Presented by Leontine Gnassou and Upama Khatri

1. Cote d’Ivoire
3ILPMS Experience
Leontine Gnassou, Upama Khatri
MEASURE Evaluation

2. Introduction
 HIV Epidemic in Cote d’Ivoire :
 Generalized, one of the highest in West Africa
 HIV prevalence: 3,7 % DHS 2012
 Level of decentralization: 3 levels
– Central : reference hospital: 2; 1 Military hospital;
1 private hospital
– Regional hospital
– Peripheral levels,
 # sites offer care and treatment: 538
 # of sites offer PMTCT: 987
 # people currently on ART: 109 926

3. ART coverage

5. 1-Patient Monitoring Systems
Used 1/2
• In 2006, the PMS tools were adapted to the Cote d’Ivoire context, pilot-
tested and rolled-out nationally
• The EMR (called SIGDEP) was developed in 2009 and used in facilities
with more than 100 patients on ART
 To align with MOH guidelines on service integration, and meet donor
requirements and global guidelines for service integration, in 2011, the
PMS was revamped into the 3ILPMS, pilot-test and implemented since
March 2012
 The specific WHO 3ILPMS tools that were adapted are the
following : Patient Card : dossier du patient, Pre ART register, ART
Register, Maternal adapted card, ANC Integrated Register, Labor and
delivery Register, Post Natal Integrated Register, Exposed Infant Card,
Integrated Monthly Report, Cohort Analysis Report
 The roll-out of the 3ILPMS is going well, the main constraint is lack of
funds for data collection tools printing

6. 1-Patient Monitoring Systems Used
2/2
 Both the paper-based system and electron system
(SIGDEP) are in use in Cote d’Ivoire depending on the
level of the facility
 The system has been implemented country-wide, and
most of the partners used this national system
 The reporting component includes the cross sectional and
cohort analysis report, the EMR can generate the same
reports
 HIV data are integrated in the broader HMIS system at the
district level with an other software SIGVISION

7. EMR: Data Entry Interface
Alerts in red to
inform of
missing data

8. View of Patient Clinical Form
Latest HAART
regimen with
date of
prescription
Click here to
view last 6
months CD4
Figures of
CD4 and
Weight
evolution
since inclusion

9. Standardized Cros- Sectional Reports
are System Generated
PEPFAR Monthly
report
Print the
document
Export the
document to
computer desk

10. 3- Strengths and Challenges
 Strengths
 CI HIV system is integrated to the HMIS
 Acceptance and use by all stakeholders
 New guidelines and procedures have been developed
 Weaknesses
 The are a lot of tools; high data collection burden reported by
service providers
 SIGDEP covers only 222 HIV Care & Treatment sites out of 538 in
the entire country
 The system requires dedicated data managers for all the sites
 The challenge of integration into HMIS is the functionality of
SIGVISION, the alterative choice of the MOH is the
implementation of DHIS-2

11. 4-Future for your country:
update/change needed
 What are the main things (or more) You country will
need to update/ change/delete in your system
following release of new WHO ARV guidance
 to reduce indicators and tools or determine the
minimum tools for the HIV patients management

12. 5-Future for WHO guideline:
update/change needed
 What do you think WHO needs to update/change for
its new PM guidance ?
 Operations Manual should provide guidance on the
process of country adaptation (e.g. how to go about it,
what other countries in region have already done,
resources available)