Lynsey Isherwood, MSc. (med)National Priority Programs Unit

National Health Laboratory Service

29 October 2014

Linkage‐to‐Care solutions for MDR‐TB in South Africa

Primary aim (overall)

To develop a comprehensive mHealth solution toimprove linkage to care for RIF (R) patientsidentified by GeneXpert technology to ensure theirrapid access to appropriate MDR‐TB treatment.

MDR‐TB mHealth in South Africa

PHC GeneXpert Patient Registered

Patient Returns

RIF resistant 2nd sputum

Patient counselled and sent home with mask

TB coordinator •Appointment at MDR‐TB Tx site•Patient informed of appointment

MDR‐TB

±3 days

±5 days

Redu

ce time to Txaccess and

 continuo

us M

&E

ID numbers

Linkage B/D 

mHEALTHSource: L.E. Isherwood

MDR‐TB patient flow

W. Cape

M&E

mHealth interventions

1. Bi-directional SMS printers

2. MDR-TB “TiA”

3. emocha (M&E)

Treatment Initiation APP

Complexity

Bi‐directional SMS printers

SMS bi‐directional printers

• Phase 1: 2096 Health Care Facilities• Phase 2: 90 Correctional Services• Phase 3: All Health Care Facilities

(90)

Connectivity “Big Brother”

Slide with compliments from emocha

Slide with compliments from emocha

Slide with compliments from emocha

In conclusion: strengthen HSS

Clearly defined, tiered reporting to MoH and other stakeholders

mHealth Solutions

Diagnostics PHCs Treatment Centres

Doctors

NursesTracers

Injection Teams

Community Advisory Boards?

Rapid treatment initiation and continuous monitoring & evaluation

Acknowledgements

• Floyd Olsen

• Portia Madumo 

•Brad Cunningham

• Lynsey Isherwood

• Sylvia Ntsimane

• Wendy Stevens

• Leigh Berrie

• Sebaka Molapo

• Sue Candy

• Naseem Cassim

•Yara Voss de Lima

•Lesley Scott

•National Department of Health

•Jason Farley

•Jane McKenzie‐White

• Louise Welsch

• Murchison Hospital CEO and staff

• Annatjie Peters

• Matsie Mphahlele

• Jhpiego South Africa

• Varough Deyde

• Adeboye Adelekan

•Dr Mark Nicol

•Dr Lindy Dickson‐Hall

Contact: Lynsey.Isherwood@nhls.ac.za