Any time an organization is able to do great good, with amazing results — especially for underserved populations — our Zerion team gets excited. This is the case for the American International Health Alliance (AIHA).
Faced with limited funding options, AIHA — an international nonprofit focused on advancing global health through locally driven, locally owned and locally sustainable health systems strengthening and human resources for health interventions — reached out to Zerion in 2016 to develop a one-of-a-kind solution with major positive implications. They appreciated our team’s flexibility, responsiveness and, most importantly, the ability to build a relationship for moving forward.
The ACT, or Accelerating Childhood Treatment, patient tracking mobile application project was launched and implemented with the Defence Forces of Zambia (DFZ) to reduce loss follow-up among children and their mothers following HIV diagnoses. The application was preloaded to mobile phones and distributed to DFZ Facility healthcare workers, community healthcare workers and DFZ HIV Secretariat M&E staff members. We recognized this effort with a 2019 Distinguished Project Award, but, want to highlight the case study as well.
HIV in Zambia
HIV in Zambia is a serious concern: 1.2 million Zambians are currently living with HIV.
Patient care is critical to the management of HIV and patient attrition is recognized as a threat to the long-term success of antiretroviral treatment programs, however, loss to follow-up — where patients do not attend care and treatment appointments is a major problem in Zambia and across sub-Saharan Africa.
AIHA needed a better way to address the problem; thus began the ACT application project.
The ACT App in Action: Why and How it Works
The primary functions of the app are:
1. Tracking patients to ensure they attend upcoming HIV care and treatment appointments.
2. Finding patients who have stopped attending appointments while bringing them back into care or removing them from records.
3. Monitoring patient viral load numbers to assist DFZ achieve nationally set targets.
In a country where HIV is prevalent, yet care is available, finding a way to reach those most at risk is incredibly important: the app makes this more possible than ever.
Using the ACT app, facility health workers are able to input a patient’s national SmartCare identification number, address, key demographic information, date of follow-up appointments and the name of the community health worker assigned to that patient’s case. Because of this link, community health workers receive alerts before upcoming appointments to provide reminders to increase the likelihood of the patient showing up for the appointment.
When a patient is lost to follow-up, information can be input into the app to redouble efforts to bring them back or provide an explanation for why the patient is no longer in treatment.
From Pilot to Launch
This needs for this project were specific, yet crucial. As such, DFZ and AIHA began working with Zerion to create and conduct a needs assessment, to create a more comprehensive solution from the start.
After the process was completed, the application was piloted at three DFZ sites in Zambia. Since then, it has been expanded to 12 additional sites. Today, 140 users are actively involved in working within the application.
Primarily, ACT is used by a third party and monitored by AIHA who is able to interpret and analyze the data received to create action plans, while reporting the data to their donor and in promotional materials to demonstrate success.
Baseline to Growth
As previously mentioned, 1.2 million Zambians are living with HIV; as of 2016, 65% were receiving antiretroviral therapy (ART), yet, only 85% of those receiving treatment were still doing so after year one.
At that point of time:
- Among pregnant women living with HIV, 83% were accessing treatment or prophylaxis to prevent transmission of HIV to their children.
- Approximately 8,900 children were newly infected with HIV due to mother-to-child transmission.
- 66% of those living with HIV knew their status.
- 58% were living with HIV with suppressed viral loads.
- 72% of women 15+ were receiving ART.
- 52% of children 0–14 were receiving ART.
Now that the application has been launched, AIHA is able to identify and address these issues and statistics head on, by using a custom dashboard to help identify the root causes of losing patients to follow-up and low treatment numbers.
Thanks to the creativity and innovation of the AIHA team, and their willingness to partner with the Zerion team, ACT is radically improving and saving lives both now and well into the future!