Title

Feasibility of an mHealth initiative integrating civil birth registration (Unique Civil Identification Number) into the Health Information System through the Pediatric HIV Care Services in Zambézia Province, Mozambique

Presenter

Celso Belo

Authors

C. Belo¹, H. Machombe², C. Rubalaine³, F. Damião⁴, A. Camões⁵, P. Paulo³, M. Bravo¹, T. Ntasis¹, H. Macul⁶, H. Magaia⁶, M. Rein⁷, C. De Schacht¹

Institutions

¹Friends in Global Health, Maputo, Mozambique, ²UNICEF, Maputo, Mozambique, ³Friends in Global Health, Quelimane, Mozambique, ⁴Provincial Department of Justice and Labor, Provincial Division of Civil Registration, Quelimane, Mozambique, ⁵Provincial Health Directorate Zambezia, Quelimane, Mozambique, ⁶Ministry of Health, Maputo, Mozambique, ⁷U.S. Centers for Disease Control and Prevention, Maputo, Mozambique

BACKGROUND: In December 2018, Mozambique passed legislation (law no. 12/2018) allowing for electronic civil registration, and a phone-based registration system was introduced. In September 2021, Friends in Global Health, in collaboration with the Ministry of Health, Ministry of Justice, and UNICEF piloted civil registration in health facilities using mobile health (mHealth) initiative in Zambézia Province, aiming to scale up pediatric civil registration, a potential means to identify duplicated HIV care registration.
DESCRIPTION: In each of four pilot health facilities, caregivers of children were referred from Maternal and Child Health (PMTCT) and Pediatric HIV service entry points to trained staff who completed the child’s birth record notification via a mobile phone-based registration system, after which a unique civil registration number was generated. For children living with HIV (CLWH), this number was transcribed in the medical record and entered into the electronic tracking system.
LESSONS LEARNED: Between September 2021-November 2022, 8131 children (up to 13 years of age) arrived at the service entry points. The proportion of children registered was 75% (6095/8131); 41% (348/852) among CLWH. Delays in registration were seen as health staff struggled to manage registrations when multi-tasking for other clinical care duties, and technical difficulties with the phone-based system (Figure). During the pilot, 64% (224/348) of CLWH who received their registration number were entered in the electronic medical record database; the remaining were registered in a database other than those from the pilot health facilities.

CONCLUSIONS: Although many children were registered through this collaborative pilot, technical inconsistencies, registration delays and clear task delineation need to be addressed before expanding the strategy. Lessons learnt from this project would inform the design of mHealth systems used to improve the identification of silent transfers of individuals in HIV care.

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