How attention to privacy supports continuity of care in Swaziland: Confidential, complete HIV care through better health information systems

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Sam Wambugu_MEASURE Evaluation

Sam Wambugu of MEASURE Evaluation

The following is a guest post

by Sam Wambugu, of MEASURE Evaluation

In the United States, electronic medical records have removed the tedium of filling out replicate health forms at every doctor visit. But now the same is true for low- and middle-income countries like Swaziland in southeastern Africa where MEASURE Evaluation, a USAID-funded global program, is helping make digital health systems a reality. I work with local partners in Swaziland to plan and support the implementation of electronic medical records and integrated health information systems, which are key in the treatment of HIV patients to ensure they do not drop out of the healthcare system.

Along with a team of technical specialists, I create guidelines and protocols to protect patient privacy and confidentiality when medical records go digital. So far, three health facilities have functioning electronic medical records systems, and a dozen more are lined up to launch by the end of September 2016.

Electronic medical records mean more than convenience—they mean a higher quality of care with less cost to the patient and the system. Each visit is better coordinated, with no duplication of services. This is especially true of patients who undergo a series of treatments and referrals, including HIV patients. With integrated health information from multiple sources, decision makers will have a larger pool of health data to work with, something that is especially important when tracking infectious diseases.

Systems that ensure medical professionals can easily refer patients help the sector achieve the President’s Emergency Plan for AIDS Relief 90-90-90 goal by ensuring patients continue to receive medical care instead of dropping out of treatment. The goal’s targets are that 90percent of people living with HIV know their HIV status, 90 percent of people who know their HIV status are accessing treatment, and 90 percent of people on treatment have suppressed viral loads.

Digital health records help foster more trust between patients and providers. Although digital records can be copied or altered just like paper records, MEASURE Evaluation is ensuring protocols are in place to make electronic medical record data more secure. These data are often sent via Wi-Fi hotspots from one point of care to the next, making the information potentially vulnerable to hackers. The work MEASURE Evaluation is doing to support the health sector in Swaziland ensures such vulnerabilities are addressed before there is a breach.

We shouldn’t wait until data are compromised to be thinking about safeguards, so we’re developing guidelines and protocols — and making them understood by health care workers — to protect medical records from security challenges that come with the use of information technology. MEASURE Evaluation is using the success of the processes used in Swaziland as a foundation for discussions to implement such processes in other low- and middle-income countries supported by USAID.

Electronic medical records and health information system projects like the one in Swaziland help people get the right services, at the right time, and in the right place, which ultimately saves time, money, and lives.

Sam Wambugu is a Senior Health Informatics Specialist, at MEASURE Evaluation.

For more information visit, and see a new MEASURE Evaluation report, A Primer on the Privacy, Security, and Confidentiality of Electronic Health Records.

3 thoughts on “How attention to privacy supports continuity of care in Swaziland: Confidential, complete HIV care through better health information systems

  1. w. nderitu

    Great technological innovation there to cope up with the dynamic life actually saving lives , time and resources. Good stuff Mr. Wambugu, a paradigm in informatics via the trending tech is the way to go.

  2. W. Nderitu

    Great and progressive innovation on health information systems by Sam; MEASURE Evaluation Program. That will absolutely promote improved health to HIV patients due to privacy and timely coordination of treatment.

  3. Samuel

    With digital data patients follow up really becomes easier and again confidentiality issues are ensured because in often most times patients on ART for example prefer using two health passports to ensure their status is not public . Hence receiving not optimum care because prescribing officers at times forget to enquire about HIV Sero status just by seeing what is in the Health passport not knowing the client has two Health passports for confidentiality purposes.


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