Scaling-up health information systems to improve HIV treatment: An assessment of initial patient monitoring systems in Mozambique
Scaling-up health information systems to improve HIV treatment: An assessment of initial patient monitoring systems in Mozambique
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DOI：
10.1016/j.ijmedinf.2016.11.002
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发表时间：
2017-01-01
影响因子：
4.9
通讯作者：
Shade, Starley B.
中科院分区：
文献类型：
--
作者：
Hochgesang, Mindy;Zamudio-Haas, Sophia;Shade, Starley B.
导言：在资源有限的国家迅速扩大艾滋病毒护理和治疗的规模，需要同时快速发展卫生信息系统，以支持高质量的服务提供。莫桑比克是一个艾滋病毒流行率为11.5%的国家，该国建立了全国范围的患者监测系统，该系统具有标准化的报告工具，供所有艾滋病毒治疗提供者以纸质或电子形式使用。在莫桑比克迈向协调、可持续的卫生信息系统的过程中，对PMS初步实施情况的评估可以为未来的发展提供信息和加强。目标：进行这项评估的目的是：1)确定数据收集和报告流程以及可用的PMS资源；2)为PMS的协调和可持续性提供循证建议。方法：对PMS的基线评估是与8个非政府组织一起进行的，这些组织支持卫生部在莫桑比克提供90%的艾滋病毒护理和治疗。研究小组在所有11个省的18个卫生机构进行了结构化和半结构化调查。79名工作人员接受了采访。演绎先验分析分类指导分析。结果：卫生机构实施了纸质和电子监测系统，取得了不同程度的成功。在使用的地方，强大的电子经前管理系统促进了所需指标的设施级报告；提高了识别因随访而失去的患者的能力；并支持设施和患者管理。实施监测系统面临的挑战包括缺乏患者水平HIS的国家指南和规范，可变系统的实施和功能，以及有限的人力和基础设施资源，以最大限度地提高系统功能和信息利用率。结论：这项初步评估支持需要国家指南来协调、扩展和加强与艾滋病毒相关的卫生信息系统。建议可能有益于其他具有类似流行病和资源限制环境的国家，这些国家寻求改善经前综合症的执行情况。(C)2016爱思唯尔爱尔兰有限公司。保留所有权利。
Introduction: The rapid scale-up of HIV care and treatment in resource-limited countries requires concurrent, rapid development of health information systems to support quality service delivery. Mozambique, a country with an 11.5% prevalence of HIV, has developed nation-wide patient monitoring systems (PMS) with standardized reporting tools, utilized by all HIV treatment providers in paper or electronic form. Evaluation of the initial implementation of PMS can inform and strengthen future development as the country moves towards a harmonized, sustainable health information system.Objective: This assessment was conducted in order to 1) characterize data collection and reporting processes and PMS resources available and 2) provide evidence-based recommendations for harmonization and sustainability of PMS.Methods: This baseline assessment of PMS was conducted with eight non-governmental organizations that supported the Ministry of Health to provide 90% of HIV care and treatment in Mozambique. The study team conducted structured and semi-structured surveys at 18 health facilities located in all 11 provinces. Seventy-nine staff were interviewed. Deductive a priori analytic categories guided analysis.Results: Health facilities have implemented paper and electronic monitoring systems with varying success. Where in use, robust electronic PMS facilitate facility-level reporting of required indicators; improve ability to identify patients lost to follow-up; and support facility and patient management. Challenges to implementation of monitoring systems include a lack of national guidelines and norms for patient level HIS, variable system implementation and functionality, and limited human and infrastructure resources to maximize system functionality and information use.Conclusions: This initial assessment supports the need for national guidelines to harmonize, expand, and strengthen HIV-related health information systems. Recommendations may benefit other countries with similar epidemiologic and resource-constrained environments seeking to improve PMS implementation. (C) 2016 Elsevier Ireland Ltd. All rights reserved.