Implementation and outcomes of an active defaulter tracing system for HIV, prevention of mother to child transmission of HIV (PMTCT), and TB patients in Kibera, Nairobi, Kenya

Thomson, Kerry A.; Cheti, Erastus; Reid, Tony

doi:10.1016/j.trstmh.2011.02.011

Cited by 52 publications

(62 citation statements)

References 29 publications

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“…There are several approaches for tracing defaulters such as using CHW, home visits, phone calls, written reminders, collaboration with community-based organizations and outreach teams (Cutts, 1991;Marsh, 2000;Fraser et al, 2007;Forster et al, 2008;Thomson et al, 2011;Chadambuka et al, 2012). My findings showed similar approaches and in addition, I have elaborated on a new approach, where clients could be used to inform other clients as a way of countering limitations arising from managerial and clients' perspectives.…”

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confidence: 71%

“…These systems mainly support two tasks: identifying and tracing defaulters. Thomson et al (2011) present an example of a defaulter tracing system in a HIV/TB program with the following steps: patient is enrolled into the program; patient misses the scheduled appointment; patient is identified as a potential defaulter; health worker traces patient, health worker documents outcome and enters data in the computer system which could be statistically analyzed. In the literature, several approaches for tracing defaulters are suggested, including using CHW (Community Health Workers), home visits, phone calls, written reminders, collaboration with community-based organizations and outreach teams (Cutts, 1991;Marsh, 2000;Fraser et al, 2007;Forster et al, 2008;Thomson et al, 2011;Chadambuka et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, the paper contributes to HIS literature which has elaborated how designed tools are utilized in practice at the level of primary health care of developing countries' context. In this literature there are few studies which have elaborated defaulter tracing practices in maternal and child health settings (see for example DeRenzi et al, 2012;MacLeod et al, 2012); since most studies on defaulter tracing practices are in vertical programs such as tuberculosis, HIV/AIDS and PMTCT (see for example Jones et al, 2005;Fraser et al, 2007;Nglazi et al, 2010;Busza et al, 2012;Thomson et al, 2011;Kalembo and Zgambo, 2012;Marcos et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…The study had identified defaulters' information practices of identifying, tracing and documenting the outcome similar to the literature (e.g. Nglazi et al, 2010;Thomson et al, 2011;Mwatawala et al, 2012). Nevertheless, in maternal and child health settings, I did not observe similar statistics of defaulter practices similar to Thomson et al (2011).…”

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confidence: 99%

“…Nglazi et al, 2010;Thomson et al, 2011;Mwatawala et al, 2012). Nevertheless, in maternal and child health settings, I did not observe similar statistics of defaulter practices similar to Thomson et al (2011). The findings have elaborated that in defaulter tracing practices different information systems are used, both facility based (health care IS system) and community based information systems (village registration system, and CHW notebooks).…”

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confidence: 99%

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Challenges in Implementing Patient‐centred Information Systems in Tanzania: An Activity Theory Perspective

Shidende

2014

E J Info Sys Dev Countries

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Defaulter tracing systems are patient centred information systems which are used to enhance monitoring of patients who have dropped out of health programs. The aim of this study is to explore the operation of defaulter tracing systems in practice. The study has been undertaken in Tanzanian health facilities by using qualitative data collection methods. Activity theory is employed as a conceptual framework to analyze the findings. Findings show that the implementation of defaulter tracing system is challenged by issues of the existing information systems, such as absence of clear guidelines and tools, and information recording incompleteness, as well as contextual issues. The paper contributes to Healthcare Information System literature (HIS) which has elaborated how patient centred information systems are utilized in practice at the level of primary health care. This study concludes by providing implications for policy, practice, design and implementation.

