ARV Down Referral Patient Management System

Down Referral is a mechanism to increase access to care for large numbers of patients requiring Anti-RetroViral (ARV) therapy.  Down referral to primary health care sites often ensures that patients receive treatment within walking distance of their homes, reducing the financial burden associated with transport and loss of income for clinic visits. In South Africa PEPFAR-funded NGO Right to Care has worked with US biotech company TherapyEdge to develop a module for TherapyEdge’s suite of HIV treatment products.
The system maintains patient record continuity between the initiation site and the primary health care down referral site. The higher level prescribes the drugs. The lower level records the details of each patient visit: if the the patient is stable the drugs are issued, if not the patinet is referred up again.

One minor problem wth the system: how many primary health care facilities have computers with internet connectivity?

Ward Committee Data Management System

The South African Department of Cooperative Governance and Traditional Affairs is currently developing a web-based data management system aimed at expanding and strengthening community based participation in local government.

Ward committees are the structure that makes it possible to narrow the gap between local municipalities and communities, since they have the knowledge and understanding of the citizens and communities they represent. There are 3895 ward committees in South Africa, comprising each of 10 members. The Local Government sub-municipal ward committee structure is meant to play a critical role in participatory democracy.

The proposed Web-based data management system will paint a global yet detailed picture of the ward committees, display exhaustive ward profiles information and fill essential knowledge gaps on the functionality and effectiveness of the ward participatory system.

The system is due for launch in December 2009.

The DREAM Project

Sub-Saharan Africa could soon have medical records of people living with HIV and AIDS patients run electronically, thanks to The DREAM Project which now operates within the framework of the national health systems of several African countries. DREAM has now spread to 10 African countries: Mozambique, Malawi, Tanzania, Kenya, the Republic of Guinea, Guinea Bissau, Cameroon, Congo RDC, Angola and Nigeria and is being used by thousands of professionals in 31 centres and 18 molecular biology laboratories that are already operational and by now has reached its fourth version.

The Dream Project aims to introduce the essential components of an integrated strategy for the prevention and treatment of HIV/AIDS and will provide efficient management of the clinical data regarding the treatment of the patients and epidemiological analyses. The project is intended to serve as a model for a wide-ranging scale-up in the response to the epidemic in a unified manner of gathering data by different centres in different countries, monitoring of centres and for the refining of therapies.

DREAM was launched in Mozambique in March 2002, following two years of groundwork. However, the idea for the project was born in 1998 when the Community of Sant’Egidio– a Christian movement founded in Rome in the late 1960s that has a strong base in Africa – decided to fight the devastating impact of HIV/AIDS.

The medical files of over 73,000 assisted patients are managed by this software and the data collected with it have become essential for the epidemiological research that is carried out to improve the effectiveness of the therapy.

Specific software for the management of the patients’ EMR has been created within the DREAM programme in order to deal with the challenges deriving from the context in which DREAM operates. Setting up a computer infrastructure in health centres, providing a power supply, as well as managing the data and the project resources efficiently and reliably, are some of the challenges the project aims to solve.

As for Internet connections, especially regarding bandwidths that are not always adequate, the matter is tackled in different ways. Careful enquiries made to local Internet service providers (ISP) have allowed many centres to have good quality Internet access at an accessible price. In cases where this was not an option, the problem has been resolved by using satellite connections, usually installed in our laboratories.

For all the rural centres that are not connected to the Internet, it has been possible to transfer requests for tests via flash disk from the centre to the laboratory. The same applies to the transfer of backup of the centres. Once the backup reaches the laboratory, the software makes it possible to send all the backup of the satellite centres to a centralised server. Another important point: the size of files sent is reduced, to make them as robust as possible, so as not to be vulnerable to possible loss of data. An incremental backup system with especially strong redundancy was designed in order to achieve this.

Testifying to the quality of the networks (electrical as well as computer) of DREAM centres, VoIP communication systems have been introduced (at times supplied by the operators), which have allowed for the reduction in intercontinental teleconsultation costs. DREAM has chosen to invest in intensive short-term personnel training, followed by more prolonged in-service training with the support of expert personnel at the workplace.

Community intervention models have also been developed, such as outpatient care, community and home-based care. These do not require extensive resources and can be set up quickly. As a backup, a small number of high technology centres capable of supporting large areas (e.g. molecular biology laboratories) have been set up. In every DREAM treatment centre, a computer with the DREAM Software is available for all staff members; everyone follows the patient as per his/her specific competence and tasks and while doing so, has all the updated data of the said patient at his/her disposal.

