MOH-CBoH-SI / Central Board of Health and JHPIEGO

Agness is a midwife and the coordinator for Prevention of Mother-to-Child Transmission (PMTCT) and test counseling services at the Nangongwe Clinic in Kafue District, Zambia.  The clinic started using the Smart Card — or electronic medical record system (EMRs) — in April 2005, and already has more than 1,000 clients who are users of this system.

With the Smart Card service, Agness can access up-to-date medical information on her patients and compile end-of-month reports faster than when she used paper records.  She has participated in trainings on the use of the EMR and is proud to be able to work with the new technology to care for her patients.

Zambia is the first country in Africa to introduce the EMR technology that is critically important for people on antiretroviral therapy because it allows careful monitoring of their drug use and resistance.  Helping to keep more people from having to switch from first-to second-line drugs, EMRs also provide a way to save the enormous costs associated with second-line regimens.

Patients also appreciate a Smart Card health record that is close to their fingertips.  Bester, a 30-year-old woman receiving PMTCT services at Nangongwe, thinks it is good that all her medical information is in the card so that “…even if I get into an accident and can’t explain myself, the doctors have all of my information.”  She regularly brings the card with her to the clinic and is pleased that her medical record is always complete and current.

As of October 2006, more than 60,000 people in Zambia had received EMRs, and the number of Smart Cards distributed and sites set up with the Continuity of Care Patient Tracking System (CCPTS) is increasing daily.  The transition to health care facilities using Smart Cards has been fairly smooth and adherence for use is estimated at 98%.

The EMR system is funded by the President’s Emergency Plan for AIDS Relief, and is the product of collaboration between the Zambian Ministry of Health and the U.S. Centers for Disease Control and Prevention (CDC) Global AIDS Program (GAP).