Strategic Information for
Anti-RetroViral Treatment
Programmes
Summary of
Workshop
WHO and UNAIDS
Geneva
June 30- July 2 2003
WHAT KIND OF INFORMATION
DO WE NEED?
Needs, resources, access, coverage
What are and will be the needs for treatment?
What resources are available and what will be needed?
How many have access? Who has access?
Programme Monitoring & Evaluation
Is the programme performing according to plans?
Is the programme able to contain drug resistance development?
Does the programme make a difference? Is it achieving its goals?
How much does it cost and how cost effective is it?
Patient monitoring
Operations Research
How can programme implementation be improved?
What are the best models of implementation?
What can be done to improve health systems?
Research
Can we provide more efficacious and more effective interventions?
What impact do programmes have?
DATA COLLECTION for
Monitoring and Evaluation
Input
Process
Output
Outcome
Household
Surveys
Programme Monitoring
Facility
surveys
Patient
monitoring
Impact
HIV/STI
surveillance,
surveys
Patient
monitoring
PROGRAMME MONITORING
(SERVICE DELIVERY POINT LEVEL)
Strategic Information
Field
Assessment tools ……………...Country needs
Clinic monitoring
Protocol that specifies the kind of data that
need to be collected, forms and technologies
to be used, communication/reporting etc.
Outline the system Link patient data, drug supply,
fees
Methods / technology to be used
Contents definitions indicators - kind of outcomes
Priorities
Steps needed
Operations
Research
PROGRAMME MONITORING
Strategic Information
Field
Programme M&E
Logistics
ARV drug resistance
surveillance
Care and support
programmes
Care and support
programmes
Assessment tools ……………...Country needs
Plan that outlines framework, key
process, output, outcome, impact indicators
and how data will be collected
Assessment of feasibility different systems
Develop LMIS; Use of technology (mobile phone,
software, bar codes etc.)
Surveillance among newly
infected persons (e.g. VCT)
every 2-3 years
Health facility survey and indicators
to assess the quality of treatment of OI
and palliative care
Community or household survey /
Routine data from NGOs etc.
to assess coverage of home based
care and support
Priorities
Steps needed
Operations
Research needs
PROGRAMME MONITORING
Strategic Information
Field
Human resources
Private sector
Patient monitoring
Assessment tools ……………...Country needs
Assessment of current staffing, staffing
needs, provider survey, district level
Assessment of feasibility of including
private sector in M&E system
Laboratory capacity assessment
Community preparedness Survey, qualitative research, with
communities and PLWHA
Priorities
Steps needed
Operations
Research needs
Risk behaviour trends
Surveys, qualitative research, develop
strategy to assess changes and maximize
positive prevention effects
HIV testing & counselling
Service assessment (access and quality),
community readiness, stigma, disclosure, obstacles
PROGRAMME MONITORING
(OUTCOME ASSESSMENT)
Strategic Information
Field
Assessment tools
Country needs
AIDS surveillance
WHO clinical case definition
Reporting forms by main health facilities
Health, morbidity, etc.
Monitoring of body weight, being
ambulatory, engaged in work or
employment etc.
Quality of life
WHOQoL, MOS-HIV, MQoL-HIV
Costs
Cost monitoring at facility and
at central levels
CD4+ cell counts, viral loads
Immunology
Priorities
Hospitalization
Hospital statistics with HIV status
(% HIV+ in medical ward, duration admission)
Mortality / survival
Individual patient monitoring, through paper records
smart cards, etc. / special studies
ART monitoring as part of HIS: users and producers
DEMAND
SUPPLY
Users
of
health
information
at
each
level
Production
of
health
information
at
each
level
Global
Regions
Countries
Districts
Service Delivery Points
Knowledge
Action
Collection
Analysis
Dissemination
Communities
ART as part of HIS: tool coverage by level
Modelling
&
estimates
Countries
Surveys
Sample VR
Provinces
Districts
HMIS
Vital registration
Censuses
Outbreak surveillance
Global
Regions
Communities
Facilities
ART and HIS
 ART - Need to develop sound patient
tracking system, including drugs, fees etc.
 ART – Demand to provide access, numbers
of treatment, impact of treatment
 ART – Risks, will go at the cost of other
health information fields
 ART – Opportunity to make significant
progress in service statistics, vital
registration, household surveys – build HIS
Uganda
Location of PMTCT sites, 2004
Uganda
Location of HIV counselling and testing sites, 2004
Uganda
Location of sites providing ARV therapy, 2004