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Linkage Officer Model 28 March 2019 Care and Treatment Programme
Linkage Officer Model
28 March 2019
Care and Treatment Programme
• The Linkage Officer Model - Context
• Linkage Officer Recall Sheet
• Monthly Linkage Officer Report
• NDOH Tracing Report
• Amathole Linkage Rates
• Improved Linkage with Linkage Officers: Amathole
• Amathole 10x10 Same Day Initiation Rates
• OR Tambo Linkage Rates
• Chris Hani Linkage Rates
Outline
Linkage Officer Model - Context
• TB HIV Care deployed 55 linkage officers across 41 highest burden facilities in Amathole District, Eastern Cape
• The intervention aimed at improving linkage to care (initiation), retention in care and quality of care
Linkage Officer Model - Methodology
• LO reviews all the HTS and PHC Registers as well as the TIER.net ‘Waiting for ART’ report
• These are checked against TIER.net and the folders to see who has not been initiated
• List of clients not yet initiated is recorded on a HIV recall sheet with relevant contact details
• LO calls clients a maximum of 3 times after which the client is referred to the ward based outreach teams (WBOTs) at the weekly linkage meeting held at the facility and home visit is requested
Linkage Officer Recall SheetMonthly Linkage Officer Report LO Name: Facility:
LINKAGE OFFICER Sa
fety
Blo
od
s
Miisse
d
Ap
po
intm
en
ts
Lo
st to
Fo
llo
w
up
To
sta
rt A
RT
(pre
vio
usly
teste
d H
IV
po
sitiv
e)
Vir
al L
oa
d
VL
no
t
su
pp
resse
d
Oth
er
Tota
l H
IV R
eca
ll
Mis
se
d
ap
po
intm
en
t
Sp
utu
m
Sp
utu
m re
su
lts
mis
sin
g
NO
T c
on
vert
ed
& R
x n
ot
ext
en
de
d
HIV
Te
stin
g
AR
T i
nitia
tio
n
Sta
rt T
B R
x
Tota
l TB
Re
call
To be recalled
# Traced telephonically week 1
# Traced telephonically week 2
# Traced telephonically week 3
# Traced telephonically week 4
# Traced telephonically week 5
Successfully recalled telephonically week 1
Successfully recalled telephonically week 2
Successfully recalled telephonically week 3
Successfully recalled telephonically week 4
Successfully recalled telephonically week 5
# Traced by home visit week 1
# Traced by home visit week 2
# Traced by home visit week 3
# Traced by home visit week 4
# Traced by home visit week 5
Successfully recalled by home visit week 1
Successfully recalled by home visit week 2
Successfully recalled by home visit week 3
Successfully recalled by home visit week 4
Successfully recalled by home visit week 5
# clients not reached by phone or visit
Number to carry over to next month
Monthly Linkage Officer Report
Monthly Linkage Officer Report Consolidation
Sa
fety
Blo
ods
Miisse
d A
ppo
intm
ents
Lo
st to
Fo
llow
up
To
sta
rt A
RT
(pre
vio
usly
te
ste
d
HIV
po
sitiv
e)
Vir
al L
oa
d
VL
no
t suppre
sse
d
Oth
er
Tota
l H
IV R
eca
ll
Mis
se
d a
ppo
intm
ent
Sputu
m
Sputu
m r
esults m
issin
g
NO
T c
onve
rte
d &
Rx n
ot
exte
nde
d
HIV
Te
sting
AR
T i
nitia
tio
n
Sta
rt T
B R
x
Tota
l TB
Re
call
Linkage Officer Indicator
l
Total number to be recalled
Total number traced telephonically
Total number successfully recalled telephonically
Total number traced by home visit
Total number successfully recalled by home visit
Total clients not reached by phone
NDOH Tracing Report - Telephonic
Data DescriptionApril-June 2018 July-Sep 2018 Sept-Dec 2018
HIV TB HIV TB HIV TB
Number of clients identified for Tracing
Refers to all defaulters that have been identified for tracing. It includes Early and Late missed appointments as well as unconfirmed loss to follow up. Excludes pre-ART clients.
3541 136 3778 108 7323 321
Number of clients traced through Telephonic tracing
Refers to clients who were traced telephonically. The outcome of this tracing activity might be: 1. Successful (Client reached and appointment made)2. RIP (Client has died)3. Transfer (Client reached, receiving treatment at another facility)4. Message (Client unavailable, left a message)5. Unsuccessful (Client reached but unwilling to return)6. Lost (Client cannot be reached, incorrect number or no answer)
3128 89 3372 88 6853 299
Number of clients who were contacted telephonically and referred back to the facility
Refers to clients who were contacted telephonically referred back to the facility (Outcome = Successful).
