improving maternal child health (mch) services

7/27/2019 Improving Maternal Child Health (MCH) Services

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Improving Maternal Child Health (MCH)services delivery: The role of the Zambian

SmartCare eHealth system

Presenter: George Muyunda

Jhpiego Zambia Country Office

1st FIGO Africa Regional Conferenceof Gynecology and Obstetrics,

Addis Ababa, Ethiopia, October 2013


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What is SmartCare?

The National Standard Electronic Health Record(EHR) System of Zambia

Provides Continuity of Care for clients

Collects micro data that can be aggregated atany level for decision making/support

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Vision

Each person in Zambia has a completeelectronic health record

Assurance for continuity of access to high quality

confidential care Provision of up-to-date information to caregivers

at point of service delivery

Provision of timely information to health policymakers

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Mission

To enable the provision of quality health care forEveryone, Everywhere, Every time, by improving

health information systems

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History & Milestones

2004: Consensus building, Continuity of Care(COC) concept formation, and resourceidentification

2005: Ante-natal Care (ANC) pilot in KafueDistrict with 98 percent patient return rate withSmart Card

2006: Integration with Anti-retroviral Therapy(ART) Patient Tracking System (PTS) to createa Continuity of Care Patient Tracking System(CCPTS), later renamed SmartCare

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History & Milestones contd

2007: Role-Based Security; National andprovincial level training begins; SmartCarecompetency required for ARV dispensing

accreditation 2009: SmartCare Certification program instituted

2011: Under 5, Family Planning, OPD modules,etc. included

2013: over 750 sites deployed to. SmartCarealso deployed to 14 PSE health traininginstitutions

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Collaboration/Partnerships

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Role of Jhpiego in SmartCareimplementation

Support the creation ofComputer Labs

Support Deployment andmaintenance of SmartCare &

SmartCare Computers Capacity building to Tutors and

Lecturers

Technical Support andSupervision

Incorporating SmartCare inPSE Curriculum

Pre-Service

In-Service Support Deployment and

maintenance of Smartcare,Computers and other SmartCareEquipment

Capacity building: Service providers,

District and Provincial Managersand supervisors

SmartCare Support Staff

Technical support andSupervision

Support Data Migration

Promote SmartCareInstitutionalization

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The agony of paper records

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Maternal Child Health (MCH) Modules inSmartCare

Antenatal Care (ANC) including Prevention ofMother-To-Child Transmission (PMTCT)

Delivery

Post Natal Care (PNC)

Under Five (U5)

Family Planning

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SmartCare:Data Collection

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Registers

Forms Tally sheets

Direct Data

Entry

Etc.,..


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At the Clinic/Hospital

Clients/Patientsregistered on first

clinic visit

All clinicalinteractions

recorded/entered

Clients/Patientsgiven Smart Card,which contains acopy of all their

records

Client/patient is registeredand their details areentered in a facilitys

database; even if they

forget to bring their SmartCard to each visit, their

record is available!

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SmartCare is designed for portability

Records also copied

onto an encrypted

Smart Card

Smart Card carried by the

client/patient from facility

to facility

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Continuity of Care: The Smart Card

Stores all healthcare servicerecords for a client/patient

It provides continuity of care

for the Client/Patientwherever they go

Provides durable, portableand confidential storage for

data

Replaces paper records

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A Maternal Child Health Provider at work

A MoH MCH Care giver providing health service to a

mother while entering service data into SmartCare. The

mother goes home with an updated Smart Card.

Records also saved onto an

encrypted Smart Card

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Sample reports: CD4 Monitoring

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Sample reports: Medication History

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What Providers said during routinesupport visits

It has helped to

standardize theapproach to health

care, improved recordkeeping, report

generation and thequality of care

SmartCarepromotes quality of

health service

delivery as it providesmedication and

laboratory test resultshistory for bothmother & child

resulting in continuity

of care

SmartCare is goodand beneficial as it

facilitates easy dataentry, continuity ofcare, prevents loss ofrecords, easyreporting and followups

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Challenges

High Staff turnover

Lack of electricity

Power outages

Data entry/use & roll up to the center

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Conclusion

The observations are encouraging thatSmartCare enhances the quality of healthservice delivery in Zambia

However, a detailed study needs to beconducted in the future to confirm theseobservations

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Hillary Clinton and SmartCare

The former US Secretary of State, Hillary Clinton, holds up a Zambia

SmartCare Care Card and said she had worked 10 years in the US topromote electronic health records and said she might need to send

people to Zambia to see how it was done. This wasduring her visit to

Zambia in June 2011.

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Thank you

Amasegenalo

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