Evelyn Castle

1 Year Evaluation of EMR at Asibitin Yara

Evelyn Castle -- 15th July 2010

Yesterday I traveled for the day down to Kaduna to do an evaluation of the EMR system that I set-up last year. I was a little worried going down there, afraid that it wasn’t working well or that it wasn’t having any effect. Boy was I wrong! I was blown away with the effect it was having on data collection, but more importantly, on the people! I was incredibly inspired and am now scheming for ways to raise some more money so that I can get back there and do more work. So here is what happened:

I drove down to Kaduna in the morning and got to the clinic around 10:30. Our meeting was supposed to start at 11, so I had enough time to see everyone and say hello before hand. I finally got to see my good friend Helen Lolo! She was away last time I visited the clinic so it was really good to finally see her. Helen and I had the best conversations last year. She is so honest about everything and incredibly intelligent. Anyways, after that, I went over to the records room to see how Ibrahim and Yakubu were doing. When I walked in, they were both on the computers, typing away. Also in the room were 2 new Records Keepers that just graduated from the University.

Our meeting started out pretty ordinary. I asked who was using the EMR; it is just Yakubu and Ibrahim but they are going to teach the 2 new people soon. I asked what they were using the EMR for; they said to enter in immunizations. They want to do Antenatal but they just don’t have the time. Well I asked, why not? There are normally no more then 100 children that come into the clinic each week. I know they can type faster then that, so what’s up? Well it turns out, they had decided that they wanted the records to be 100% complete so they were going back and entering in all the immunizations from when the computer wasn’t working.

WOW. To me, that is pretty amazing. They see the value and importance in having complete and accurate records, and are willing to do more work for it. Turns out, they are almost up-to-date on all the immunizations. There is a total of over 1,000 children immunizations records in the EMR currently.

So next I asked how they were doing the reporting. Ibrahim explained that he used the Reporting Module on the EMR. I was a little skeptical that he was being honest so I said “Are you sure?” ….. and he looks at me and says “Yes! Look at what I have been doing with the data each month!” and points behind me. I turn around and on the wall were 4 hand drawn bar graphs and pie charts depicting the data that he was collecting each month.

I was blown away. Seriously blown away. Before the EMR was in place, the records were a guess, at best. And because everyone knew they weren’t accurate, no one really cared what the  numbers were. But now, with a little bit of information, Ibrahim was inspired enough to take the time to hand draw bar graphs! I am not sure if everyone understands how monumental this is and I don’t know if I am giving this justice in my description. But, this is huge. Giving someone just a little bit of empowerment and seeing the results of that is amazing.

Not to mention the fact that Ibrahim and Yakubu are finally getting to do the job that they studied to do. They put themselves through school, studying for many years, learning how to analyze data and now the EMR is finally allowing them to do the job they want to do!

Another amazing thing is that the EMR system actually helped them to realize that, not only were the “return” immunizations not being recorded properly, but that some people were stealing money from the clinic. Once they realized this, they were able to tell the Matron and now “return” immunizations are being recorded properly! And Ibrahim told me that he was, and I quote, “excited to finish the “first” immunizations so that he can go back in and enter the “return” immunizations so that the immunization records would be up to date”. So cool.

Also during the meeting, Ibrahim and Yakubu were sure to tell me what more they wanted the EMR to do, what they didn’t like about it, that they wanted more computers so more data could be entered, and what I needed to fix for them. To me this was pretty cool because most of the time I am working with people, it’s like pulling teeth to try to get them to actually TELL ME what they want/need. I think it is a Hausa thing but it is REALLY hard. The fact that I barely had to ask what they needed and Ibrahim and Yakubu felt comfortable enough with me to tell me straight away was a really cool experience.

Right now I am finishing my report on the 1-year Evaluation for the clinic and it will be up soon online. We are trying to raise some money to get the clinic more computers and we want to set up our solar system there.

Below are the pictures of the graphs that Ibrahim made and just of the Records Room in general. Before I left, I asked Yakubu to let me take a video of him entering in a child’s immunization record so that people back home could see how it works. Its pretty amazing. I am working on making a short video and will upload it soon!