pencarian artikel penelitian dari dua database yaitu <em>Ebsco</em> dan <em>Scopus. </em>Hasil analisis sembilan artikel penelitian terpilih menunjukkan bahwa teknologi informasi memberikan pasien pendidikan dan dukungan pada pasien diabetes mellitus. Teknologi informasi telah digunakan untuk meningkatkan kualitas asuhan pasien diabetes mellitus,   memungkinkan tenaga kesehatan lebih efektif mengelola pasien dan untuk membantu pasien mengelola sendiri penyakitnya sehingga penelitian dan publikasi terkait diperlukan untuk meningkatkan perawatan pasien diabetes mellitus di rumah.</p>


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Adebola Adedimeji ◽  
Nareen Abboud ◽  
Behailu Merdekios ◽  
Miriam Shiferaw

Objectives. Despite the availability of services to prevent mother-to-child transmission (PMTCT) of HIV, socio-cultural, health system and operational factors constrain many pregnant women from accessing services or returning for followup thereby increasing the risk of vertical transmission of HIV to newborns. We highlight and describe unique contextual factors contributing to low utilization of PMTCT services in Arba-Minch, Ethiopia. Methods. Qualitative research design was utilized to obtain data through focus group discussions and in-depth interviews with antenatal clinic attendees, health workers health facilities in the study area. Results. Awareness of PMTCT services and knowledge of its benefits was nearly universal, although socioeconomic, cultural and health system factors, including stigma and desire to prevent knowledge of serostatus, impede access to and utilization of services. Health system factors—lack of appropriate followup mechanisms, inadequate access to ARV drugs and poorly equipped manpower also contribute to low utilization of services. Conclusion. Reducing mother-to-child transmission of HIV in sub-Saharan Africa will be more effective when unique contextual factors are identified and addressed. Effectiveness of PMTCT interventions rests on a well functioning health system that recognize the importance of social, economic, cultural contexts that HIV positive pregnant women live in.


2019 ◽  
Vol 61 (1) ◽  
Author(s):  
Flavia Strato Shayo ◽  
Bob Mash

Background: Ending new paediatric HIV infections continues to be a global health priority. Cuba and other countries have demonstrated that elimination of mother-to-child transmission is possible through Prevention of Mother-to-Child Transmission (PMTCT) interventions. As Namibia works on improving PMTCT there is a need to identify the local modifiable factors to achieve zero new HIV infections.Aim: This study aimed to identify the modifiable factors within the PMTCT programme, which contributed to the acquisition of HIV infection among children.Setting: The study was carried out in the Onandjokwe District, Northern Namibia.Methods: A descriptive audit was undertaken of 59 medical records of mothers and their children under two years, who acquired HIV despite the PMTCT programme between 2014 and 2016.Results: The study found that overall HIV transmission was only 2%, but 80% of the paediatric HIV infections could be prevented by implementing the existing Namibian PMTCT recommendations. Overall 61% of modifiable factors were related to mothers, 30% to health workers and 10% to the health system. The top three modifiable factors were the mother defaulting on ART during pregnancy or breastfeeding, the health worker not intervening when the mother failed the first-line ART regimen, and poor coordination of care between the hospital and primary care.Conclusion: Although overall transmission is low with the PMTCT programme, the majority of remaining HIV infections among children under two years could be prevented by addressing the modifiable factors identified in this study.


2019 ◽  
Vol 4 (1) ◽  
pp. 55 ◽  
Author(s):  
Nimas Ayu Lestari Nurjanah ◽  
Tri Yunis Miko Wahyono

Background: HIV / AIDS is still a global health problem which needs to be addressed including prevention of HIV / AIDS transmission from mother to child. Prevention of transmission is carried out by implementing the Prevention of Mother to Child Transmission or PMTCT program. The PMTCT program is considered successful in reducing the risk of mother-to-child transmission, but this has not been done well and thoroughly, various kinds of challenges have occurred in the implementation of the PMTCT program.Objective: To know the challenges that occur in implementing the PMTCT programMethod: This study uses a systematic review based on Preferred Reporting Items For Systematic Reviews & Meta-Analyzes (PRISMA)  to identify all the literature published using relevant keywords.Results: challenges in implementing the PMTCT program are the lack of information on HIV treatment, lack of family support, the heavy workload experienced by health workers and the limited availability of HIV testing equipment and drug stocks.Conclusion:  The success of efforts to prevent HIV / AIDS transmission from mother to child does not depend on one party only, but involves several parties, the active role of health workers in providing education and information about HIV / AIDS to mothers and their families is not enough but must be added with active roles and support from family members to HIV mothers as the primary motivator for good behavior in accordance with the guidelines for PMTCT.


Sign in / Sign up

Export Citation Format

Share Document