Profile
The Rwanda Ministry of Health strives to provide and continually improve the health services of the Rwandan population through the provision of preventive, curative and rehabilitative health care thereby contributing to the reduction of poverty and enhancing the general well being of the population.

Situation and Challenges
Rwanda is rapidly expanding anti retroviral (ARV) care and treatment for People Living with HIV/AIDS (PLWHA). Today, approximately 10,000 Rwandan adults are receiving treatment, and the government plans to expand coverage to as many as 101,000 adults and children by 2007.

Information for timely and informed decision-making is critical for Rwanda to successfully achieve its goal of rapid ARV program scale up. Effective program management requires policy makers and care providers to closely monitor program issues. These issues include patient adherence to treatment regimens, drug resistance, ARV drug and lab supplies (to avoid shortages or stock-outs). The government's ability to establish effective program management mechanisms is vital to successful delivery of ART to an increasing number of people.

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Rwanda TRACnet Drug Supply and Program Indicator Dashboard

Solution
TRACnet is Rwanda's dynamic Information Technology solution designed to collect, store, retrieve, and disseminate critical program, drug, and patient information related to HIV/AIDS care and treatment. The system was implemented to support the Rwandan Government's vision of rapidly scaling up HIV/AIDS clinical services in a variety of health care settings. Under the leadership of the Ministry of Health and the Treatment Research and AIDS Centre (TRAC), TRACnet is being deployed to increase the efficiency of Rwanda's HIV/AIDS program management, and enhance the quality of patient care.

With a bilingual English and French telephone and web interface, TRACnet employs a practical and sustainable approach to using information technology. By leveraging existing infrastructure - mobile telephone networks, connected and standalone computers, and underlying paper record systems - TRACnet has been deployed nationwide to connect every health facility providing ARV treatment and related services.

How TRACnet Works
TRACnet provides a central repository of HIV/AIDS program information and delivers real-time information for decision-making. The system has transformed a largely paper-based one way information flow that took several weeks, into a bi-directional data exchange completed in seconds. (See diagram below). As such, it allows decision-makers and supervisors to quickly analyze and respond to program information.

What TRACnet includes:

• Program Indicators
• Drug inventory information from point of care
• Patient registry
• Lab results
• Group and individual communications
• Management Dashboards

Results
The results achieved since deployment in January 2005 include:

  Coverage: Deployed in all 94 health facilities offering ART in Rwanda, accounting for 100% of all ART patients in Rwanda. In addition, approximately 6,000 individual case records are monitored securely using the system.

  Trained Personnel: More than 200 site level users have been trained to submit monthly program indicator reports and weekly consumables (drug) reports.

  Access: Most users (more than 90%) access the system via a toll-free telephone interface, thereby minimizing infrastructure-linked constraints (unreliable power supply, poor or non-existent internet connection), as well as the cost of accessing the internet.

  User Adoption: Anecdotal evidence has shown that most health facility personnel own mobile phones, and that those who have a phone, and are accustomed to using text messaging features, demonstrate an ease of use after 15-30 minutes of training.