Lost to Follow up- Manual

Chapter 7: Future Possibilities There is always some work that can be taken up in the project. Projects end. Work never ends and there is always a scope for improvement and innovation. The following are suggested with the intentions that these possibilities will be made into a reality Future possibilities 1. Clear written instructions on various issues needs to be given to the ART centre for appropriate response from them.

2. LFU list/ MIS list automatic line list generation- automatic and on daily basis using PLHA software that is free of errors and dependable. This calls for exercising proper authority on the PLHA software makers and coordinating with the various facilities.

Unless this happens, the data is malleable and influencable.

3. Updating the addresses, phone numbers regularly as a routine practice in the centers.

Making the field tracking easy by various means such as taking the caregiver phone number for tracking ease, and caregiver address etc 4. Reducing the time frame- as of now, unless the MIS tracking in place, nearly 100 days are lost between the client choose to become LFU and started tracking. This needs to be reduced by early identification of the cases and timely tracking of LFUs 5. Regular follow up of the LFU reenrolled on a specific basis 6. Counseling module for the LFU clients- at home, & at the ART centre, CCCs need to be developed, tested and made into part of the counseling curriculum and refresher training as well. Training is required for all health care providers in the ART centre.

7. Giving importance for the first six months to the first time clients is necessary to prevent clients becoming LFU. Even though extensive counseling is provided to the first time clients, all the on ART new clients should be treated, followed up for the first six months vigorously so as to prevent the LFUs. 8. Daily due list phone follow up and MIS cases tracking along with LFU should get the importance and focus.

9. Making LFU tracking a regular and consistent activity in all programs related to care and support interventions 10. In future, the focus should be on the loss between the testing at ICTC and registration at ART centers, and the loss between the Pre-ART and on ART, besides on prevention.

11. Multi-Pronged Strategy is required to reduce LTFU. Some of the components in that strategy would be-institutionalization of coordination and information sharing mechanisms among hospital and NGO teams, setting up of easy to use electronic patient tracking systems both at the hospital and in the field, monthly coordination meetings with all the program partners and referral agencies for sharing of information on lost to follow-up cases, strengthening of documentation on recording of patient progress, provision of travel incentives for poor clients, prioritization of the home visits for lost to follow-up clients, patient education on importance of follow-up care, training