Ongha-Ongha Health Centre is one of seven facilities in the country that are successfully rolling out the Short Message Service (SMS) reminder system to encourage patients on antiretroviral treatment (ARV) to continue taking their medicines.
The system, in addition to community health workers who go into the villages to trace defaulters, has contributed to the retention of defaulters by 17 percent.
During a roundtable discussion outlining the success story of Ongha Health Centre, Evans Sagwa, the country project director at Systems for Improved Access of Pharmaceuticals and Services (SIAPS) Namibia, explained how the SMS reminder system is linked to the Electronic Dispensing Tool at Ongha Health Centre’s pharmacy.
Sagwa said the SMS reminder system reminds a patient who is due to collect their medicine one day ahead of their appointment. “The message is written in such a way that it should not be overly revealing because of confidentiality,” explained Owen.
The system then sends another SMS reminder the morning that the patient should collect the medicine. The system is designed in such a way that if a patient does not collect their medicine, another text message would be sent out to encourage the patient to collect the medicine.
It does this for several days and if the patient still does not show up at the clinic then the patient is put on a list of defaulters, who are to be followed up on.
“It’s not policing, but it is providing support to the patient,” Sagwa added. He explained that once a person is diagnosed with HIV they have to strictly adhere to their treatment regimen unless the doctor advises otherwise.
A patient can collect their medicine every month, every two months or every three months, depending on a number of factors.
Sagwa noted the pharmacy is a supportive service to make sure that medicines are available and the patients who need the medicines receive the medicines, “specifically for HIV treatment”.
The Electronic Dispensing Tool at the pharmacy is supported by the US government through the United States Agency for International Development (USAID).
“The computer at the pharmacy is loaded with that dispensing tool. The tool is used to record the patients receiving treatment and the demographic information, such as their gender and age,” he said.
He said the application records the information on the HIV treatment that the patient is receiving.
“HIV treatment is made up of a combination of medication and it is called a regimen. The tool helps to schedule appointments for the patient’s next visit, because once the patient is put on treatment they shouldn’t stop treatment unless directed by the doctor,” Sagwa stated.
Appointment dates are important because in the system there is a date that indicates that the patient needs to return for their medicine.
In addition to dispensing medicine, the pharmacy team also reinforces the messages the patient would have received from the doctor or nurse, emphasising that the medicine should be taken correctly. Patients at Ongha Health Centre are getting consistent information to reinforce their treatment, a proud Sagwa added.
US Ambassador to Namibia Thomas Daughton recently stated that preventing the spread of HIV and treating AIDS presents great challenges, including achieving and sustaining high levels of adherence to anti-retroviral treatment.
“I am greatly pleased that the Electronic Dispensing Tool, which is another application supported by the US government, is being successfully used in Namibia to schedule and track the dispensing of ARVs to patients and to monitor early warning signs regarding potential HIV drug resistance,” Daughton said.
HIV drug resistance is a dire consequence of interrupted and mismanaged patient ARV regimens, he noted.
The Electronic Dispensing Tool is being rolled out in more than 50 health facilities, however only seven facilities have the SMS reminder system at present, with Ongha Health Centre being one of them. The other sites are in Windhoek, Walvis Bay, Outjo, Omaruru, Ongwediva and Eenhana.