PREVENTION AND MANAGEMENT OF HIV/AIDS IN THREE TERTIARY HEALTH INSTITUTIONS IN SOUTH WESTERN NIGERIA

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ROLE OF HEALTH INFORMATION OFFICERS IN THE

PREVENTION AND MANAGEMENT OF HIV/AIDS IN THREE TERTIARY HEALTH INSTITUTIONS IN SOUTH WESTERN NIGERIA

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Professional Health Information Managers (Health Information Officers) manage and construct health information programs to guarantee and accommodate medical, legal and ethical standards. They play a crucial role in the maintenance, collection and analyzing of data that is received by doctors, nurses, and other healthcare players. In return, these healthcare data contributors rely on the information to deliver quality health care. Health Information Officers possess competent professional authority required for search and use of health data and reports, information for case studies, research education, training, and compilation of numbers of facts to measure outcome of care, use of medical symbolisms, practical views and medical symbolisms, practical views and medical observations and accomplishments (Wikipedia, 2010).

Health Information Officers are of two principal cadres, that is, technicians and officers with Higher National Diploma. Ordinary National Diploma holders are classified as technicians.

IHVN (2007) highlights the role of Health Information Officers as:

• ensuring proper data management

• follow-up on issues raised in data error log

• checking data entered into electronic database

• liaising with anti-retroviral coordinator on Monitoring and Evaluation issues that need to be addressed.

• ensuring enough supply of forms

• ensuring security of patient monitoring and management forms

• ensuring that data collection tools are available at the various service areas

• troubleshooting data flow choice points

• carry out spot and back checks of the registers and forms.

Hassan (2005) identifies Health Information Officers in prevention and management of HIV/AIDS to be: • strategic members of the health team

• first contact of the health teams with patients

• the memory of the health team

• the data bank managers of the health

• strategic members of research team.

Generally, Health Information Officers are responsible through the department for the followings:

i) to initiate, process, and check the patient records from inpatient, outpatient and emergency services to ensure that all the necessary form and information are available.

ii) to cooperate with the medical, nursing and other health care service officials in order to obtain comprehensive patients records and to design and develop effective medical records form.

iii) to assembly medical records in accordance with the prescribed standard order iv). to code and index medical records as per international classification of diseases and operations.

v). to maintain and preserve patient records including X-rays and diagnosis reports in a scientific way for the period recommends in the “retention schedule”.

iii) to retrieve medical records to meet the needs of patient care, medical education, medical training, medical research, medical legal problems and the evaluation of patient care.

iv) to provide and maintain a system for transcription of selected medical reports.

v) to control movement of patient files in order to achieve a unit record system, to protect files from unauthorized disclosure, to ensure confidentiality for the legal interests of the patient, the hospital, and the physician through proper custody of the records.

vi) to participate and cooperate with committees such as medical records, quality assurance, infection control, administrative, financial and other committees.

vii) to carry out the work of central registration for initiation new patient records including the patient master index.

viii) to schedule and register follows-up appointment cases and referral cases in the outpatient department.

ix) to register and maintain records for emergency cases including medical legal cases in the accident and emergency department.

x) to carry out admitting procedures for patients requiring hospitalization xi) to coordinate with other services related to those of the medical records department for effective filling and retrieval of patient records. xii) to prepare and complete procedures related to medical reports, certificates, and birth and death reports, and to submit data to appropriate authorities.

xiii) to register admitted and discharged causes in the ward register, schedule appointment for follow-up cases and to carry out the related ward clerk duties.

xiv) to retrieve and preserve the patient\s property in the admissions office in the absence of relatives who assume those responsibilities.

xv) to expedite the procedure of the department in accordance with the standards and rules established by the hospital.

xvi) to develop and maintain an information because mechanism for providing statistical data, and for submitting months reports concerning activities of the hospital and department, and for providing suggestions for effective functioning and future developments.

xvii) to develop education programs for the training of medical record personnel.

xviii) to observe the ethics of the medical record profession and to strive for new innovations to improve department functions.

xix) to expedite any responsibilities related to the medical record department allocated by the chief of the medical record or central information department of the hospital.

