Improving Quality of Care and Management of HIV/AIDS through Electronic Based Community Drug Distribution Point Application (e-CDDP App).

By Racheal Kemigisha.

Reach Out Mbuya Parish HIV/AIDS Initiative (ROM) is running an Electronic Based Community Drug Distribution Point Application purposed to improve adherence to treatment and management of HIV/AIDS by expanding coverage to over 90 percent in the ROM and Rural Initiative for Community Empowerment West Nile (RICE-WN) selected communities.

Presently, we have a total of two thousand eight hundred and twenty-three (2823) clients enrolled on the application with two thousand six hundred forty-four (2644) by the end of October at the ROM cddp sites all together, and two hundred eighty-two (282) in RICE-WN( Arua district).

Among these is Namakula Sarah 42, a client from Mutungo who in the past would visit the main facility in Mbuya. She would then have to wait for almost a full day to get medication but now she appreciates the e-CDDP Application that has reduced the entire process to five (5) minutes or even less.

Namakula Sarah being assessed by a Community ART and TB Treatment Supporter (CATTS) using eCDDP from ROM outreach in Kiswa Community- Mbuya,Nakawa Divison.

 For Sarah Nambya a mother of three, it has been cumbersome for her in the past. “I would spend the entire day waiting for my turn to get medication yet I work two jobs one in the morning and the other in the evening but now it takes a few minutes, today I first reported to work then came here.,” she narrates.

Though the use of this application has challenges like, failure of some clients to turn up for appointments, we are able to see improved coverage and quality of services by decongesting clinics, reducing client waiting time and transport cost by taking services closer to clients.

 Nambya Sarah 33, receives medicine during the ROM outreach in Kiswa Community.

Nabukwasi Teopista, the one of the CATTS said, the e-CDDP Application has eased her work. ‘’Once we assess the client information updates are automatically sent to the cloud, Backup database (Cddp-App Web API at the main Facility).”

The application which has an inbuilt database is able to synchronise with the shared database. The application also has two interfaces- the desktop interface and the mobile interface. The desktop interface is used at the main service centre to capture information about the clients. The initial registration of the clients is done using the desktop interface. The mobile interface enables users of a mobile device (phones and tablets) to access doctor prescriptions and dispense the prescribed drugs.

Step by step guide on how the application operates;

1.  The Clinician Screens patients eligible for CDDP as they capture the clients’ data into the electronic system/excel sheets.
2. 2-3 days before the specific clients CDDP-appointments, the patients’ files are retrieved by the registry clerk supported by the respective community health workers.
3. Thereafter, these files are taken to the clinicians to cross check whether the CDDP Register corresponds to the named cddp clients to ensure that all of them scheduled for that appointment date, are included on the list.
4. The Drugs given are then packed by the pharmacy staff in the presence of the community health workers to be delivered to the clients in their respective CDDP sites, together with the Tablets.
5. The Community Health Workers synchronize clients’ data using internet(mifi) However, after synchronization of the clients’ data, the app operates while off internet.
6. The Clients are then assessed by the community health workers using the CDDP- Application (Tablets) while being given their drugs.
7. The data is then saved temporarily on the tablets until all the clients on the specific CDDP appointment have been assessed, thus saved to the cloud there after.
8. The Clients Data can now be accessed by the specific project team members for usage i.e. making reports, comments, as well as following up clients for referrals and missed appointments.

Eligible clients should be;

1. Above 19 years’ old.
2. Adherence of 95% and above (and keep their appointment).
3. Without co-existing chronic medical/surgical condition such hypertension, diabetes mellitus, malignancy.
4. The project targets PLHIV who have been on AntiretroviralTherapy (ART) for at least 12 months and on their current regimen for at least 6 months.
5. Virologically suppressed with ((viral load less than 1000copies/µl (plasma) or 5000copies/µl (DBS).)
6. No active TB or other WHO stage III/IV opportunistic infection.
7. Not pregnant or lactating woman.