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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

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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

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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

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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

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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+

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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

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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

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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)

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Routine Feedback to Site:PLWHA Enrolment in Care (all sites)

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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

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Thank You