Page 38 - Connecting cities and communities with the Sustainable Development Goals

United for Smart Sustainable Cities
Connecting cities and communities with the Sustainable Development Goals

2.2 Implementation
The application of the HITSystem was jointly conducted with the assistance of several partners including (but
not limited to):
▪ Global Health Innovations (developers of this system)

▪ Kenya Medical Research Institute
▪ OnTarget (Internet marketing company)
▪ Academic Researchers (from University of Kansas Medical Center and Children’s Mercy Hospital
Kansas City)
▪ Walter Reed US Military HIV Research Program (training and implementation)

▪ NASCOP
For the designated hospitals for the pilot project in Kenya, the HITSystem can be accessed on computers and
laptops, using mobile broadband, which eases the implementation of this system even in remote areas (if
required). The HITSystem has been built to generate regular alerts directed at health providers other EID
stakeholders and lab technicians, when time sensitive interventions are required in a particular child’s case.
These alerts are directed at tracking and identifying children who have omitted their treatments for a defined
period of time. An inbuilt text messaging mechanism in the HITSystem sends messages to mobile phones of
the parents when test results are ready or follow-up visits for treatment are needed.

In Kenya, especially Nairobi, the HITSystem was implemented from April 2011 to November 2013 at certain
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health facilities. The implementation was conducted between April 2011 and May 2014.
The health facilities chosen for the pilot were selected based on logistical feasibility, absence of other EID-
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related interventions for HIV and the approval from the respective hospital stakeholders.

2.3 Outcomes
This pilot project in Kenya has been carried out with remarkable ease and effectiveness. It was noted that
relatively limited penetration of ICTs, telecommunications and Internet connectivity had minimal negative
impact on the continuance of the project. The sustained efforts of the stakeholders facilitated the successful
adoption, implementation and continuous maintenance of the HITSystem. With the monitoring mechanism
in place, HITSystem was able to ensure that treatments were provided on time.

The principles of the HITSystem were found to be in line with EID guidelines and the results of this pilot
project surpassed the expectations and outcomes observed in national statistics. A feedback mechanism was
also incorporated into the implementation procedure of the HITSystem to ensure that the participants were
satisfied with the services received. This also helped improve the existing line of treatments and reduced
response time for emergencies.

It was noted that the HITSystem successfully reached nearly all mother–infant pairs, who were enrolled in
EID services at the targeted health facilities. However, it was observed that nearly 40% of HIV-exposed infants
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in Kenya are never enrolled in EID, thereby not receiving the benefits of the HITSystem.

29 The follow-up periods for this process ranged between 6 and 38 months depending on the month of initial
implementation of the designated facility.
30 Lessons learned from implementing the HIV infant tracking system (HITSystem): A web-based intervention to
improve early infant diagnosis in Kenya, 2015.
31 Lessons learned from implementing the HIV infant tracking system (HITSystem): A web-based intervention to
improve early infant diagnosis in Kenya, 2015.

32 U4SSC series