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1
Use of Routine Feedback Reports to Site and District
Staff in Cote d’Ivoire
Hermann BrouAnnual Meeting, M&E satellite meeting
Johannesburg, July 28, 2010
2
Context
» Our program started in October 2007
» As of the end of June 2010:
• 112 supported sites located in 13 health districts
• 8,729 PLWHA enrolled in care
• 4,740 patients ever started ART
3
ICAP-CI M&E TeamM&E Director
Abidjan
M&E AssistantAbidjan
Database ManagerAbidjan
Data officerDaloa
Data ClerksSites
- District Bouafle- District Sinfra- District Zuenoula- District Konahiri
Data OfficerDaloa
Data ClerksSites
-District Daloa- District Issia - District Vavoua- District Seguela- District Mankono
Data OfficerDaloa
Data ClerksSites
- District Gagnoa - District Oume - District Divo - District Lakota
M&E AssistantDaloa
4ICAP-CI Technical team
Site Multidisciplinary team
ICAP-CI Information System
HIV Care & Treatment service
Site Data Clerk
Health District DirectionCSE
ICAP-CI, M&E unitRegional office
Abidjan office
Other clinical services/clinics (Lab, ANC, etc)
Community activities
MOH(DIPE, PNPEC)
• PEPFAR – CI• ICAP - NY
→ Data report flow→ Feedback
5
When Do We Make Feedback & For Whom?
»To ICAP-CI Technical team• Monthly feedback: report s on all programmatic areas
• Quarterly analysis: trend, achievement of targets
»To Health district / site• Monthly feedback: 20 keys indicators about Testing &
Counseling, PMTCT, Care & Treatment, TB/HIV
Ex: # of pregnant women tested HIV+ VS # of pregnant women received PMTCT prophylaxis
• Semi-annual meeting: to assess achievements, identify difficulties and develop or modify strategies
6
Monthly Feedback to District / Site:How is It Provided?
» In paper or electronic format• An overall table for all 20 keys indicators and charts
• Specific analysis on a selected theme (sometime)
• Automatically generated by aggregate database (Daloa office)
• Printed copies transmitted to staff and pasted in site
» For more details, technical advisor or officer call providers
• Systematically for 2nd line ART regimen and TB patients tested HIV+
7
Routine Feedback to Site:Care & Treatment
»Tracking of ART prescription: Ensure prescriptions are consistent with national guidelines, especially for second-line therapy
»CD4 count: Following-up and monitoring of CD4 counts at 6 months, 12 months
»Discontinuation of ART: Percent of patients lost-to-follow up
8
Routine Feedback to Site:PMTCT
»For HIV-infected pregnant women:• Percent of those who received PMTCT prophylaxis
• Percent of those enrolled in care
»For HIV exposed children:• HIV test within 12 months
• If HIV-infected, initiation of ART
9
Routine Feedback to Site:TB/HIV
» In care and treatment:• percent of patients enrolled in care who are screened for TB
• for patients suspected TB-infected, what is done?
»At TB clinics:• percent of TB patients who received counseling for HIV test
• tracking of patients co-infected with TB/HIV (Cotrimoxazole prophylaxis and enrollment in care)
10
Routine Feedback to Site:PLWHA Enrolment in Care (all sites)
11
Challenges
»Train site staff to analyze data
»Establish functional multidisciplinary team MDT) at all sites, especially ART sites
• ICAP staff attend to first meeting
• Monitoring MDT meeting (number of meetings, participants,…)
• Support MDT costs meeting
»Improve quality of data collected• Develop of SOPs for DQA
• Implement DQA in collaboration with district staff
12
Thank You