# Programme records for NGO clinics: SRH, HIV, TB and outreach > ART, TB, SRH and outreach registers, cohort reports and DHIS2 export for NGO and programme sites in Ethiopia, every site on one system, kept separate. Source: https://www.medicine.et/for/ngo-programmes Site: Bloom Medicine — https://www.medicine.et --- Programme registers, cohort reports and defaulter tracing on the same record as the rest of the clinic — entered once, at the point of care, by the people giving the care. With HIV, mental-health and confidential SRH charts sealed, and every site on one system, kept separate. ## Measured in Ethiopia - **93%** — of pre-ART patients lost to follow-up at a rural Ethiopian hospital were lost within the first six months ([Research note · Missed appointments](https://www.medicine.et/research/missed-appointments)) - **46.7%** — timeliness of HIV programme HMIS reports across public facilities in Jimma town (2022) ([PLOS ONE, 2026](https://doi.org/10.1371/journal.pone.0357022)) - **76.5%** — of HIV viral-load tests at the Amhara Public Health Institute reference lab had a delayed turnaround (2018) ([BMC Health Serv Res, 2019](https://doi.org/10.1186/s12913-019-4077-2)) - **23.60%** — of 423 people on ART at Nekemte Specialized Hospital reported perceived breaches of confidentiality ([HIV/AIDS Res Palliat Care, 2022](https://doi.org/10.2147/HIV.S350091)) ## The problems we hear from NGO and programme sites - **Clients lost to follow-up in the first months** — Most losses from HIV care happen early. A defaulter found at month-end is a defaulter found too late. - **Cohort reports counted, not generated** — The cohort report and the monthly return are tallied from registers by data clerks — late, and only as accurate as the count. - **Viral-load results nobody acts on** — An unsuppressed result that sits in a folder is a client who should have started enhanced adherence counselling weeks ago. - **Confidentiality that depends on the folder** — Clients who fear being seen do not come back. A paper file can be read by anyone who handles it. - **Outreach that leaves no record** — Youth sessions and community activities happen away from the building, with no visit and no bill — so they rarely show up in the data. - **Paper and screen, side by side** — Keeping the paper register and an EMR at the same time makes both worse. The record has to be the one place the work is written. ## What changes - **Defaulters the day they miss** — Differentiated service delivery models and defaulter tracing for ART, and defaulter tracing with transfer in and out for TB — with reminders by Telegram, WhatsApp or SMS. - **Cohort reports generated** — The ART and TB cohort reports, the HMIS return and a DHIS2 export come from the visits already recorded. - **Charts sealed by default** — HIV, mental-health and confidential SRH charts can be sealed, with break-the-glass access and unusual reads flagged — and a waiting room that calls numbers, never names. - **Every site, one system** — Run several programme sites on one system, each kept separate, administered from one console and compared side by side. ## HIV care, ART and TB on the national registers The ART clinic runs on enrolment with the unique ART number, initiation, the follow-up form, regimen and status changes, and the viral-load loop with enhanced adherence counselling. TB runs on the presumptive and unit registers with the TB number, treatment and DOT cards, contact screening and preventive therapy. - Unique ART number, follow-up form and the ART cohort report - Viral-load loop with enhanced adherence counselling - PMTCT and HIV-exposed infant follow-up, PrEP and PEP - TB and DR-TB treatment cards, DOT card, contact screening and TPT - Leprosy register with disability grading, and the TB cohort report ## Youth-friendly SRH services and outreach Family planning and ANC visits, HIV testing and counselling, STI cases and counselling sessions run on the youth client profile. Community outreach is recorded as it happens, without a visit or a bill. - Family planning and antenatal visits - HIV testing and counselling, and STI cases - Counselling sessions and the youth client profile - Community outreach recorded without a visit or a bill ## The modules NGO and programme sites use - [HIV Care & ART](https://www.medicine.et/features#hiv-art) (add-on) — The ART clinic on one record: enrolment, follow-up, viral load and the cohort report. - [TB & Leprosy](https://www.medicine.et/features#tb-leprosy) (add-on) — The unit TB register and treatment cards, with results flowing in from the lab when you have one. - [Sexual & Reproductive Health](https://www.medicine.et/features#srh) (add-on) — The registers a youth-friendly service keeps, including work done away from the building. - [Security & Privacy](https://www.medicine.et/features#security) — Each role sees only its own work, and every action carries a name and a timestamp. - [HMIS & Surveillance](https://www.medicine.et/features#hmis) — The national returns a facility is legally required to file, produced from the work already recorded. - [Multi-Branch & Multi-Facility](https://www.medicine.et/features#multi-branch) — Several facilities on one system, separated by default and administered from one place. - [Laboratory](https://www.medicine.et/features#laboratory) (add-on) — Ordering from the room, a worksheet for the bench, and results that keep their corrections. - [Mobile App](https://www.medicine.et/features#mobile-app) — The facility in a pocket for staff, and still readable when the connection drops. - [Data Exchange](https://www.medicine.et/features#interoperability) — Records that can leave the building in a standard shape when the patient or the system needs them to. ## Questions ### Is the unique ART number supported? Yes. Enrolment with the unique ART number, ART initiation, the follow-up form, and regimen and status changes. ### Does it produce the ART and TB cohort reports? Yes, both — along with the HMIS return and a DHIS2 export. ### Does it produce PEPFAR or Global Fund indicator reports? Not as built-in reports. It produces the national cohort reports, the HMIS return and a DHIS2 export, and reports export to Excel for further analysis. Talk to us about your donor’s requirements. ### Does it replace or sync with SmartCare? No. Bloom keeps its own programme registers and reports, with FHIR R4 read access and CDA documents for exchange. It does not sync with SmartCare or other national EMRs, so check your programme’s requirements first. ### Who can see an HIV chart? Only the roles you authorise. HIV charts can be sealed; opening one means breaking the glass, which is logged and flagged. ### Can we run several programme sites? Yes. Multiple sites on one system, each fully separated, with a central administration console and every site’s numbers side by side. ### Can outreach workers record on a phone without network? The staff mobile app is readable offline, but saving new records needs a connection. Outreach can be recorded once the team is back in coverage. ## Cited research - [Missed appointments in Ethiopia are a clinical failure, not an empty chair](https://www.medicine.et/research/missed-appointments) — 39.2% of hypertensive patients in South Gondar follow-up clinics missed their appointments. In HIV care, 93% of patients lost to follow-up disappeared within six months. The Ethiopian evidence measures the harm, not the lost revenue. - [Reporting on time and reporting correctly are different problems](https://www.medicine.et/research/dhis2-data-quality) — Ethiopia runs one of the world's largest DHIS2 deployments — 30,000+ facilities, 95% reporting rates. The national maturity assessment scores data quality and infrastructure far lower. Submitting a report and submitting a correct one are not the same achievement. - [Proclamation 1321/2024 makes patient data a legal duty, not a filing habit](https://www.medicine.et/research/patient-data-protection-law) — Ethiopia now has a comprehensive personal data protection law. Health data is classified as sensitive personal data, breaches must be reported to the regulator within 72 hours, and the obligations apply to private clinics — not only to hospitals.