Featured Projects

Better Care through Better Patient Management in Nigeria

[Back to Research & Evaluation summary]

As a patient management and monitoring officer for GHAIN, Vincent saw with his own eyes the transformation of a medical records department.

Monitoring patients and managing their care is critical to the successful delivery of antiretroviral therapy (ART). In areas that lack a strong history of patient management, this can be a challenge to health care professionals working with HIV/AIDS.

Vincent Ahonsi is a patient management and monitoring officer for GHAIN, Global HIV/AIDS Initiative in Nigeria, a project leading the expansion of HIV/AIDS treatment, care, and prevention programs in that country. He works with health facilities providing ART. One of them, the Mainland General Hospital in Yaba-Lagos, is particularly significant.

Vincent has had three separate experiences with this hospital. The first encounter took place when he was a student. His second contact was as a family member of a patient there. Most recently, he visited the hospital as part of his job and can testify to the transformation that has occurred.

In March 1990, as a student at the University of Lagos, Vincent was sent to Mainland General for training. The hospital had a reputation in the medical community for having an inefficient medical records system. "Much to my surprise," said Vincent, "I often saw patients walking the grounds of the hospital clutching their medical charts. I heard from other students and staff that many patients leave the hospital with their charts never to return."

The medical records systems in some facilities make patient monitoring difficult. With the right systems in place, staff can improve their record keeping capabilities, enhancing patient care and treatment.

Then in 2003, he retuned to the hospital with his sick aunt whose husband had died of AIDS-related causes. The hospital confirmed that she was HIV positive but then told her that there were no vacancies for HIV patients and they would have to go somewhere else.

In 2005, Vincent had to visit the facility again. By then the hospital had participated in GHAIN for several months. When Vincent approached the gates he was uncertain about what he would find.

The contrast between previous experiences and the present one was startling. "I found the facility to be vastly different from what I remembered," according to Vincent. "I had the benefit of seeing first hand what the United States government support had provided for the facility, particularly in medical records and health management information systems."

The medical records department had been rehabilitated. It was establishing an effective patient monitoring and management system that promoted confidentiality and the maintenance of long-term clinical information. The staff had been trained in HIV/AIDS sensitivity issues and stigma and discrimination. The entire hospital was developing a culture of clinical information for better clinical care of HIV/AIDS patients.

Vincent acknowledges that while the hospital might have improved on its own, partnering with the GHAIN project accelerated change. That means more Nigerians will benefit from better, more sensitive, and more comprehensive ARV treatment.