Not only does this make procedures more efficient and the work of the centre more streamlined, it has also served to guarantee the quality of data, with each staff member able to verify the said data from his/her own station.

Centres are lcoated within a 150 km radius of cities and have been equipped so that they can offer the same qualitative level of treatment and monitoring as those closer to the cities. Apart from supplying equipment, the transport of blood samples and periodic supervision by DREAM staff are also organized.

The attention paid to the requests of the end users, covering every aspect of care and treatment, the possibility of having homogenous data from different countries, are only some of the significant features which have made this computer system an indispensable tool for the management of treatment and for epidemiological research. » Kenya » Dream project aims to manage HIV/AIDS in Africa electronically

Question Box

Question Boxes bring information to people who cannot or do not access the Internet directly. Question Boxes leap over illiteracy, computer illiteracy, lack of networks, and language barriers. They provide immediate, relevant information to people using their preferred mode of communication: speaking and listening. As such, Question Boxes combine the ease of using mobile phones with the enormous information and communication power of the Internet.

Question Box users can use their mobile phones to call our call centers, or they can use the physical Question Box Units to call for free.

We have launched the Applab-Question Box hotline in collaboration with Grameen Foundation’s AppLab in Uganda. This collaboration takes Question Box to a new platform – making the service available directly via mobile phone. 40 Grameen Community Knowledge Workers (CKWs) in the field spread the word to villagers in Mbale and Bushenyi regions. Users make calls from the CKWs’ mobile phones into our call center in Kampala. This program is made possible by a grant from the Bill & Melinda Gates Foundation.

Callers ask questions in seven local languages. Because the Internet is not consistent in Uganda, Open Mind in partnership with Appfrica has developed a local Knowledge Base filled with information on frequently-asked topics. This allows for efficient searches no matter the conditions.

Ujima Project

The Ujima Project is a collection of databases, documents and other information that attempts to bring transparency to the workings and spending of Africa governments, multinational non-governmental organizations and business enterprise in African countries. Because few African countries have freedom of information laws, getting at this information from inside the countries can be difficult.

The Ujima Project can be described as “reverse transparency.” Although the information might be hard to come by in African countries, aid donors, international organizations and agencies maintain a wealth on data pertaining to the continent. While this information is public, it tends to be scattered among governments in the United States and Europe, and international organizations like the Global Fund. We take the information from the various sources and put it into one easily searchable place.

The Ujima Project supports the work of African journalists and transparency advocates. It is a project of the Great Lakes Media Institute, a 501(c)3 organization, initially founded to support the training of Rwandan journalists and the resulting Great Lakes Media Center in Kigali. Investigative Reporters and Editors, an international journalism organization of investigative reporters and editors based at the University of Missouri-Columbia, has played a key role in the development and support of this endeavor. This website was launched in “beta” version in September 2009.

The Ujima Project – Investigative Reporting for Africa

AU Boundary Information System

As part of the Delimitation/Demarcation and Capacity Building Programmes of the African Union Border Programme (AUBP) a Boundary Information System (BIS) is being established in the African Union. The BIS seeks to establish a Database of boundary and border related information relating to all African Countries.

Specifically, the BIS being established is aimed at:

  • The storage, presentation and retrieval of varied data relating to African borders such as Status of a given boundary
  • Background data such as maps, satellite imagery etc
  • Responsible agencies for border management
  • Position of demarcation marks, border land infrastructures etc
  • Processing boundary record such as coordinate transformations and analysis
  • Recording border activities and datasets of cross-border cooperation.

The AU is currently looking for a Geographic Information System (GIS) Officer to develop the project.

‘Who owns what?’ the ISS Database of Politicians Assets and Interests

This online database is the result of two years of research which has yielded almost 6000 records submitted between 2004 and 2008 by elected members in the National Assembly, National Cabinet, Nine Provincial Legislatures and Cabinets as well as the countries six metropolitan areas (cities). For the first time the publicly accessible disclosure forms of cabinet members, MP’s, Members of Provincial Legislatures and City Councillors will be made available through a searchable public database.

This is the first comprehensive database of its kind on the African continent and one of the few examples of such databases internationally. It is hoped that it will prove a useful tool for Researchers, Civil Society, the Media and ultimately promote not only oversight of but also integrity in public life in South Africa. The records were collected with the support of the various public institutions and by and large reflects their commitment to open, accountable governance as envisaged in the Constitution.

The Conflicts of Interest Database and Webportal

see also Who Funds Who