Contact tracing of HIV clients is resource intensive especially for high burden facilities in Malawi. To help improve client retention in HIV care and reduce workload for healthcare providers, the Lighthouse Trust team is working with a number of partners and stakeholders (including Department of HIV, STI and Viral Hepatitis, Kamuzu Central Hospital, Lilongwe District Health Office, Malawi National Health Sciences Research Committee and the University of Washington’s International Training and Education Center for Health - I-TECH) to implement a study that involves the use of hybrid automated and manual two-way texting (2WT) intervention to support proactive interaction between healthcare providers and HIV clients. The 2WT system is powered by CHT, clients registered in this intervention receive weekly automated motivational messages on diverse topics, clinic visit reminders on day 3 and 1 before the visit and reminders for those who missed visits on day 2, 5 and 11 after missing the visit. Clients can also send texts and interact with healthcare providers to confirm visits, report transfers and request for rescheduling of their clinic visits.
Point of care electronic medical record systems (EMRs) are used to manage HIV care and antiretroviral treatment. When a client is registered in the EMR and a barcode is generated and a client is assigned a patient alphanumeric ID. When this study commenced, the study team experienced transcription errors in capturing the alphanumeric patient IDs in the 2WT system. To help resolve this issue the team incorporated the barcode feature in the 2WT system to enhance the quality of data captured and improve the process of sharing data from the EMR to 2WT system based on the alphanumeric patient IDs. The team is using the binary code scanner which is compatible with a wide range of Android versions (newer and old Android versions). During the registration process, a user clicks on the launch app and it will direct the user to scan the barcode using the Binary Eye scanner, resulting in the patient ID form field being filled automatically. Plans are underway to scale the 2WT intervention to more facilities in Malawi. Currently, there are ongoing CHT barcode feature enhancements that will support the scanning of barcodes in Enketo forms without using a third party barcode scanner app.
You can read more about the use of 2WT intervention for ART retention in Malawi here, thank you the Lighthouse Trust team (@Geldert and Maggie), Hannock and @cliff for the great presentation and demo, you can access the barcode community story presentation here. We look forward to getting more updates from your team on the impact of the 2WT intervention in Malawi