Our Priorities > Enhancing Access Improving Infrastructure and Technology
In 2001, the Abbott Fund and the Health Ministry identified Muhimbili National Hospital, the country's leading teaching and reference hospital, located in Dar es Salaam, as a starting point for a nationwide effort to help strengthen the country’s healthcare system. Muhimbili’s deteriorating facilities and services were often ill equipped to meet the needs of patients across the spectrum of care – from urgent emergency care to chronic disease management.
A modern outpatient department was built, containing a training facility for students and hospital staff. Hospital management received training to strengthen department organization and financial management, and a modern IT system was installed to track inventory, prescriptions and patient health history. These improvements helped to increase hospital-generated revenues by more than 50 percent in the first two years of the partnership.
Building on the initial work at Muhimbili, an ambitious plan was developed to strengthen other critical parts of the country’s healthcare system, including renovating clinics and laboratories, donating laboratory equipment, and conducting more than 20,000 healthcare worker trainings.
The Muhimbili outpatient department was the first to integrate HIV treatment into its other outpatient services, helping to mitigate the stigma associated with HIV status. The partnership also upgraded testing and treatment capacity in hospitals, clinics and healthcare facilities at more than 90 sites throughout the country, bringing services to some rural areas for the first time.
Most public health laboratories, including Muhimbili’s Central Pathology Laboratory building, were inefficiently designed and understaffed, and physical infrastructure and equipment were in a state of disrepair – leaving a critical gap in patient services.
The Muhimbili hospital laboratory building was modernized and computerized to provide the accurate diagnostic testing that is crucial for lifelong monitoring of people with chronic illnesses such as diabetes and HIV. Patients can now get test results on the same day, rather than coming back days or weeks later to receive a diagnosis.
The partnership also identified emergency care as a critical area of focus. In the past, emergency medicine was not a recognized, trained medical specialty in Tanzania, and there were no formal emergency care services available at hospitals in the country. As a result, patients coming to public hospitals for acute conditions generally received limited care until a specialist was available to provide treatment – a key contributing factor to the country’s mortality and morbidity rates.
In 2009, the first public Emergency Medical Department in Tanzania was dedicated at Muhimbili National Hospital. The building renovations, staff training and new equipment are supported by a grant from the Abbott Fund. The training and services provided at the new EMD had an immediate impact, providing critical care for more than 120,000 patients in its first three years. The EMD also serves as an important training ground for East Africa’s first residency program in emergency medicine, with the first class of residents graduating in 2013.
Over the years, assessments of Tanzania’s healthcare system identified laboratory services as one of the weakest links in providing quality patient care, especially for patients with chronic diseases such as diabetes and HIV. Most public health laboratories were understaffed, and physical infrastructure and equipment were in a state of disrepair – leaving a critical gap in patient care.
In 2007, the Abbott Fund committed $10 million to modernize all 23 regional-level laboratories in Tanzania over three years.
The partnership built or renovated the laboratories to a standard design that focused on increasing efficiency and safety. It also supplied equipment, prioritized preventative maintenance and quality assurance strategies and provided on-site mentorship to laboratory staff.
The nationwide lab modernization project was completed on time (within three years) and on budget and is now increasing the capacity and improving the quality of Tanzania’s 23 regional-level laboratories. These labs support 121 district laboratories that provide services to more than 200 care and treatment centers – effectively upgrading testing and diagnostics capabilities across the country.
Results from the modernization of the first lab showed dramatic improvements, including increasing the number of tests from an average of 15,000 to 134,000 per year and reducing the turnaround time from an average of 3-14 days to less than 24 hours. The number of patients utilizing the laboratory facilities rose from an average of 5,000 to 38,000 per year, indicating improved patient confidence and convenience. The modern working environment also has boosted staff morale and productivity.
Expert Abbott employee volunteers also serve as mentors for the laboratory staff, helping to address staffing issues, improve workflow, create and implement standard procedures and ensure lab quality assurance, as well as improve lab perception by doctors and hospital staff, market lab services and lay the foundation for accreditation.
Abbott mentors maintain ongoing contact with host labs, providing both on-site support and troubleshooting advice remotely. Exposure to international experts has improved staff buy-in and provided long-term support. In addition, all of the mentors agreed that the experience and the technical exchange of information were priceless, providing growth for both the mentors and for their new friends from Tanzania.
In Cochabamba, Bolivia’s third-largest city, an estimated 10 percent of adults suffer from diabetes. Centro Vivir con Diabetes (CVCD), Abbott Fund’s and Direct Relief’s local partner, diagnoses and treats patients with diabetes throughout the city while also working to raise awareness through a variety of activities, like the diabetes walk pictured here.
