AMPATH Attachment Report – 2012
Chepkoilel University College
Flame of Knowledge and Innovation
ACKNOWLEDGEMENT
Thanks to AMPATH for giving me this opportunity to be in this organization and its entire staff for making my attachment a remarkable experience. Special appreciation to:
- Mrs. Jepchirchir Kiplagat: Research Manager
- Ms. Eunice Gift: Assistant Research Manager
- Mr. Alfred Koskel: Research Assistant
- Dr. Ann Mwangi head of biostatistics department
- Mr. Koech and Mr. Keter: Biostatisticians
- Mr. Gilbert Simiyu , Ms. Monica Mwaniki and Mr. James Osanya: Data Managers
- My fellow interns.
DECLARATION
I hereby declare that this attachment report is my work and has not been published or written elsewhere
CHAPTER 1
1. INTRODUCTION
OBJECTIVES OF ATTACHMENT
- To acquire knowledge on data collection, data entry, data cleaning, data coding, data exporting, data quality, data analyzing and data presentation.
- To learn how to use statistical packages like STATA, SPSS, R and SAS.
- To learn how to create databases using Microsoft Access and Excel.
- To learn how to create questionnaires.
- To acquire knowledge on field and functional activities of a participating organization.
- To build a curriculum vitae.
- To acquire knowledge on health data collection.
ABSTRACT
This is an attachment report in AMPATH from 2nd May to 31st July 2012. It outlines the scope of the report, including how AMPATH works, its brief history, the duties and responsibilities undertaken, and the new skills and knowledge gained. The abstract highlights the collaboration among different departments to create an academic model aimed at improving the health of the Kenyan population. This is achieved through the identification, development, and timely dissemination of health and healthcare system information for decision-makers in medical care, public health, and public policy in Kenya and other resource-constrained settings.
ACRONYMS
- AMPATH - Academic Model Providing Access to Healthcare
- IU - INDIANA UNIVERSITY
- SPSS - Statistical Package for the Social Science
- SAS - Statistical Analysis System
- STATA - Data Analysis and Statistical Software
- R - Open Source Programming Language for Statistical Computing
- HAART - Highly Active Antiretroviral Therapy
- PMTCT - Prevention of Mother to Child Transmission
- PHI - Haart and Harvest Initiative
- HCT - HIV Counseling and Testing
- FPI - Family Preservation Initiative
- LACE - Legal Aid Centre
- IFS - Immuno Suppressed
- AMRS - Academic Medical Recording System
- DTC - Diagnostic Testing and Counselling
- PCP - Pneumonia
- PTB - Pulmonary Tuberculosis
- CD4 - Cluster Domain
- NFDA - No Known Food and Drug Allergies
- HNAN - HIV Associated Nephropathy
- PHC - Primary Health Care
COMPANY BRIEF HISTORY
AMPATH (Academic Model Providing Access to Healthcare) is an academic model for the prevention and treatment of HIV/AIDS. It is a collaboration between Indiana University School of Medicine and Kenyan institutions, offering food, income, and other support to enhance the existing health infrastructure. It monitors antiretroviral treatment and aims to prevent HIV transmission, particularly from mother to child. AMPATH began in November 2001 with two sites and has expanded to 55 sites, with 30 being satellite sites. It treats approximately 130,000 patients and serves over 500,000 individuals through community-based services. The model is resource-conserving and integrated into the broader health system, with a focus on community-based care and support.
AMPATH MISSION
- To provide and expand sustainable access to high quality care through:
- Provide excellent healthcare for individuals and population
- Develop passionate leaders in pharmacy
- Perform research focused on local needs and global solutions
- Establish critical healthcare infrastructure and systems
VISION
Innovative, provide and enhance quality care for all people through teamwork and dedication
PRINCIPLES
As an IU Kenya program, the ampath consortium, moi university faculty in health sciences and MTRH the program will seek to:
- Support and sustain a world class program of high quality research across a broad spectrum ranging from basic sciences to translation and implementation research
- Enhance all the healthcare institutions engaged in its research
- Open working groups to any interested faculty of the ampath consortium who are committed to collaborative research
- Develop human capacity through training and education
- Create infrastructure that enhances institutional capacity for the conduct of world class research.
π‘ VALUES
- Ampath works to embrace
- • Service with humility
- • Spirit of collaboration and partnership
- • Mutual respect and mutual benefit in organization partnership
- • Focus on vulnerable populations
- • Efforts to eliminate health disparities.
RESEARCH DEPARTMENT
Conducts clinical and operational research. It entails data collection, data entry, data management, data cleaning, data exporting, data presenting so that health care services can be of high quality.
FOOD DISTRIBUTION
Distribution centers that provide food prescribed by the nutritionist to eligible patients and their dependents. The food comes from the donations and other provisions from the HHI and World food program which supports AMPATH by providing beans, corn and corn-soya blend.
FAMILY PRESERVATION INITIATIVE (FPI)
Helps clients to have a sense of economic security through teaching clients new skills in jewelry, papermaking and tailoring. It does this by providing loans to ampath clients to start business so that they can be financially stable.
PSYCHOSOCIAL SUPPORT
Provide psychosocial support groups to all clients so that they live positively to deal with stress, stigma and adherence. It also provides individual counseling.
SOCIAL WORK
They identify clients difficulties and barriers to help children and others who are vulnerable and disabled. They also work with other units and departments to ensure clients receive the highest quality of care
ORPHANS AND VULNERABLE CHILDREN
This unit offers help to children and their families by providing for schooling school fees, school uniforms and other needs. It also helps to cater for caretakers by counseling them to be better parents.
