Strengthening Disease Surveillance To Enhance Retention Among Patients Attending Comprehensive Care Centre At Coast General Hospital, Kenya

Abstract

Background: Having all human immunodeficiency virus (HIV) infected patient retained in medical care at regular interval is linked to positive health outcome. To achieve unmet gaps in UNAIDS 95:95:95 all HIV infected patient must be maintained in care with regular medical clinic attendance. Surveillance systems have shown to be an effective way of tracking progress and identifying gaps in the care provision process. From an Organization capacity baseline assessment report in Coast General Hospital (CGH). The following were identified as challenges in monitoring and tracking patients in care were identified: absence of a multidisciplinary team on HIV surveillance, surveillance system not optimally used lack of awareness by staff at service delivery points on their role in surveillance and lack of budget for surveillance. The Coast General Hospital reports have shown that patients are missing their clinic appointment attendance. Thus patients retention on HIV care is a problem with many lost to follow up. Objective: To strengthen the HIV surveillance to enhance retention among patients attending Comprehensive Care Centre at Coast General Hospital. Significance: The project implementation and utilization of recommended practices has contributed in improvement in HIV care cascade to achieve the unmet gaps in UNAIDS 95;95; 95 strategy. Methods: The project involved studying the strategies which was in use, identifying the gaps in the strategies, taking action to enhance retention and coming up with recommendation of suitable strategies of enhancing retention of patients on HIV care. Outcomes: Functional multidisciplinary HIV surveillance team was established and staff participation on HIV care resulting to 99% retention of HIV patients on care as result of improved adherence of HIV patients on scheduled medical appointments. Coast General Hospital had High identification of newly tested positive with 96% Linkage to care and treatment among newly tested positive .Viral suppression improved from 84% in 2017 to 93% 2018. Project activities and recommendation has been included in day to day programme of HIV patient care at CCC for sustainability, where the mentor and two UHIV medium term fellows are key champion. Summary: HIV patient attendance of clinic regularly for care is very important for successful clinical outcome