HIV/AIDS is human Immunodeficiency virus that attacks the body’s immune system with which the body fights diseases. When a patient’s immune system is damaged or compromised, the body is not able to fight disease. A person has HIV upon infection. This also may be called HIV disease. HIV disease progresses to AIDS which is Acquired Immunodeficiency Syndrome. HIV is fourth highest cause of death in the world. It is a major global health emergency. It affects all region of the world 70% of which are in Africa. It fans epidemic of TB in many African countries. Its impact is much greater where there is poverty and social inequality (UNAIDS 2007).

Estimated 42 million people are living with HIV/AIDS; one third of which are between 15-24 years. Most people are unaware they are infected and young women are more vulnerable. An infected person will always have it despite treatment. (UNAIDS, 2007)

There are two types of HIV identified as at 2005 (NIMR, 2005). HIV I causes worldwide epidemic while HIV II is found mostly in Africa. HIV is transmitted through sex. It is also transmitted through unscreened infected blood and blood product, pregnant mother to foetus, and use of unsterilised instruments and equipment.

HIV is not transmitted by hugging, kissing, massage, shaking hands, living in the same house, insects or animal bites. The driving forces include: lack of social health information and education, distinct lack of voluntary and routine HIV testing, cultural practices, poor health care system, poverty, denial and stigmatization, and rape.

The HIV epidemic has decreased the growth of the population and economic development. It has increased orphan population and cost of health care. It has taken priority over all other essential health care programme.

A role or a social role is a set of connected behaviour, rights and obligations as conceptualized by actors in a social situation. It is an expected behaviour in a given individual social status and social position. It is vital to both functionalist and interactionists understanding of society. Social role posits the following about social behaviour:

1. The division of labour in society takes the form of the interaction among heterogeneous specialized positions, we call roles.

2. Social roles included appropriate and permitted forms of behaviour, guided by social norms, which are commonly known and hence determine the expectation for appropriate behaviour in these roles.

3. Roles are occupied by individuals, who are called actors.

4. When individuals approve of a social role (i.e. they consider the role legitimate and constructive, they will incur costs to conform to role norms, and will also incur costs to punish those who violate role norms.

5. Changed conditions can render a social role outdated or illegitimate, in which case social pressures are likely to lead to role change.

The anticipation of rewards and punishments, as well as the satisfaction of behaving prosaically, account for why agents conform to role requirements (Wikipedia, 2010).

Preventive Medicine or Preventive Care: this refers to measures taken to prevent diseases, (or injuries) rather than curing them or treating their symptoms. The term contrasts in method with curative and palliative medicine, and in scope with public health methods (which work at the level of population health rather than individual health) (Wikipedia, 2010).

There are three levels of prevention of diseases (or injuries): primary, secondary and tertiary levels.

1. Primary prevention avoids the development of a disease. Most populationbased health promotion activities are primary preventive measures.

2. Secondary prevention activities are aimed at early disease detection, thereby increasing opportunities for interventions to prevent progression of the disease and emergence of symptom

3. Tertiary prevention reduces the negative impact of an already established disease by restoring function and reducing disease-related complications.

Diseases management is defined as “a system of coordinated health care interventions and communications for populations with conditions in which patient selfcare efforts are significant”. It is the process of reducing health-care costs and/or improving quality of life for individuals by preventing or minimizing the effects of a disease, usually a chronic condition, through integrative care (Wikipedia, 2010).

1.2 Statement of the Problem

Health information officers learn to identify and generate what information and data that are needed by doctors, hospital administrators, other health professionals, and how they are used in effective health care delivery.