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confidence: 71%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Challenges in Implementing Patient‐centred Information Systems in Tanzania: An Activity Theory Perspective

Shidende

2014

E J Info Sys Dev Countries

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The effect of tracer contact on return to care among adult, “lost to follow‐up” patients living with HIV in Zambia: an instrumental variable analysis

et al. 2021

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Introduction Tracing patients lost to follow‐up (LTFU) from HIV care is widely practiced, yet we have little knowledge of its causal effect on care engagement. In a prospective, Zambian cohort, we examined the effect of tracing on return to care within 2 years of LTFU. Methods We traced a stratified, random sample of LTFU patients who had received HIV care between August 2013 and July 2015. LTFU was defined as a gap of >90 days from last scheduled appointment in the routine electronic medical record. Extracting 2 years of follow‐up visit data through 2017, we identified patients who returned. Using random selection for tracing as an instrumental variable (IV), we used conditional two‐stage least squares regression to estimate the local average treatment effect of tracer contact on return. We examined the observational association between tracer contact and return among patient sub‐groups self‐confirmed as disengaged from care. Results Of the 24,164 LTFU patients enumerated, 4380 were randomly selected for tracing and 1158 were contacted by a tracer within a median of 14.8 months post‐loss. IV analysis found that patients contacted by a tracer because they were randomized to tracing were no more likely to return than those not contacted (adjusted risk difference [aRD]: 3%, 95% CI: –2%, 8%, p = 0.23). Observational data showed that among contacted, disengaged patients, the rate of return was higher in the week following tracer contact (IR 5.74, 95% CI: 3.78–8.71) than in the 2 weeks to 1‐month post‐contact (IR 2.28, 95% CI: 1.40–3.72). There was a greater effect of tracing among patients lost for >6 months compared to those contacted within 3 months of loss. Conclusions Overall, tracer contact did not causally increase LTFU patient return to HIV care, demonstrating the limited impact of tracing in this program, where contact occurred months after patients were LTFU. However, observational data suggest that tracing may speed return among some LTFU patients genuinely out‐of‐care. Further studies may improve tracing effectiveness by examining the mechanisms underlying the impact of tracing on return to care, the effect of tracing at different times‐since‐loss and using more accurate identification of patients who are truly disengaged to target tracing.

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RED for PMTCT: An adaptation of immunization's Reaching Every District approach increases coverage, access, and utilization of PMTCT care in Bondo District, Kenya

Kanyuuru¹,

Kabue²,

Ashengo³

et al. 2015

Intl J Gynecology & Obste

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a b s t r a c t a r t i c l e i n f oKeywords: Access Coverage Maternal and child health Prevention of mother-to-child transmission (PMTCT) Reaching Every District approach Utilization Gaps exist in coverage, early access, and utilization of prevention of mother-to-child transmission of HIV (PMTCT) services in Kenya. The Maternal and Child Health Integrated Program, led by Jhpiego, piloted an adaptation of immunization's Reaching Every District (RED) approach in Bondo District as a way of improving PMTCT care. Routine district-level monthly summary service delivery pre-and post-implementation data were analyzed. Marked improvements resulted in the proportion of HIV-infected and non-infected pregnant women completing four focused prenatal care visits, from 25% to 41%, and the proportion of HIV-exposed infants (HEIs) tested at six weeks, from 27% to 78% (P b 0.001). The proportion of HEIs tested for HIV infection at 12 months was 52%, while 77% of HEIs were issued antiretroviral prophylaxis by the end of the pilot. Implementation of RED for PMTCT demonstrated that PMTCT services can be delivered effectively in the context of the existing community strategy and resulted in increased coverage, access, and utilization of care for HIV-positive pregnant women and their children.

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Implementation and outcomes of an active defaulter tracing system for HIV, prevention of mother to child transmission of HIV (PMTCT), and TB patients in Kibera, Nairobi, Kenya

Cited by 52 publications

References 29 publications

Challenges in Implementing Patient‐centred Information Systems in Tanzania: An Activity Theory Perspective

Challenges in Implementing Patient‐centred Information Systems in Tanzania: An Activity Theory Perspective

The effect of tracer contact on return to care among adult, “lost to follow‐up” patients living with HIV in Zambia: an instrumental variable analysis

RED for PMTCT: An adaptation of immunization's Reaching Every District approach increases coverage, access, and utilization of PMTCT care in Bondo District, Kenya

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