CVCD held a diabetes awareness fair in a park across the street from its clinic. The event offered free testing and counseling for those found to have Type I or Type II diabetes.
Many of those tested were young adults from low-income families. CVCD is the region’s only diabetes clinic, delivering care at little or no cost to patients.
Since 2006, CVCD has screened and cared for more than 90,000 diabetes patients in Cochabamba, including Type I and Type II diabetes. In addition to our financial support, Abbott donates blood-testing equipment for the clinic as well as for patients’ personal use.
We also help support CVCD’s lifestyle education courses for diabetes patients. Before CVCD began its educational outreach, health care practitioners in the region tended to treat diabetes as a temporary disease rather than a lifelong condition.
As part of its mission, CVCD sends trained social workers to visit diabetes patients at home to ensure that they know how to manage their condition.
Thanks to CVCD, the annual rate of detection of diabetes in Cochabamba has increased by 250 percent. Since 2006, CVCD has served more than 90,000 diabetes patients, counseling them on disease management techniques and healthy living habits.
Recently, the Abbott Fund helped its Bolivian partner Clinica Vivir con Diabetes to obtain iPads and the specialized programming needed to track diabetes patients. A new record is created for each new patient at the diabetes clinic.
The patient’s name and home address are noted and stored, along with any available medical history. In addition to tracking individuals, the program consolidates medical data, allowing analysis of the information later.
The patient’s home address is instantly pinpointed on a map, and the location is saved as part of the record.
In the examination room, the patient’s blood glucose level is tested, and the number is noted on his electronic record, along with other medical notes.
Simple, bold graphics and a touchscreen help patients as they describe their medical histories. No reading or writing ability is required, and even the youngest and the oldest can understand the images.
After being examined, patients meet with an endocrinologist who has full, instantaneous access to individual records. The doctor interviews the patient and adds her notes directly to the file. No medical transcription is needed, lowering the chance of accidental errors.
On later visits or in case of emergency, staff can quickly access the records for each individual. That means faster response time and more accurate diagnosis, prescriptions and treatment. With diabetes sharply on the rise in Bolivia, the technology is an effective tool for helping patients manage their disease and live healthier lives.
In 2001, Tanzania's deteriorating Muhimbili National Hospital, the country's leading teaching hospital, was selected as a starting point for improvements to the country's health system. Today, with assistance from the Abbott Fund, facilities, systems and training have been radically improved throughout the hospital and in more than 90 other Tanzania health facilities, leading to significant improvements in patient care and health outcomes.
As in developed nations, the introduction of modern information technology and digital recordkeeping can revolutionize the delivery of health care services in developing regions. Abbott is partnering with a wide range of nonprofit organizations, government agencies, health care professionals and other stakeholders to help improve health care system capacity and infrastructure through digital innovation.
For example, we are partnering with Direct Relief International to develop a new, open-source, server-based electronic medical records system to help combat Bolivia's growing diabetes problem. Supported by both grants from the Abbott Fund and donated equipment from Abbott, this system has trained hundreds of diabetes educators, identified thousands of diabetes patients and referred these patients for treatment. The system uses tablet computers equipped with GPS technology to enable mapping of patient locations, even in the poorest urban sections of the country. This data, in turn, helps public health officials conduct detailed epidemiological studies that will enable them to target educational programs and outreach services more accurately.
Tradition of Support in Tanzania
Abbott also has a long tradition of supporting health care infrastructure and technology development in Tanzania – where we have engaged in a public-private partnership with the Government of Tanzania to strengthen the country's health care system for more than 11 years. To date, Abbott and the Abbott Fund have invested more than $100 million in this comprehensive program. Our activities include working to comprehensively modernize Muhimbili National Hospital with a new emergency department and outpatient treatment center, a modernized laboratory building and a hospital-wide information technology system that tracks inventory, prescriptions and patient health history. In 2011, we completed a project to build new laboratories to improve diagnostic and monitoring capabilities at 23 regional-level hospitals. Additionally, we have supported more than 20,000 health care worker trainings in HIV care and treatment, voluntary counseling and testing, laboratory equipment operation, hospital information technology and hospital management. Abbott has also donated 1 million rapid HIV tests to launch Tanzania’s national HIV testing campaign and partnered with the Baylor International Pediatric AIDS Initiative to build a pediatric AIDS Center of Excellence in Tanzania.
Note: All data reflects Abbott activities in 2012. Some content has been adjusted to remove data specific to AbbVie, which became a separate company on Jan. 1, 2013.