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Improving Appointment keeping of HIV Positive clients at Moroto Regional Referral Hospital (RRH), Uganda
Geofrey Ssekalembe, Brian Matovu, Sri Surmarmi, Haksama Setya

Last modified: 2018-09-16

Abstract


Background

The ART clinic at Moroto RRH serves seven districts in the Karamoja region and has been supported by Strengthening Uganda's Systems for Treating AIDS Nationally (SUSTAIN) project since 2011. Currently, it has enrolled over 1,000 patients on HIV care, however appointment keeping still remains a challenge. SUSTAIN however initiated a Quality Improvement (QI) project in April 2017 towards improving appointment keeping of HIV positive patients. This QI project rose as a result of a very low patient appointment keeping (below 50%) and more so had further declined in March to 45% from 47.6% in February.

The specific objectives of this project are to streamline clients’ appointment process with in the implementation period, to increase awareness of clients about the importance of keeping appointments, to increase staff knowledge and practices about the appointment system.

Materials and Methods

A comparison analysis study has been made for a period of three months since the QI interventions and the last three months before the project. The number of patients who kept their appointment is compared to those that were given appointment.

Results: Improvement since the start of this QI project as evidenced in the preceding months of April (79.5%), May (81.5%) and June (83.7%) as compared to the previous months of January (41.6%), February (47.6%) and March (45%). It is projected to be 100% in August 2017 and onwards keeping other factors constant

Conclusions: Interventions to improve this are; conducting routine intensive adherence counselling and health talks by the counselors to ignite a sense of appointment keeping, initiating mobile services to communities through patients’ team leaders, issuing two-month supplies of ARV drugs to stable clients, harmonizing appointment dates for clients from the same family and Village to encourage collective support and also provide food to clients on clinic days to encourage them keep their appointments since it’s on record that they appear when there is food to be served.