By: Lunga Memela (HST Communications Engagement Lead)
"The joy of working with SyNCH is seeing patients who are clinically stable on their chronic medication and who do not need to consult with a healthcare professional at each visit to their clinic, being able to collect their monthly medication without spending hours going through paperwork and facility processes," says HST's eThekwini SyNCH Monitoring and Evaluation Co-ordinator, Khayelihle Shozi. Why so? Khayelihle explains it to us in a brief interview with HST's Communications Unit.
Contextualising SyNCH
Upon the National Department of Health (NDoH) realising that high patient volumes and a shortage of human resources within public health facilities were resulting in increased patient waiting times which limited the duration of their consultation with healthcare professionals and thereby affected their access to medicines and quality of care, the Department developed the Central Chronic Medicines Dispensing and Distribution (CCMDD) / Dablapmeds programme, which enables clinically stable patients to collect government-issued medication for free at convenient pick-up points (PuPs) across the country.
Because the CCMDD programme had been paper-based and therefore subject to process inefficiencies and a lack of transparency, HST worked with the NDoH and system developers (ASG Technologies) to develop SyNCH (Synchronised National Communication in Health) as a standardised, automated process for all provinces implementing CCMDD, and continues to support its operation in partnership with the NDoH. The development, implementation and continued management of this undertaking is an SA SURE PRO sub-project at HST, funded by PEPFAR through the U.S. Centers for Disease Control and Prevention (CDC).
SyNCH is a real-time web system designed to improve process flows for end-to-end visibility of the CCMDD programme, ensure compliance with the Standard Treatment Guidelines (STGs), monitor medicine collection status, and promote the rational prescribing of essential medicines. That is why SyNCH Monitoring and Evaluation Co-ordinators like Khayelihle need to be on the ball, ensuring that patients are linked to care 24/7 through the system. He joined HST as a SyNCH Support Technician in 2019 and was promoted in the same year to his current position.
What makes you passionate about working in the field of monitoring and evaluation?
"Truly speaking, it's the people!" says Khayelihle. "It's rewarding to see patients benefit from processes that make their experience at clinics user-friendly and rapid. It's also the healthcare workers on the ground who improve the quality of clinical care and efficiency for patients who seek their expertise. The efforts of teams who monitor and evaluate implementation, and mitigate challenges, add value to the public health experience."
Why is monitoring and evaluation important in the health sector?
"The health environment is complex and constantly changing as social circumstances are always in flux, especially in our beloved country," Khayelihle notes. "Having teams that focus on addressing challenges that arise on a daily basis allows for resolutions to be provided as speedily as the changes arise. This work relies on good-quality performance data, which is why M&E functions are invaluable."
How does using SyNCH make your work easier than having to use paper-based monitoring and evaluation systems?
"SyNCH enables speed, compliance, rational medicine use, reduced workload, transparency, process flow monitoring and placement of reports on continuity of care at your fingertips," he explains. "The system can be accessed from any device that has Internet connectivity from anywhere. These points alone prove that it is a world-class system that makes my work 10 times easier than having to try find a paper trail on what is happening regarding patients or how a facility is working in order for me to intervene with fast solutions."
What form of training did you receive in order to become competent with SyNCH?
"Based on my role in implementing the programme at a facility or pick-up point level, I had to undergo a five-day training programme," says Khayelihle. "However, when training facility-based personnel, one would conduct targeted training based on what they need to do on the system in a phased approach up until the user is comfortable with daily use of the system, which can be for a few hours, or a day or longer, depending on how quickly the user grasps how they need to utilise the system."
How does SyNCH help you with generating the required regular reports?
"SyNCH's high level of accessibility means that I do not have to be at the facility in person to get the reports I need; I can generate them in a matter of seconds and easily understand them, as all the indicators are clear. SyNCH is a real win for the health system."
How has the introduction of SyNCH benefited the eThekwini community?
Khayelihle lists a number of advantages enabled by the use of SyNCH:
- Data recording and management for easy tracking and tracing of patients
- Elimination of incorrect prescriptions
- Improved compliance by prescribers
- Tracing and tracking of patient medication parcels
- Ensured compliance with the STGs for improved patient management
- Monitoring of medicine collection status for improved medicine supply
- Promotion of the rational prescribing of essential medicines
- Reduced workload (because the system eliminates the need for paperwork)
- Reduced waiting times for patients needing repeat prescriptions.
What does your typical work day entail?
"My day starts off with checking for any pressing issues that have been raised by my line manager, and then for issues logged through the national SyNCH Helpdesk that have been escalated to me for assignment of a SyNCH specialist to resolve," he says. "This will be followed by monitoring of the SyNCH M&E Support Specialists' services to facilities to ensure that the outcomes align with the project objectives through our monitoring and reporting tools, including the weekly plan."
"I then co-ordinate any scheduled stakeholder engagements, and monitor the utilisation of SyNCH at facilities and pick-up points for escalation and mitigation planning. This involves checking script renewal rates, the continuity of care rate, manual prescriptions that may still be created in some facilities, saved prescriptions, prescriptions rejected by the service provider which require amendment within seven days, and parcel management. I also monitor and analyse prescriber trends, and follow up on lists of patients who miss collection dates, or are reflected as 'dormant' and 'closed' on the SyNCH system. Equipment-related queries and requests have to be dealt with, and I will conduct a supervised support visit when a facility needs my level of support if scheduled."
What are your goals and aspirations?
"My immediate goal is for eThekwini to reach and maintain the third UNAIDS '95' target (that by 2025, 95% of all people receiving antiretroviral therapy will be virally suppressed), and my hope is that SyNCH will be recognised as the main steering tool used in all public health facilities to meet that target," says Khayelihle. "My other aspiration is to complete my Master's degree in Systems Analysis."
Khayelihle is family-orientated, so when not travelling, he loves spending time with family and close friends.