Vertical Systems for Monitoring and Evaluation of HIVAIDS

1
Vertical Systems for Monitoring and Evaluation of
HIV/AIDS

• PMTCT Team/GAP
• Informatics Team/GAP

2
Background

• Successful public health strategy rely on
  accurate and timely information
• Key epidemiologic and programmatic information
  can be summarized by 4 Ws
• WHO
• WHAT
• WHERE
• WHEN
• Information can be collected from multiple
  sources using a variety of systems

3
Integrated vs Vertical Systems

• Integrated health information systems
• Broadly defined
• Reflects real world
• Resource efficient
• Sustainable
• Vertical health information systems
• Narrowly defined
• May be duplicative
• Simpler to conceptualize, build, and deploy

4
Vertical Systems

• Focus on the requirements of program and users
• Country, donors
• Can be developed more quickly since integration
  with other systems is not necessary
• By generating quality information, create demand
  for good data

5
Vertical Systems

• Vertical does not mean isolated
• Integrated does not mean comprehensive
• Vertical ? Loose integration

6
Loose Integration

• Standard data definition
• Standard GUI
• Standard application structure
• Folder location
• Standard import/export
• Standard analysis / indicators
• Standard reports

7
PMTCT Management System

• Standardized data collection and monitoring
  procedures
• Provides program monitoring information to
  identify progress and challenges and improve
  PMTCT services
• Facilitates standard reporting of national and
  international PMTCT indicators
• Supports PMTCT program and reporting requirements
  of the Presidents Emergency Plan
• Flexible to accommodate country-specific needs
• Adheres to emerging standards for integrated
  disease surveillance systems

8
PMTCT-MS Components

• Registers (ANC and LD)
• Monthly summary forms
• PMTCT-MS Epi Info application
• Reports and graphs
• Support materials sample protocols, checklists,
  training materials, job aids

9
PMTCT-MS Overview

• PMTCT service data recorded in registers kept in
  ANC and LD wards
• Additional columns added to standard registers
• Monthly summary forms tally registers to report
  number of women and children receiving PMTCT
  services
• Monthly summary forms reported and entered into
  computer
• Reports and graphs generated to provide feedback
  to program managers and health care workers

10
Data Collection and Reporting Procedure
Health Facility
ANC Register
Maternity (LD) Register
ANC Monthly Form
Maternity (LD) Monthly Form
Send Forms
District / Regional Office
Feedback
National Office
Data Entry
Forward flow Feedback
Analysis
Feedback
11
Advantages of PMTCT-MS

• Provides systematic method for collecting,
  reporting, and analyzing data
• Utilizes standard registers already in place
• Adaptable to local needs
• Provides "real-time" monthly summaries of PMTCT
  program coverage and uptake
• Provides program management information to all
  levels
• For program planning and resource distribution
• To identify progress and challenges and improve
  PMTCT services
• Utilizes free, publicly access software (Epi
  Info)
• Generates standard reports and graphs
• Can integrate with and strengthen national HMIS

12
Limitations of PMTCT-MS

• Does not track individual patients over time
• Does not resolve clinical management issues
• Does not link patient information between ANC and
  LD wards
• Patients who attend different health facilities,
  could be double counted
• Sufficient human and computer resources are
  needed

13
Next Step

• Smart data exchange between systems
• Creation of standard core data elements
• Loose integration with TB (ETR), GID (IDS)
• Further refinement of reference system
• Deployment
• Tanzania
• Botswana
• Nigeria
• Namibia (?)
• Others