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From data to action: Using Service Performance Assessment and Improvement (SPAI) process to promote utilization of HIV & AIDS data generated through Lot Quality Assurance Sampling (LQAS) survey. …

From data to action: Using Service Performance Assessment and Improvement (SPAI) process to promote utilization of HIV & AIDS data generated through Lot Quality Assurance Sampling (LQAS) survey. Experiences from East Central Uganda

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  • 1. Strengthening TB and HIV&AIDS Responses in East Central Uganda From data to action: Using Service Performance Assessment and Improvement (SPAI) process to promote utilization of HIV & AIDS data generated through Lot Quality Assurance Sampling (LQAS) survey . Experiences from East central UgandaAuthors: Presentation to theOdong Tonny, Denis Businge Capacity Building Summit,todong@starecuganda.org Birchwood Conference Center, Johannesburg, South Africa. 21st March 2013
  • 2. Strengthening TB and HIV&AIDS Responses in East Central Uganda Background to STAR- EC  A five years (2009-2014) program funded by USG through USAID  Implemented by JSI Research & Training Institute Inc.(JSI) in collaboration with Ministry of Health-Uganda  Serves about 9% of the country’s population (Approx. 3.1m people)  Works through district based structures and Civil Society Organizations (CSOs)  Operates in 9 Districts of East CentralThe 9 districts served: UgandaBugiri, Buyende, Namutumba, Namayingo,Mayuge, Iganga, Luuka, Kamuli & KaliroProgram goal: To increase access to, coverage of, and utilization of quality and comprehensive HIV&AIDS and TB prevention, care and treatment services
  • 3. Strengthening TB and HIV&AIDS Responses in East Central Uganda Description of context Many community based HIV & AIDS and TB programs /projects often gathers a lot of dataThese data are generated from multiple sources such as; - Routine disease surveillance - Health facility records - SurveysAnnually, STAR – EC conducts survey using Lot QualityAssurance Sampling ( LQAS) techniqueThe first survey focusing on TB and HIV & AIDS indicators wasconducted in 2009 and this generated a lot of data 3
  • 4. Strengthening TB and HIV&AIDS Responses in East Central Uganda Description of context . However, most lay program implementers have limited capacity to make meaning out of the available data Thus the use of data to influence key decisions is severely affected Methodology In 2010, Management Sciences for Health (MSH) / STAR- E LQAS project introduced SPAI process in East Central Uganda as a technique to promote data utilization STAR – EC applied this technique on 2010 LQAS survey results 4
  • 5. Strengthening TB and HIV&AIDS Responses in East Central Uganda Key steps undertaken in SPAI process District based program implementers ( who formed SPAI team) were convened for 5 days residential workshop. The list of all indicators that were investigated during 2010 LQAS survey was provided to the team The team thoroughly reviewed the indicators and identified those that were poorly performed as well as the sub- counties affected The affected indicators and sub- counties were later prioritized for performance improvement 5
  • 6. Strengthening TB and HIV&AIDS Responses in East Central Uganda Key steps cont…..Example of how indicators and sub- counties were prioritizedIndicator Target Of all sub counties surveyed, Sub- counties scoring below target1.Proportion of men who know a mother can 59% Bunya A, B and Etransmit HIV to her infant during pregnancy2. % of adults (15years and above) who have 57% Bunya B and Cever taken an HIV test Bunya A, B and E3. % of adults (15 + years ) who know a 57%place where to get ARVs for HIV patients( Bunya B and EPriority sub- counties for intervention 6
  • 7. Strengthening TB and HIV&AIDS Responses in East Central Uganda Key steps cont…. The team later conducted constraint analysis by discussing the factors leading to poor uptake of HIV Testing and Counseling (HTC) services in the affected sub counties The next step involved target and objective setting of the desired health situation that the district needs to achieve ( e.g. achieve 70% population tested for HIV) Next, the team developed Performance Improvement ( PI) strategy by looking at critical activities and means to deliver them. E.g. training of health workers, creation of more out reaches for HTC services, effective mobilization for HTC services, supplies- timely requisition of HIV test kits, better records management, infrastructural development etc. Lastly, the team developed performance improvement and monitoring plans 7
  • 8. Strengthening TB and HIV&AIDS Responses in East Central UgandaAn extract of PI plan generated during SPAI process Strategy PI Activities Planned Respo Critical Source of Time Frame Element Products nsible PI Critical for PI Perso Resources Resources n Requirem Start End ents Date Date1.Training Training in HCT 4 training Dr. One STAR-EC, 24th 8th April sessions of 30 Muwa Vehicle, MOH, January 2011 1.1 Identification & training of trainers participants nguzi Fuel , SDS 2011 1.2 Identification & invitation of Facilitators of the completed Venue, TOT Facilitator 1.3 Identification & invitation of trainee participants s, Stationery, 1.4 Identification & hire of venue Perdiem,fu 1.5 Training of health workers in HCT el,Vehicle, Venue, Training of health workers in comprehensive 2 trainings of 30 th th 11 13 May HIV/AIDS care participants each April 2011 1.1 Identification & training of trainers undertaken 2011 1.2 Identification & invitation of Facilitators of the TOT 1.3 Identification & invitation of trainee participants 1.4 Identification & hire of venue 1.5 Training of health workers in HCT
  • 9. Strengthening TB and HIV&AIDS Responses in East Central Uganda ResultsSTAR-EC LQAS results: 2010-2012 9
  • 10. Strengthening TB and HIV&AIDS Responses in East Central Uganda Challenges SPAI process requires trained facilitators to guide the lay program implementers SPAI can best be conducted in a workshop setting thus need for funds to run the workshop Activities and strategies proposed needs to be implemented using the available resources in the district but program implementers tend to think of external funding 10
  • 11. Strengthening TB and HIV&AIDS Responses in East Central Uganda Lessons LearnedSPAI is a good approach that; - Enable lay program implementers to discuss and analyze data - Identify health service gaps & set priorities - Come up with action plans to address the gaps - Promotes service uptake through data utilizationCollaboration between implementing partners is critical tointroduce good practices in HIV intervention ConclusionData generated through LQAS surveys and other means are relevant only if the data can be used to effect change. 11
  • 12. Strengthening TB and HIV&AIDS Responses in East Central Uganda Acknowledgement Government of Uganda (GoU) USAID JSI / STAR- EC MSH/STAR- E LQAS EC district SPAI teams & Program implementers