Enhancing EID Services: Healthcare Workers’ Perceptives on Health System Challenges in Zambia"

Abstract

The pediatric HIV burden is significant, with 46% of 1.7 million affected children lacking treatment in 2020 globally. In sub-Saharan Africa, up to 49% of HIV-infected children remain undiagnosed, contributing to high AIDS-related mortality. In Zambia, early infant diagnosis (EID) coverage for HIV exposed infants (HEI) is suboptimal with 71% receiving timely virologic testing, indicating gaps in case identification. We explored healthcare workers' perceptions on EID, appointment systems and associated challenges. The study utilized a phenomenological research design involving 19 healthcare providers from the mother and child health (MCH) department in Kabwe and Chibombo districts of Central Province of Zambia. All Content and thematic analyses were done using NVivo 10 software. Healthcare providers reported using parallel systems such as paper based registers and an electronic medical records system, SmartCare, while leveraging routine immunization visits to identify and track HEIs’ appointments from birth to 9 months. Health care providers highlighted challenges with paper cohort based registers leading to incomplete documentation and difficulties in tracking HEIs’ appointments especially after 9 months due to decreased attendance of post-routine immunizations. Parallel data entry in both SmartCare and paper-based registers added more workload, leading to incomplete records, hindering effective appointment tracking due to lack of critical information. Therefore, streamlining data collection processes, removing parallel systems and reducing modules, providing additional training to healthcare workers on electronic management systems may contribute to improved monitoring and tracking of HEI for better outcomes.