PREVENTION
Offers prevention services to clients by providing them with services offered outside the hospital such as voluntary counseling and testing, home based counseling and testing, prevention with positives, condom distribution and behavior change communication.
LEGAL AID
Offers legal aid to clients who have legal issues.
PHC
Primary Health Care (PHC) focuses on safe delivery, family planning, immunization and child health (MCH), safe water, implementation of community health strategy.
2. AMPATH DEPARTMENTS AND DESCRIPTION
AMPATH has different departments that offer different services but with an objective of establishing critical healthcare infrastructure and systems. The department's are:
CLINICAL SERVICES
This are services offered by the clinic or modules whereby clients are tested again to confirm HIV status. If positive, the client is registered and given an ampath id number and a number of lab investigations are done.
PROVIDER INITIATED TESTING AND COUNSELLING (PICT)
Provides an opportunity to every hospital client to receive free HIV counselling and testing services including with psychological support
HAART PHARMACY
Provides reliable and consistent supply of medications along with appropriate counseling
OUTREACH DEPARTMENT
Clients fill locater forms that help the outreach department locate them to ensure more time for the days, in this situation the client misses their appointments for more than two months. The problem is if outreach department locates the client, he/she is brought back to the clinic and the missed appointments are rescheduled.
NUTRITION SERVICES
This department provides nutritional support to the clients to help them maintain their health and improve their immune system. The department also provides education on proper nutrition and conducts assessments to determine the nutritional status of the clients. In addition, the department provides food supplements to clients who are malnourished or at risk of malnutrition.
PREVENTION DEPARTMENT
This department provides services to reduce risk of HIV infection. It offers education on HIV prevention, condom distribution, voluntary counselling and testing (VCT), and prevention of mother-to-child transmission (PMTCT) services. The department also conducts community outreach programs to raise awareness about HIV prevention.
HEALTH INFORMATION DEPARTMENT (HHI)
Demonstration trainings on different topics are done to the clients. The department also trains clients on income generating activities to help them improve their economic status and provide them with high quality farm produce.
3.1 DUTIES AND RESPONSIBILITIES
DATA COLLECTION
Data collection took place in the MTRH ward, divided into four wards (men, women, amenorrhea, and tumor). Data was collected only if the patient was an S or S-exposed child. Information was gathered from the inpatient registration form, including patient name, date of admission, discharge date, chief complaints, impression, discharge diagnosis, orders, and prophylaxis. Data was then entered into AMPATH's system using a questionnaire.
DATA ENTRY
Information collected was entered into the AMPATH database, which includes patient registration and visit details. The database checks for duplicates and provides feedback if a patient has a readmission, showing previous visit information.
DATA EDITING AND RETRIEVAL
If there is missing data, it is retrieved from the ward and re-entered into the AMRS (AMPATH MEDICAL RECORD SYSTEM) using the nurse’s unit station.
ADMINISTRATIVE DUTIES
Duties included printing, scanning of documents, and assisting in the research office.
π§ 4.2 NEW SKILLS LEARNT
- DATA COLLECTION METHODS
- DATA ENTRY
- CREATION OF DATABASE
- COLLECTING HEALTH DATA
- CREATION OF QUESTIONNAIRE
- DATA MANAGEMENT
- DATA ANALYSIS
- SCANNING OF DOCUMENTS
- PRINTING OF DOCUMENTS
- STATISTICAL PACKAGES LIKE SAS, STATA AND R
- EPIFINFO AND INFOPATH
- ADMINISTRATIVE SKILLS
- WORK ETHICS
- TERMINOLOGIES IN MEDICAL FIELD
π 4.3 THINGS ENJOYED
- Learning statistical packages helping me use what I learned theoretically in statistics
- Access to internet which could help me search for notes or read on topics when given assignments
- Interacting with the biostatisticians and data managers who helped me evaluate my career choices
- Collecting data in the ward and entering it in the AMPATH database
π€ 4.4 RELATIONSHIP WITH STAFF
During my attachment, I had a good relationship with the staff where I interacted with the Biostatisticians who trained me on data analysis and interpretation the data managers who guided me on how to manage data and clean using SAS. I also interacted with Prof. Joseph Hogan, Biostatistician and Dean in brown University who guided me on my future career and opportunities. I learnt on effective communication skills, dress code and office ethics.
π BENEFITS OF ATTACHMENT
The benefits of this attachment are: learned new statistical packages ethics in a work environment know which career choices to make strengthen my cv what to expect in a job interview
⚠️ CHALLENGES ENCOUNTERED
- Seeing people die in the ward while collecting data
- Viruses in the computer
- The staff were not there on the patients on admission hence not collecting of data of some patients as their status has not been determined.
CONCLUSION
In conclusion, to my attachment report this period is very important because I have been able to put in practice what I learned in school. All the skills I learnt such as data collection, coding, data entry, data management and analysis has increased my knowledge in statistics. This attachment has also given me the chance to learn statistical packages like STATA, SAS and R and how to analyze data using them. Other than gaining knowledge, I have developed interpersonal relationship skills in a professional setting.
RECOMMENDATIONS
- TESTING OF PATIENTS ON ADMISSION
- INSTALLING ANTIVIRUS TO REMOVE VIRUS IN COMPUTER THAT CAUSE LOSS OF INFORMATION
- INCREASING NUMBER OF COMPUTERS THAT ATTACHEES HAVE ACCESS WITH
- HAVING A STRICT SCHEDULE OF ATTACHEES ACTIVITIES AT AMPATH FROM THE DAY THEY REPORT.
REFERENCES
- AMPATH Training Institute (ATI)
- AMPATH inpatient registration form
- AMPATH website
APPENDICE
(Reserved for supporting materials.)
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