Participatory approach to data warehousing in health care UGANDA’S Perspective

Abstract: This licentiate thesis presents the use of participatory approach to developing a data warehouse for data mining in health care. Uganda is one of the countries that faced the largest brunt of the HIV/AIDS epidemic at its inception in the early 1980s with reports of close to a million deaths. Government and nongovernmental interventions over the years saw massive reductions in HIV prevalence rates over the years. This reduction in HIV prevalence rates led to great praises by the international community and a call for other countries to model Uganda’s approach to battling the epidemic. In the last decade the reduction in HIV prevalence rates have stagnated and in some cases increased. This has lead to a call for reexamination of the HIV/AIDS fight with an emphasis on collective efforts of all approaches. One of these collective efforts is the introduction of antiretroviral therapy (ART) for those already infected with the virus. Antiretroviral therapy has numerous challenges in Uganda not least of which is the cost of the therapy especially on a developing country with limited resources. It is estimated that of the close to 1 million infected in Uganda only 300,000 are on antiretroviral therapy (UNAIDS, 2009). Additional challenges of the therapy includes following through a treatment regimen that is prescribed. Given the costs of the therapy and the limited number of people able to access the therapy it is imperative that this effort be as effective as possible. This research hinges on using data mining techniques with monitoring HIV patient’s therapy, most specifically their adherence to ART medication. This is crucial given that failure to adhere to therapy means treatment failure, virus mutation and huge losses in terms of costs incurred in administering the therapy to the patients. A system was developed to monitor patient adherence to therapy, by using a participatory approach of gathering system specification and testing to ensure acceptance of the system by the stakeholders. Due to the cost implications of over the shelf software the development of the system was implemented using open source software with limited license costs. These can be implemented in resource constrained settings in Uganda and elsewhere to assist in monitoring patients in HIV therapy. A algorithm that is used to analyze the patient data warehouses for information on and quickly assists therapists in identifying potential risks such as non-adherence and treatment failure. Open source dimensional modeling tools power architect and DB designer were used to model the data warehouse using open source MYSQL database. The thesis is organized in three parts with the first part presenting the background information, the problem, justification, objectives of the research and a justification for the use of participatory methodology. The second part presents the papers, on which this research is based and the final part contains the summary discussions, conclusions and areas for future research. The research is sponsored by SIDA under the collaboration between Makerere University and Blekinge Institute of Technology (BTH) in Sweden.