Countries: Cameroon, Cote d'Ivoire, Kenya, Mozambique, Rwanda, South Africa, Thailand, Uganda, Zambia
Client(s): Columbia University
Services: Technical Assistance, Applied Technology, Monitoring, Evaluation, and Research
Technical Expertise: HIV, Applied Technology, Research, Monitoring, and Evaluation
JSI's clinical data management and quality assurance experience is internationally recognized. For five years, JSI was contracted as the Data Management Center for the Mother-to-Child Transmission Plus (MTCT-Plus) Initiative, developed in response to the UN Secretary General's Call to Action. Managed by the Mailman School of Public Health at Columbia University (the Secretariat), the center served demonstration sites in 8 countries in Africa and Asia and as such handles data related to the care of over 9,300 patients in 18 clinical facilities in Cameroon, Cote d'Ivoire, Kenya, Mozambique, Rwanda, South Africa, Uganda, Zambia and Thailand.
The clinical care paradigm for this initiative was family-centered and holistic, addressing the stigma and physical and mental health needs of HIV+ women and their family members, in addition to the distribution of anti-retroviral medications.
JSI operated the programs Data Management Center for the Secretariat, helping sites manage and automate their medical record system for MTCT-Plus patients. Seven sites began record keeping on paper forms (in a variety of languages), which were processed at JSI into electronic format; at the conclusion of the project, 14 sites were using an Access database developed by JSI. The database also had an appointment tracking system built into it. Each month, JSI's DMC staff worked with sites to resolve discrepancies in their data - providing collaborative training/technical assistance in data entry, records management, and the clinical protocol in the process. Each month, the DMC returned clean data files to each site and to the Secretariat and also produced quality/performance indicators to help staff ensure all patients were being adequately managed. Some of the key performance indicators were: (a) the number and percent of patients who had not been to clinic or had missed appointments for over 3 (6) months; (b) the number and percent of patients who had had ARV regimen changes; (c) the number and percent of patients who were eligible for opportunistic infection prophylaxis but were not currently receiving it.