On 10th February 2015, the CIDRZ Better Information for Health in Zambia study – known locally as BetterInfo – initiated study data collection activities in Lusaka, Eastern, Western and Southern provinces to begin the pilot phase of the Bill & Melinda Gates Foundation grant award of USD 4.76 million. After receiving all required international and local regulatory approvals and consulting the National, District and Provincial Health officials, Traditional leadership and Neighbourhood Health Committees where the pilot will be conducted, study training activities for the approximately 30 member study team took place at the CIDRZ offices in the capital Lusaka. Training was led by the three study PIs, Dr Elvin Geng of University of California – San Francisco, Dr Charles Holmes and Dr Izukanji Sikazwe of CIDRZ, and Study Coordinator Sandra Simbeza, Co-investigators and CIDRZ BetterInfo study management.
The purpose of the ‘BetterInfo’ study is to systematically gain a better understanding of why some patients enrolled in antiretroviral treatment (ART) stay in care, while others are ‘lost’ from care. It is estimated that as many as 25-40% of patients in HIV care and treatment programmes are lost-to-follow-up. The ‘BetterInfo’ study will trace ART patients, learn of their outcomes, and ask questions about why they have that outcome. This information will enable the study team to more accurately estimate the treatment outcomes of patients who are lost from HIV care thereby gaining a better understanding of the percentage of patients who have chosen to disengage from ART care, those who have chosen to re-engage in ART care at a different facility, and those that have passed away. Understanding this information will allow Zambian health programmes and facilities to better meet the needs of ART patients so that they stay in care. The ‘BetterInfo’ study staff will use best practices when tracing ‘lost’ patients to protect privacy and confidentiality, and if a patient has stopped receiving treatment they will encourage them to resume ART care.
The ‘BetterInfo’ study will be conducted in 30 sites in Western, Southern, Lusaka and Eastern Provinces of Zambia over a 29-month period and will be able to provide more accurate estimates of HIV care patient outcomes at both clinic and provincial levels which will help the Zambian Ministry of Health, and Ministry of Community Development Mother and Child Health to make informed decisions about HIV care service provision.