CommCare as a Tool to Reduce Loss to Follow Up Case Study: CDC Partners in Mozambique Jolani de la Porte Presented by:

Background Adherence to HIV and TB regimens is important to improve patient outcomes and prevent the spread of the disease In Mozambique HIV prevalence in adults between 15 - 49 years of age is 11.5% In Mozambique in 2014 retention in care is at 67% at 12-months and 52% after 36 months among HIV patients undergoing ART2 1Deeks SG, Gange SJ et al. Trends in multidrug treatment failure and subsequent mortality among antiretroviral therapy-experienced patients with HIV infection in North America. Clin Infect Dis. 2009 Nov 15; 49(10):1582-90. 2 Fox MP, Rosen S. Patient retention in antiretroviral therapy programs up to three years on treatment in sub-Saharan Africa, 2007-2009: systematic review. Trop Med Int Health. 2010 Jun; 15 Suppl 1():1-15.

Nationally Consolidated LTFU mHealth Toolkit for HIV/TB Mozambique

LTFU strategy Identified Contacted Referral Made Returned to Health Facility Completed 6 months

Problem Contacted Identified Referral Made Arrived at Health Facility Completed 6 months follow up

Solution: App Workflow + Identification Contact Referral Arrival Recuperation

Solution: Summary Tools

Solution: Drill-down reports Identified Contacted Referral Made Arrived at Health Facility Completed 6 months follow up

Solution: Drill-down Reports Referrals Made Name Type of Referral Days Open CHW Responsible

Solution: Drill down Reports Name Days Open Defaults Emailed Reports Mobile Reporting CHWs or Supervisors Web Reports

Summary Strengthen LTFU process through: Improved patient tracking and two way communication between community and clinic levels Timely supervision and follow up on patients who are at risk of dropping out at each step of the LTFU process through actionable reports Improved quality of home visits and adherence counselling Provide better insights into reasons patients are dropping out for more targeted interventions Support scale-up of LTFU strategy through nationally consolidated LTFU toolkit

Download Application from CommCare Exchange Ali, any outcomes/conclusions worth mentioning? https://www.commcarehq.org/exchange/59cc05b652dfcaec152760b7eec7bbf3/info/