Kisumu, September 2014 – April 2015
Most PhD students who have entered candidacy find themselves in a lab with four walls, high-tech instruments, a private work bench, and a set of controlled experiments. As a doctoral student of public health doing my dissertation in Kenya, however, my lab has none of those elements.
Instead of four walls, I have four research sites spread throughout Western Kenya from which I am gathering data. Instead of high-tech instruments, we have paper clinical charts from which I am abstracting numbers into an Excel spreadsheet for later analysis. Instead of a private workbench, I share a wooden desk in small, simple workroom with several other research assistants. And the effects of HIV and AIDS are anything but controlled. It is not an experiment – it is a very harsh reality.
I came to FACES in October of 2014 and was immediately thrown into the data collection process at three FACES-supported community health centers in the rural parts of Nyanza Province. I began to grasp the magnitude of the challenges surrounding data collection in these areas: medical records are all kept on paper charts, primarily in the format of a “register.” These registers record each patient visit sequentially in one book organized by visit date, rather than longitudinally for each individual patient according to patient identification number. While this design may be optimal to allow for uniform service delivery and outcome reporting, it requires provider effort to flip back and forth through the register to find prior patient visit data. For researchers, it means lots of time spent abstracting data and manually linking them by a set of patient identifiers.
Through the dedication of the people at FACES, change is slowly impacting even the more remote facilities. I was privileged to be involved in the implementation of one of the first electronic medical record systems for prenatal care in the region. Over time, the advances that FACES is making will streamline the process of data collection and research. More importantly, however, I believe that they will positively impact care services for HIV-affected families in Kenya.