A Rapid Evaluation of the Uganda MoH Training Program on the Use of HIV Patient Monitoring Tools
Due to the chronic nature of HIV/AIDS, accurate, up-to-date patient records are vital to ensuring that HIV/AIDS patients receive quality care. Recognizing this, the Uganda Ministry of Health (MoH) hasdeveloped a set of patient monitoring tools—registers and cards—to aid health workers in recording encounters with HIV/AIDS patients, tracking services provided, ensuring that needed services are provided, and provide data to the district level. The MoH has developed a training course to help health workers use these tools accurately and completely. Such training was conducted for 23 health facilities in Mbale Region in August 2009. The USAID Health Care Improvement Project (HCI) conducted a rapid evaluation of that training session and some of its outcomes to determine whether it improved health workers’ performance in using the tools.
Data were collected in 10 of the 23 facilities through a retrospective record review and interviews with facility in-charges and medical superintendents. Three patient monitoring tools were reviewed at each facility: cards for recording either pre-antiretroviral therapy (ART) or ART care and two registers for recording pre-ART and ART care. Pre-training performance was based on the quality of patient recordkeeping (that is, how well they were completed) in June and July 2009 and post-training performance on the same tools the following September and October.
The evaluation found that the training was well implemented, on schedule, and gave all participants a training manual and a copy of the patient monitoring tools. The knowledge test given to trainees at the start of the training and at its conclusion was also given twice, four days apart, to a comparison group of similar persons who did not attend the training. The training group’s performance increased 10.0 percentage points over the four days while that of the comparison group increased 5.9 percentage points. The 4.1 percentage point difference was not statistically significant.
The evaluation concluded that the training was not, on its own, sufficient to ensure adequate use of the patient monitoring tools. In addition to training, the MoH can improve patient monitoring by ensuring adequate stocks of these tools at facilities, assigning a facility staff member to be responsible for data management, and assigning a facility staff member to supervise record and data management functions.