Based on in-country consultations, capacity to provide high-quality TB/TBHIV services\nis sub-optimal and not unrelated to weak supervision. Within the National TB Program (NTP)\nin Nigeria, supervision is entirely paper based; time consuming and structured in a way that rapid\nreview of results is neither available nor timely resolution of problems. Objective: Describe the\nvalue of smart phones in improving quality of supervision. Methods: This is a descriptive study.\nWith the NTP open to exploring innovative ways of strengthening supervision, Health Systems\n20/20 in collaboration with the NTP proposed a pilot use of smart phones for supervision at\nhealth facilities, with focus in Abia state. The State was purposively selected for the study. A stakeholders\nmeeting was convened to fully engage all key TB partners. Situation analysis was conducted\nin Abia state, a south-east state selected for the pilot, out of which 4 facilities were identified.\nNational and state supervisory checklists were reviewed, programmed & uploaded unto the\nsmart phones. The State TB teams were trained on the use of the smart phone & 6 supervisory visits\nwere conducted within 4 consecutive quarters in Abia state for each facility. Results: Within the\npilot sites, the smart phones were noted to be user friendly with rapid review of results done at\neach visit. Immediate feedback and corrective action for identified challenges were made. However,\nthe record of previous findings and recommendations could not be retrieved on the spot during\nsubsequent visits due to storage capacity of the phone. The time spent on supervision was reduced\nto 2 hrs per facility using the smart phones compared to 4 hrs when using the paper based\nat other sites. With scale up from 4 to 45 DOT centers, the treatment success rate in the state TB\nprogram increased from 76% in 2011 to 85% in 2012 reporting year, for cases registered in the\nprevious year. Conclusions: NTP through support of other partners should adopt and scale up the\nuse of smart phones for supervision nationwide.
Loading....