2769 88 2617 58 4289 299
Number of clients who returned to care after Telephonic tracing
These are clients that have returned to the facility to access ART services. 2565 72 2487 39 4132 296
72% 53% 66% 36% 56% 92%
Cadre that performs telephonic tracing
Who is actually making the phone calls?Linkage Officer
Linkage Officer
Linkage Officer
Linkage Officer
Linkage Officer
Linkage Officer
Is this cadre DOH or PEPFAR-funded
Are the people who are making the calls DOH or PEPFAR funded? PEPFAR PEPFAR PEPFAR PEPFAR PEPFAR PEPFAR
NDOH Tracing Report – Physical tracing
Number of clients identified for physical Tracing
Refers to all defaulters that have been identified for physical tracing. It includes Early and Late missed appointments as well as unconfirmed loss to follow up. Excludes pre-ART clients. Generally, this list should include clients who have not returned to care after telephonic tracing, or could not be contacted telephonically.
489 33 373 27 2507 186
Number of clients traced
Refers to the number of clients who were traced. The outcome of this tracing activity might be: 1. Successful (Client reached and appointment made)2. RIP (Client has died)3. Transfer (Client reached, receiving treatment at another facility)4. Message (Client unavailable, left a message)5. Unsuccessful (Client reached but unwilling to return)6. Lost (Client cannot be reached, incorrect number or no answer)
451 28 273 25 2226 150
Number of clients who were found and referred back to the facility
Refers to clients who were physically traced and referred back to the facility. 328 25 243 20 1104 211
Number of clients who returned to care after physical tracing
These are clients that have returned to the facility to access ART services. 255 23 215 20 693 45
52% 70% 58% 74% 28% 24%
Cadre that performs physical tracing
Who is actually doing the physical tracing?Linkage Officer
Linkage Officer
Linkage Officer
Linkage Officer
Linkage Officer
Linkage Officer
Is this cadre DOH or PEPFAR-funded
Are the people who are doing physical tracing DOH or PEPFAR funded? PEPFAR PEPFAR PEPFAR PEPFAR PEPFAR PEPFAR
Amathole Linkage Rates
93%
110%
101%109%
101% 98%
88%94%
104% 108%
92%
76%
98%
0%
20%
40%
60%
80%
100%
120%
0
50
100
150
200
250
300
350
400
450
Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19
Amathole 10x10 Linkage rate
TX_NEW HTS_POS Linkage rate
Improved Linkage with Linkage Officers: Amathole
116%
124%119%
98%
115%
106% 106% 108%
98%
90%
98%
109%
95%88% 86% 89%
101%97%
93%87% 88% 87% 86%
80%
0%
20%
40%
60%
80%
100%
120%
140%
201710 201711 201712 201801 201802 201803 201804 201805 201806 201807 201808 201809
TX_NEW/HTS_POS
Linkage Officer (n=41) No Linkage Officer (n=113)
OR Tambo Linkage Rates
72%78%
85%
68%
100%
88%78%
73%
145%
95%84% 83%
97%
0%
20%
40%
60%
80%
100%
120%
140%
160%
0
100
200
300
400
500
600
700
800
Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19
OR Tambo 10x10 Linkage rate
HTS_POS TX_NEW Linkage rate
Chris Hani Linkage Rates
85%
104%
116%
93%
83%73%
84%
95% 92%
122%
98%
77%
107%
0%
20%
40%
60%
80%
100%
120%
140%
0
50
100
150
200
250
300
Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19
Chris Hani 10x10 Linkage rate
HTS_POS TX_NEW Linkage rate
February Frenzy recall
7255
6542
1887
0
1000
2000
3000
4000
5000
6000
7000
8000
Total clients requiring recall Total clients contacted Total clients brought back into care
February Frenzy recall data
• Linkage Officers improve linkage to ART
• The Linkage Officer recall sheet allows measurement of successful recall for
each step of the HIV and TB cascades
• The Linkage Officer model has been successful in Amathole and is now
being implemented in OR Tambo and Chris Hani districts
• Tracing and Tracking Tool will elucidate reasons for missed appointments, to
inform future retention strategies and disaggregate EM/LM/uLTFU
demographic data
Summary
Thank you!
