| Overview : The surveillance of TB, MDRTB, TB/HIV is necessary as the country strives to control this epidemic and there is an essential need to update data to improve the epidemiological profile of tuberculosis disease in Belize, and to improve the treatment outcomes in those most affected. This significant milestone will help to improve data collection, analysis and socialization of information so as to stimulate policy development. The Belize Health Information System (BHIS) is a comprehensive electronic health record system and is the Ministry of Health’s main tool for the capture of health data, and is a web-based open source system that consists of several modules. Having been launched in 2008 this can be found in the major health facilities, and represents an unrivaled opportunity for data capture of information that can be utilized for both cross sectional and longitudinal reporting and analysis. The full potential and ability of the system has yet to be explored and capitalized upon therefore this represents a significant opportunity and priority, and that which we must explore to the fullest. Global Fund Round9 and our country’s Combined TB and HIV grants presents us with funding to strengthen Belize’s Health System, and we seek the services of a suitably qualified consultant to improve the use of cross sectional and longitudinal, TB data captured within the BHIS in the following areas: - TB Case-based Surveillance – TB case surveillance aims to collect data at the individual patient level on a longitudinal basis, starting from the moment of TB diagnosis. Collated at a regional level these data provide insight into the TB epidemic and care provided in Belize. At this point few countries in the region have a TB case-based system for surveillance, used for national reporting. Much work needs to be done in Belize as we are starting from ground zero.
- Disease Cohorts for TB, MDRTB and HIV/TB – The EMR of the BHIS facilitates the tracking of patients over time. The analysis of this longitudinal health data can allow for more meaningful and probing analysis which can ultimately be used to improve patient care and outcomes. Moreover, the longitudinal data analysis of various disease cohorts such as HIV is increasingly being seen along with the increasing trend towards EMRs and the advancement in technology. This feature of the BHIS EMR has not been utilized in this manner to date.
- TB and HIV/TB Cross Sectional Data - Traditionally these HIV and TB data are analyzed and presented on an annual and/or quarterly basis for the purpose of informing strategic programmatic direction and action. A comprehensive revision of the information presented and method of data analysis since the implementation of the BHIS has yet to be done for TB all forms. Moreover, although much of the TB data is being captured in the BHIS it is still largely being reported via a parallel manual mechanism. This has lead to duplication of efforts on the part of the already limited staff and hampered the buy-in of the BHIS.
This consultancy is also intended to be a capacity building exercise for the National Epidemiology Unit, the TB Coordinator, the monitoring and evaluation officer in data manipulation and analysis utilizing relational database structures through the engagement and mentoring of the relevant staff throughout the entire process. This is intended to utilize HIV and TB data as entry points in the first instance with the aim for the eventual extension of methodologies, approaches and lessons learnt to work with data for other diseases such as NCDs. |
