Using Mobile Phones (mHealth) to Improve Tracking and Tracing of HIV Care and Treatment Clients Presented by Jabulani Mavudze Regional Research, Monitoring and Evaluation Team Leader (SAfAIDS)

Aim and Objectives of the mHealth Initiative The aim of the mHealth initiative is to strengthen linkages between communities and health facilities Expected Outcomes Increased number of clients referred for PMTCT, HTC, and family planning services Increased number of clients who accessed services after referral Improved adherence to appointment dates by PMTCT clients Increased retention of mothers and infants in HIV care and treatment services

Demographic Details of Selected sites Name of Health FacilityEstimated Population Size in the Catchment Area Estimated Number of Household Number of VHWs Operating in the Catchment Area Ngundu20,8062,50014 Takavarasha9, Vuranda3,9371,3156 Zivuku9,2411,1208 Chishave –Control Site13,9081,73810

The mHealth Model mHealth Portal Community Referral Facilitators Information of clients who accesses services Village Health Workers SMS sent to VHWs with information of clients to be followed up Information of clients referred District Health Information Team, SAfAIDS & BHASO Provision of mentoring, supervision, and technical assistance Data review and analysis Health care Workers Appointments and follow ups details B A C D Mentoring, supervision and TA Provision of mentoring, supervision, and technical assistance

Methodology Baseline assessment: (Facility registers, referral slips, one on one interviews) Routine monitoring data: (mhealth data, facility registers) Pilot Phase endline evaluation: (Facility registers, referral slips, one on one interviews)

Appointment Reminders for the Period April 2014 to September 2015

% of Individuals who Honoured Appointments after Reminder by Sex

% of Individuals who Honoured Appointments after Reminder by Age

Defaulters Followed up and Accessed Services During the Period April 2014 to September 2015

% of Defaulters who Accessed Services after Follow-up by Sex

Lessons Learned Engaging community referral facilitators who are openly living with HIV to follow up on PMTCT clients is commendable strategy VHWs were motivated by the use of mobile phones to follow up on clients and also referring new clients. mHealth contributed to the improvement in data quality including timeliness in reporting Tracking and tracing of PMTCT clients depends on information captured in the Appointment diaries which are completed by nurses. mHealth equipment can be used for other purposes such as information dissemination through social medial platforms such as WhatsApp, SMS for EID, etc

Key Recommendations National Level Government and its development partners to scale up mhealth targeting high priority sites Formalization of Public –Private partnerships on mHealth in Zimbabwe Health Facility level Strengthening accuracy and completeness of clients records since mHealth relies on these registers especially the Appointment Diaries Consider authorization of Community Referral Facilitators to complete Appointment Diaries to lessen workload of nurses Integration of mHealth and Electronic Patients Monitoring System (ePMS) Community Level Motivating VHWs and CRFs through consistent mentoring & supervision and regular monthly meetings between health care workers, CRFs and VHWs. CRFs and VHWs to be familiar with HIV prevention, care and treatment issues Recruitment of more VHWs for wider reach

ACKNOWLEDGEMENTS Chivi community BHASO