In the prevention and management of epidemic diseases of global emergency like HIV/AIDS which is cardinal in health care delivery, Health Information Officers are strategic members of health and research team. International supporting Agencies such as GHAIN, IHVN, PEPFAR, etc rely heavily on data generated by Health

Information Officers at the hospital level.

However, a good percentage of the public believes that all men working in the hospitals are doctors and all women are nurses. Even educated fellows will easily omit Health Information Officers if asked to list health care delivery professionals. Ironically, some management staff of tertiary health institutions even opined that health records staff are just ordinary card issuers and custodians of card and health records alone. Health Information Officers are seldom contacted in National health Information issues for their input. The International health agencies seem to prefer any health professional with foreign Masters in Public Health in carrying out data handling in their health projects. With all the above listed problems, one can deduce that society needs to know more about the actual roles played by Health Information Officers in the prevention and management of HIV/AIDS in Nigeria.

1.3 Objectives of the Study

The main objective of the study is to investigate the roles of health information officers in the prevention and management of HIV/AIDS in Nigeria.

Specific objectives are to:

1. find out the available measures for the prevention and management of HIV/AIDS in Nigeria.

2. find out the roles of Health Information Officer in the prevention of HIV/AIDS in Nigeria.

3. examine the roles of health information officers in the management of HIV/AIDS.

4. to find out factors that facilitate the role of Health Information officers in the prevention and management of HIV/AIDS in Nigeria.

5. to find out factors that militate the role of Health Information officers in the prevention and management of HIV/AIDS in Nigeria.

1.4 Research Questions

1. What are the available measures for the prevention and management of HIV/AIDS in Nigeria.

2. What are the roles of Health Information Officers in the prevention of HIV/AIDS in Nigeria.

3. What are the roles of Health Information Officers in the management of HIV/AIDS in Nigeria.

4. What are the factors that facilitate the role of Health Information Officers in the prevention and management of HIV/AIDS in Nigeria.

5. What are the factors that militate against the role of Health Information Officers in the prevention and management of HIV/AIDS in Nigeria.

1.5 Significance of the Study

The study is most likely to be the first of its kind to study the roles of Health Information Officers in the prevention and management of HIV/AIDS in Nigeria. The public will be intimated on the roles play by health information officers in the prevention and management of HIV/AIDS in the country. Both students and practicing Health Information Officers would find this work as a developing and training material. This study would also inform the international organization about the factors facilitating and militating against the roles of Health Information Officers for necessary improvement. The HIV/AIDS patient would also enjoy more effective and efficient services.

1.6 Scope of the Study

This study is limited to the survey of roles of Health Information Officers in the prevention and management of HIV/AIDS in Nigeria. Three health tertiary institutions were selected. The survey will be carried out in Obafemi Awolowo Teaching Hospital Ile-Ife, University College Hospital, Ibadan and Federal Medical Centre, Owo, all located in Southern Western Nigeria.

All higher Health Information Officers and technicians in selected institutions would be selected for study.

Operational Definition of Terms

HIV: Human Immunodeficiency Virus that attacks the immune system of an infected person.

AIDS: Acquired Immunodeficiency Syndrome which is a advanced form of HIV diseases.

Health Professional: One who uses skills and knowledge to treat or contribute to patients’ treatment and promote wellness in a clinic environment.

Tertiary Health Institution: Hospital where the highest level of health care delivery system is being offered to the patient, training of different cadres of health personnel to high international standards and research into medical and health problems are being carried out.

Health Information Officers: health care professional specialized in creating, storing, processing, searching and using of health data and report.

Prevention of HIV/AIDS: measure taken to prevent HIV/AIDS rather than curing them or treating their symptom.

Management of HIV/AIDS: Systems of coordinated HIV/AIDS are interventions and communications.

IHVN: Institute of Human Virology Nigeria

GHAIN: Global HIV/AIDS initiative Nigeria

PEPFAR: Presidential Emergency Plan for African Relief.

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