Improving the Efficiency of Monitoring Adherence to Antiretroviral Therapy: A Case Study of the Introduction of Electronic Technologies in Gugulethu, South Africa

This paper presents a case study of the efficiency gains resulting from the introduction of electronic technologies to monitor and support adherence to highly active antiretroviral therapy (HAART) in Gugulethu, South Africa. It suggests that the rollout of HAART to resource-poor communities can be assisted significantly by the introduction of modified cell phones (to provide home-based support to people on HAART) and simple bar-coding and scanning equipment (to manage drug supplies).  The cell phones have simplified the working lives of therapeutic counsellors, allowing them to spend more time with patients and less time on administration, and enabling them to key in data directly to a database through a secure internet connection. It has helped integrate the local-level primary health service provision with the kind of centralised data capture and analysis necessary to monitor a national-level HAART rollout.