Pilot Implementation of Point-Of-Care, CD4 Counting in Mozambique’s National Health System
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Presentation at the IAS 2011 conference on 18 July 2011 by Ilesh V. Jani, Instituto Nacional de Saúde, Mozambique.
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Pilot Implementation of Point-Of-Care, CD4 Counting in Mozambique’s National Health System
- 1. Pilot Implementation of Point-Of-Care CD4 Counting in Mozambique’s National Health System Ilesh V. Jani Instituto Nacional de Saúde Maputo, Mozambique
- 3. INS
- 4. CHAI
- 5. Provincial Health Authorities in Maputo City, Maputo Province, Gaza, Sofala and Niassa
- 7. Anglican Church, Niassa Province
- 8. MSF-Belgium
- 10. ARK
- 12. HIV Rapid Testing – Leaps and Hiccups?Proficiency Testing Programs Show That Error Rates Are High in Some Settings % of Participating Institutions Number of Participations in the EQA Source: Instituto Nacional de Saúde, Moçambique
- 13. Mozambique’s National Health System Adopted a Multi-Step Evaluation Process for Point-Of-Care Technologies Technology Selection Technical Evaluation (Laboratory, Field) Pilot Implementation (Site, Province)
- 15. Type of technology (disposable, handheld, tabletop)
- 17. Mobility & Size
- 20. Power Source
- 21. Alternate Power Source Availability
- 23. Type of Sample Tubes
- 25. Reagent & Control Preparation
- 30. Number of Steps in Procedure
- 31. Type of Sample Required
- 32. Precise Sample Measurement Requirements
- 33. Batching
- 34. Result Delivery
- 35. Result Storage
- 38. Supply Chain and Distribution
- 39. Timing & Regulatory Status
- 42. One mobile team in a remote rural area in the north of Mozambique
- 44. A Mobile Team Successfully Operates in Northern Lake Niassa, Mozambique Setting: population ~20,000, area 1,600 km2. Strategy: Every 2 months, 2 community health workers, with no formal health qualifications, make a round trip of 220 km on foot or kayak, stopping at 8 health posts. Cumberland et al. Poster TULBPE060; IAS 2011
- 45. Sites with POC CD4 Perform Well in the National Proficiency Testing Program Sites with POC CD4 Sample QC49, average absolute CD4 count=400 cells/mm3 Source: Instituto Nacional de Saúde, Moçambique
- 46. A Pilot Implementation in Currently Ongoing in Mozambique’s Gaza Province Main Objectives: - Test an approach for the implementation of point-of-care CD4 counting from a health system perspective. - Develop and validate tools to assist provincial authorities in scaling-up the implementation of point-of-care assays.
- 47. Site Matrix Preliminary site list generated from a site selection matrix. Nov 2010 Provincial Coordination Provincial stakeholder meetings. Site list validated. POC ToT Central level team trains provincial trainers. Dec 2010 Provincial trainers train and certify local POC CD4 operators. Train Sites Site Introduction Sites mentored. New patient flow diagrams implemented. Sites begin to implement POC CD4. Jan 2011 Joint Stakeholder evaluation meetings. Discussion of lessons learnt. Road map for continuous improvement. Validation of tools. Periodic Evaluation May 2011
- 50. Laboratory
- 51. Clinic
- 52. Logistics and supply chain
- 56. Patient overflow - Patient education