Global Health Ideas

Finding global health solutions through innovation and technology

Freeware for HIV meds and HIV services management

This past week on the Afro-nets listserve, a consultant in the Netherlands asked about the availability of free software for management of HIV anti-retroviral treatment. The request generated some interesting feedback, as well as gave me pause to consider incentives, development, and leadership.

Tworespondents gave links to freeware options for follow up of patients on HIV anti-retrovirals (ARV). The field epidemiology group, EpiCentre (created by Medecins Sans Frontieres in 1987 – details at Epicentre’s “About us”) has freely available clinical management software called “Fuchia”. The software is updated as of October 2006. The site explains:

The “Follow-Up and Care of HIV Infection and Aids” software, otherwise known as Fuchia, has been designed tofacilitate the clinical, biological and therapeutic monitoring of HIV positive patients.

A software prototype was created at the start of 2000, in partnership with MSF France’s technical department and various medical teams working in the field. Since June 2001, a technical committee – comprising of members from five MSF sections (Belgium, France, Switzerland, the Netherlands and Spain) and the Epicentre – has been involved in the process of developing Fuchia. These five MSF divisions are also responsible for financing the development of this software.

More technically speaking, Fuchia is a database interface operating in a standard Windows environment (95, 98, Millénium, NT4, 2000 et XP), written in Object Pascal (Borland Delphi) and connected to an Access database.

As a footnote, one of EpiCentre’s field offices operates at the same Ugandan university (MUST) where I conduct field work.

The second respondent highlighted the OpenMRS wiki (open medical records). The developers explain:

OpenMRS is an application which enables design of a customized medical records system with no programming knowledge (although medical and systems analysis knowledge is required). It is a common framework upon which medical informatics efforts in developing countries can be built. The system is based on a conceptual table structure which is not dependent on the actual types of medical information required to be collected or on particular data collection forms and so can be customized for different uses. AMRS is based on the principle that information should be stored in a way which makes it easy to summarise and analyse, i.e. minimal use of free text and maximum use of coded information. At its core is a concept dictionary which stores all diagnosis, tests, procedures, drugs and other general questions and potential answers. OpenMRS is a client-server application which means it is designed to work in an environment where many client computers access the same information on a server.

These and related efforts to create functional and cost-effective ARV management databases should take a pointer from the Healthcare IT Blog – agree on a common language and foundational concepts. And has solid recommendations for any local system implementation, though the focus is on US operations.


An additional firm, South African Health Information Systems Programme is worth checking out.  A short summary of their work:

The Health Information Systems Programme (HISP) has since 1994 expanded from a pilot project in three Cape Town health districts to a global South-South-North network active in around 15 countries/states with over 200 million people in Africa and Asia. The network comprise universities, Ministries of Health, NGOs, and companies. All our ICT solutions, materials, and experiences are shared based on “Free and Open Source Software” principles. The primary focus for HISP is developing and implementing integrated Health Management Information Systems for routine data, semi-permanent data, and survey data. Databases using our District Health Information Software (DHIS) contain data representing over one billion patient visits. The DHIS is designed to support health workers and managers at all administrative levels through a balance between flexibility and standardization, and with a strong emphasis on USING INFORMATION FOR LOCAL ACTION. The DHIS has been translated into Portuguese, Swahili, Spanish, Telugu, Russian, Mongolian, and Chinese – Vietnamese and French are under way. Around 70% of overall HISP effort goes into training, with an estimated 7-8,000 health workers and managers trained in South Africa alone. The HISP network, while having university partners in Norway and Sweden, is predominantly run BY professionals from the south and FOR countries in the south.


Written by Ben

December 3, 2006 at 1:05 pm

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