On the 12 May 2008, the ECRTC held its first didactic data module training session at the Walter Sisulu university in-service hall in Mthatha. This three day training course was designed to provide participants with fundamental concepts, policies and data management principles required to effectively manage a facility ’s information. Emphasis in this course is placed on accuracy in the collection collation of clinical data, timeliness of reports and an improvement in the way health facilities share information amongst themselves. The target audience for this course are health professionals working in the field of HIV/AIDS.The topics covered in the training module included:
- The epidemiology and Natural history of HIV infection
- Approaches to prevention, diagnosis, treatment and support for HIV/AIDS
- Understanding VCT, PMTCT, Palliative care, ARVs, TB/HIV,PEP services.
- Role of the data capturer
- Definition of indicator and data element
- VCT data elements & VCT register
- PMTCT data elements & PMTC register
- ARVs data elements
- TB/HIV data elements
- Pre-ART register
- ART register
- Patient card
- Patient file
- Quality of data
- Summarising data
- Information flow guide
- Understanding how to use DHIS
- Use of data for systems improvement
The initial decision was to have different cadres of health professionals working in the HIV/AIDS care unit under one roof for this course. This decision was later reversed to training only one cadre of professional at a time in other words nurses would be trained separately from data captures etc. This was done to prevent boring particular groups with topics they were familiar with. Clinical data captures working in HIV/AIDS care facilities were chosen to form the first group of trainees. In this course
A total of 50 invites were sent out to data captures across various districts, only 26 participants arrived for the training. Similarly various ECRTC staff were recruited to assist the information officer in the training, Mrs. Mazwi did the introduction , Mrs Rozani covered epidemiology and natural history of HIV infection, Mrs Dlamini covered approaches to prevention, diagnosis, treatment and support for HIV/AIDS, Miss Ntswe covered the topics on the clinical registers, while Mrs Makhatini did the portion on systems improvement. A request was also made to the computer science department for the use of their labs for the DHIS component. This request was turned down because the timing of the training coincided with student s preparation for mid-year exams. In addition, invitations were sent to the Eastern Cape Department of Health ECDOH) and HISP to assist with the training programme. ECDOH sent a representative, Mr. Makoa. Due to logistical reasons Mr. Tlamama the HISP representative was unable to make it.
Initial Setbacks
Mr. Tlamama’s absence as well as the computer department’s refusal to avail their their labs meant that the topic on DHIS had to be scrapped .This was a major setback as participants later revealed that this was the module’s main attraction. The topic on the role of data capturers also had to be cancelled because the ECDOH representative received the training schedule late.
Lessons Learnt
The training was well received and from the individuals attended only few had ever attended a data module training prior to this.
A few had basic idea what constitutes reliable data, all understood the importance of data confidentiality.
All knew the importance of timeliness when reporting and all knew due dates for data submission.
Data element definition were poorly understood and differed from individual to individual, only data captures working in hospitals or the LSA’s with access to DHIS software had access to data element definitions.
Apart from the VCT register all HIV/AIDS clinical registers were poorly understood. The problem emanated from lack of clarity on the role of the data capturers . It was revealed that a lot of conflict existed between data capturers and nurses on who fills the clinical registers. This confusion of roles extends to data collection, collation, reporting, verification etc. Data sharing between clinical staff for strategic decision making is virtually non existent. Most data capturers were interested in the DHIS portion and expressed major dissappointment when this section was canceled.
