The Effect of Integrated Infectious Diseases Capacity Building Evaluation (IDCAP) Implementation on Improvement of Health Management S. Naikoba , T.

Rubashembusya , T. Kendle , S. Kinoti , in Rural Uganda , M. Weaver M. Mbonye , Information Systems (HMIS) L. Mpanga-Sebuyira , K. Willis
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1. Infectious Diseases Institute, Kampala, Uganda; 2. Accordia Global Health Foundation, Washington, D.C. ; 3. University Research Company Center for Health Services, Washington D.C.; 4. University of Washington;

Introduction/Background
Monitoring quality of clinical care in remote health facilities remains a big challenge. The Health Management Information System (HMIS) are poor, characterized by; Incomplete and inconsistent data Late reporting Manual system of collection and analysis Insufficient technical support To Evaluate the Impact of On-Site Support (OSS) on patient care, HMIS was strengthened for the 36 IDCAP implementing health facilities in rural Map of Uganda. Uganda showing IDCAP sites

Image 1: IDCAP Data Quality Improvement Team supporting a Site Staff: Photo by a Health Worker

Results

Presented are the results the effect of IDCAP implementation on HMIS. Analyzing data with computers rather than manual tallying reduced reporting time from 7 to less than 1 and half days on average Data accuracy checks revealed 4% mismatch (n=3,500 5% of Total Patients seen in July 2010)
Trends of Data Incompleteness Rates

Image 2: the Modified Form 5. an MOH patient record form which was modified by IDCAP staff

Conclusion
HC IV H Hospital IDCAP data quality improvement efforts has led to a significant reduction in incompleteness rates of data on key variables. Key drugs whose stock data is tracked for completeness include Artemether/Lumefantrine, Artesunate, Amodiaquine, Quinine, Amoxicillin , Doxycycline and Erythromycin.

Trends in Baseline Performance of Key Indicators IDCAP is Tracking

Method/Design
HMIS was strengthened to ensure collection of

quality data. Data is collected on clinical management of Infectious Diseases in Outpatients, TB, HIV and Maternal and Child Health Clinics. In Outpatient clinics, data is collected using a Medical Form 5 (MF5) initially modified by the Uganda Malaria Surveillance Project (UMSP) but adopted with modifications by IDCAP. The MF5 was modified from a blank sheet where patient notes would be scribbled to one coded and structured by patient demographics, history, physical and Lab examination, Diagnosis, treatment, referral and drug supplies. In TB, HIV and Maternal and Child Health Clinics, IDCAP extracts evaluation data from existing HMIS tools. Each of the 36 IDCAP implementing Health Facility (HF) received a computer and printer and power supply/backup systems (Backup Generator -10, Backup Inverter -10 and Solar System 16) MF5 collects over 95% of HF data which is electronically entered and analyzed.

IDCAP quality of patient care evaluation data system has: Improved completeness, accuracy and timeliness in reporting Reduced patient data losses Enhanced timely electronic data entry, analysis and storage. Strengthened drug supply system Improved tracking of patient care performance indicators. Using these results, IDCAP hopes to
Accordias Integrated Infectious Disease CapacityBuilding Evaluation (IDCAP) is a 3-year program funded by the Bill and Melinda Gates Foundation with the goal of evaluating the cost-effectiveness of capacity building mid-level health practitioners in sub-Saharan Africa for the treatment and prevention of infectious diseases. A comprehensive surveillance system of 36 health facilities and their patients will measure the impact of a novel package of classroom training, distance learning, and onsite support services on individual competence, facility performance, and health outcomes in the surrounding Accordias IDCAP Partners communities. About improve patient care. IDCAP

Challenges
Sites are very remote and characterized by;

Poor internet network electric power coverage. Frequent electric power outages. Poor roads This presents a challenge to technical support and maintenance to computers (hardware and software) Computers occasionally breakdown to viruses Insecurity to computer and power backup systems Some Staff have poor attitude towards collection of quality data. Staff low level of knowledge of use of computers

Acknowledgements 1. Uganda Malaria Surveillance Project 2. Accordias IDCAP Partners and Health Facilities Session 928 Abstract Number: 2461