Management of HIV/AIDS Care and Treatment Interventions: A Case for Antiretroviral Treatment (ART) Monitoring Within the Nairobi City Council

Background: High rates of defaulting and loss to follow-up (LTFU) are undermining antiretroviral treatment (ART) services in Kenya, with Nairobi City Council being no exception. Scale-up of treatment for HIV/AIDS requires long-term relationship with the patient, accurate and accessible records of each patient's history and methods to track his/her progress. Logical decision making may be compromised if right patient information is not available when needed. Objective: To improve quality by training on Quality Management concepts while at the same time developing and implementing an electronic medical database system that can be used in an ART programme to maintain and improve data quality and reduce multiple patient registration and loss of patients to follow-up. Methodology: The author and the City Council health management worked together to continuously improve care while keeping track of the care recipients. In order to achieve this, care givers were offered on-the-job training on quality management concepts while at the same time initiating and implementing a health information system (HIS) for HIV/AIDS treatment monitoring to support quality intervention outcomes within the care continuum. Results: A web-based Quality Management system developed and tested on internet protocol http://41.84.132.90 that demonstrated ability to improve quality of patient data including tracking patient identities and detecting duplicate records; accurately track patient outcomes; enablement of effective patient follow-up; improved drug supply management/accountability and ability to generate real-time reports for host institution, project management and funding agencies. Conclusion: Implementation of the project introduced evidence-based decision making in HIV care and treatment continuum within the Nairobi City Council health facilities. If similar information can be collected from all ARV treatment units in the country, it can easily be collated and used for six-monthly and annual country reports. Such data will enable the Ministry of Health to assess the effectiveness of ARV treatment in Kenya.