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        • Lighthouse Trust's Community-based ART Retention and Suppression (CARES) App in Malawi
        • Differentiated Service Delivery Models Support in UgandaEMR
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  • Patient Identity Management Toolkit
    • Modules
      • Key Considerations in Matching
        • Background
        • Phase 1 - Planning and Analysis
        • Phase 2 - Implementation
        • Phase 3 - Review and Refine
        • Frequently Asked Questions (FAQ)
      • Matching with Biometrics
        • Overview
        • Role in Identity Management
        • Choosing Biometric Characteristics and Modalities
          • Reviewing Studies and Comparisons
          • Reviewing Standards and Guidelines
          • Additional Topics to Consider
        • Trends and Developments
          • Current Trends
          • Future Developments
        • Closing
        • References
        • Glossary
    • Learn from Others
      • Map of Country Implementations
      • Reaching Health Standards and Creating Client Registry in Haiti (2021)
      • Introduction to Biometrics for Patient Identity, Presented by Simprints (2022)
      • Utilizing Biometrics for Unique Patient Identification (UPID) in Côte d’Ivoire (2022)
      • Establishing a Unique Patient Identification (UPI) Framework in Kenya (2023)
      • Malawi Master Patient Index (2023)
      • Piloting a Patient Identity Management System (PIMS) in Haiti (2023)
      • Leveraging Biometrics to Scale a Patient Identity Management System (PIMS) in Nigeria (2023)
      • Leveraging Adaptive Machine Learning Algorithms for Patient Identification in Zimbabwe (2023)
      • OpenHIE23 Meeting in Malawi. Patient Identity Management Collaborative Hackathon. (2023)
      • Strengthening Patient Identity Management (PIM) by Integrating a Client Registry in Rwanda (2023)
      • Patient Identity Management Initiatives in Ethiopia (2023)
      • Patient Identity Management Initiatives in Botswana (2024)
    • References
  • How to Provide Feedback and Input on the TIF and Toolkit
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On this page
  • Countries: Uganda
  • Overview
  • Intervention Details
  1. HIV Treatment Continuity Technology Intervention Framework (TIF)
  2. Outside the Visit
  3. Congestion Redistribution

Differentiated Service Delivery Models Support in UgandaEMR

UgandaEMR (March 2023)

PreviousLighthouse Trust's Community-based ART Retention and Suppression (CARES) App in MalawiNextPooling Patient Data

Last updated 8 months ago

Countries: Uganda

Overview

In 2016, the Uganda National Consolidated HIV Prevention, Care and Treatment Guidelines recommended “Test and Treat” for all PLHIV regardless of clinical stage or CD4 as a critical strategy to enable Uganda to achieve the UNAIDS 90-90-90 goals. In the same guidelines, Uganda also adopted differentiated services delivery (DSD) model for HTS, HIV care, and treatment, recognizing “no size fits all” and to take care of individual’s unique needs. This led to a goal to migrate from paper-based DSD implementation to electronic to allow health workers to categorize patients as stable/unstable, enroll and track patients within DSD models, ease reporting and analysis.

This approach was embedded into UgandaEMR with community-based workflows implemented using UgandaEMR Mobile, a mobile and offline-capable solution. Technology support is tiered from facility-based support to district/implementing partner to national level support.

Plans to integrate with Medic Mobile for community-based care.

Intervention Details

  • National scope with specific implementations in high-volume facilities and urban centers.

  • Plans to scale up the CRPDDP model to more facilities.

  • Uganda EMR

  • Uganda EMR Mobile

  • ARTAccess for community retail pharmacy drug distribution integrated using a FHIR API (starting out with 60 facilities supporting 42,000 clients)

Categorization of patients into different DSDM models based on stability and care needs:

Stable Clients (stable on first- or second-line ART regimen at least 6 months, virally suppressed, WHO stage 1 or 2, 95% or better adherence over past 6 months, no TB or TB previously treated) utilize community resources to decongest facilities:

  • Fast Track Drug Refill (FTDR)

  • Community Client Led ART Delivery (CCLADs) - client-based groups in community rotate drug pick-up

  • Community Drug Distribution Points (CDDPs) - clients pick up drugs and receive clinical evaluation when due, including Community Led Drug Distribution Points (CLDDP) and Community Retail Pharmacy Drug Distribution Points (CRPDDP)

Unstable/new patients utilize services within facilities:

  • Facility Based Individual Management (FBIM) – clients needing extra attention

  • Facility Based Group (FBG) - for complex or stable clients desiring peer support

Calculations and Data Sharing:

  • Tracking patient appointments, adherence, and viral load testing.

  • Data synchronization between EMR, mobile app, and At Access system.

Health workers, data personnel, and pharmacy staff are trained to use the EMR and mobile applications.

Adjustments to the mobile app and EMR to suit local guidelines and patient needs.

Ensuring secure data transfer and storage, particularly with the integration of multiple systems.

Managing data synchronization, ensuring data security, and adapting to new guidelines.

Facilities routinely seeing 1000 patients per day were reduced to 300-600 patients per day.

Significant reduction in facility congestion, improved patient management, and better adherence to care protocols.

Scope

Tools/Technology

Data Processes

People

Implementation Considerations

Governance Considerations

Challenges

Successes

Impact

Resources

Notes page
DSD Uganda website
Link to presentation recording