​Launch of a pediatric HIV consultation hotline

​In January 2014, Baylor College of Medicine Children’s Foundation Malawi (BCM-CFM) and Tingathe launched a Pediatric HIV Consultation Hotline to provide Ministry of Health (MoH) clinicians access to real-time clinical support and answers to specific clinical questions via mobile phone.  
 
The line is open during business hours and staffed by BCM-CFM clinical officers with BCM-CFM pediatricians and pharmacists standing by to back up. The service is available for free to any health care worker providing pediatric care.  Users seeking answers to their clinical questions can simply send a text message or “flash” the mobile phone number and await a call back from the consultant.  The caller can then ask his or her question and discuss the scenario with the consultant, listening to his or her advice and choosing the best solution for the problem. 
 
The service was piloted at six sites and ultimately rolled out to all 19 sites where Tingathe is active.  To publicize the new service, fliers and business cards with the hotline phone number were distributed at clinician-wide and one-on-one meetings.  Clinicians are also reminded about the availability of the hotline during routine mentorship visits to the sites.

Mentors Menard Bvumbwe (standing) and Linda Dziweni-Sato (sitting) supervising during an ART clinic visit

In its first 2 months, 11 telephone consultations were completed, for an average of 1.2 calls per week. The consultations required little time—only one call went over 5 minutes, which allowed the staff to carry on with their regular clinical duties while also being available to answer the phone.  Of the 12 calls, 4 (36%) were placed by health surveillance assistants (HSAs), 3 (27%) were clinical officers or medical assistants, 2 (18%) were nurses.  Most of the calls placed (5, 45%) were regarding general ART. Other topics included: drug side effects (2, 18%), tuberculosis and isoniazid prophylactic therapy (2, 18%), (1, 10%) second line ART, and exposed infant care (1, 10%). 
 
Overall, the Pediatric HIV Consultation Line is proving to be an effective and inexpensive method of providing best practice answers to specific clinical questions and continued independent medical education to HIV care providers in Central Region, Malawi.