Linking PEPFAR Data To Gis Inglis


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  • Linking PEPFAR Data To Gis Inglis

    1. 1. Linking PEPFAR Reporting Data to GIS to Improve Health Programs in Kenya: NYANZA 28 th January 2009, Arusha, Tanzania
    2. 2. Presenters: <ul><li>Andrew Inglis – Macro International Inc. </li></ul><ul><li>Michael Ochieng – APHIA II NYANZA with Engender Health </li></ul><ul><li>Contributing Author </li></ul><ul><li>Samuel Muhula – APHIA II NYANZA with Engender Health </li></ul>
    3. 3. Background <ul><li>Project’s goals are: </li></ul><ul><ul><li>To reduce the risk of HIV transmission </li></ul></ul><ul><ul><li>To reduce the fertility rate in Nyanza Province, Kenya </li></ul></ul><ul><li>APHIA has a demand creation component that has promoted Counselling and Testing (CT) uptake since April 07 reaching over 1 million participants </li></ul><ul><li>APHIA II Nyanza project is supported by USAID through PEPFAR funds </li></ul>
    4. 4. INSERT GRAPHIC TO ADD MAP MAP IS 6.17” TALL HIV Prevalence in Kenya, KAIS 2007
    5. 5. Distribution of APHIA supported CT sites overlaid on population density – Sept 08 data INSERT GRAPHIC TO ADD MAP MAP IS 6.17” TALL
    6. 6. Counselling and Testing in Nyanza <ul><li>Currently, 65 VCT sites are being supported, an increase from 15 sites in April 2007 </li></ul><ul><li>Despite concerted efforts, reporting data showed that CT uptake remained low in Nyanza </li></ul><ul><li>The M&E unit sought to know why </li></ul>
    7. 7. Stakeholders Involvement <ul><li>Who was needed? </li></ul><ul><ul><li>M&E officers who managed data (PEPFAR reporting data) </li></ul></ul><ul><ul><li>GIS trainer(s) </li></ul></ul><ul><ul><ul><li>Local resource </li></ul></ul></ul><ul><ul><li>Donor (USAID) </li></ul></ul><ul><ul><li>Decisionmakers who will use the maps </li></ul></ul><ul><li>Resources needed </li></ul><ul><ul><li>Organized PEPFAR reporting data </li></ul></ul><ul><ul><ul><li>Data can be “Geo-Tagged” </li></ul></ul></ul><ul><ul><li>GIS data </li></ul></ul><ul><ul><li>Database software </li></ul></ul><ul><ul><ul><li>Preferably Access over Excel </li></ul></ul></ul><ul><ul><li>GIS software </li></ul></ul><ul><ul><li>GIS training materials and resources </li></ul></ul>
    8. 8. Stakeholders Involvement <ul><li>How they were engaged… </li></ul><ul><li>M&E officers </li></ul><ul><ul><li>Providers of the PEPFAR reporting data, </li></ul></ul><ul><ul><li>Received the GIS training </li></ul></ul><ul><ul><li>Produced the maps based on the PEPFAR data </li></ul></ul><ul><li>GIS trainers </li></ul><ul><ul><li>Facilitated the linkage between PEPFAR data GIS data </li></ul></ul><ul><ul><li>Trained M&E officers in linking the data and producing maps based on the data </li></ul></ul><ul><ul><li>Supported M&O officers after the GIS training </li></ul></ul><ul><li>Decisionmakers and Donors </li></ul><ul><ul><li>Initiated demand for maps of PEPFAR data </li></ul></ul>
    9. 9. Process <ul><li>Pre-GIS training </li></ul><ul><ul><li>Requested copies of PEPFAR reporting data </li></ul></ul><ul><ul><li>Customized GIS training using participants’ data </li></ul></ul><ul><ul><li>Began linkage of PEPFAR data to GIS datasets </li></ul></ul><ul><li>During GIS training </li></ul><ul><ul><li>Provided a step-by-step guide to linking their data to GIS datasets </li></ul></ul><ul><ul><li>1 full day focused on linking their datasets to GIS dataset </li></ul></ul><ul><ul><li>Produced maps based on the linked datasets </li></ul></ul><ul><li>Post GIS training </li></ul><ul><ul><li>Continued the linking of their datasets to GIS dataset </li></ul></ul><ul><ul><li>Supported mapping activities </li></ul></ul>
    10. 10. The Linkage of data to GIS datasets <ul><li>Principle of the linkage </li></ul><ul><ul><li>“ Geo-tagging ” of data </li></ul></ul><ul><ul><ul><li>Location: e.g. district, name of facility </li></ul></ul></ul><ul><ul><li>Organize data by “Geo-tag” </li></ul></ul><ul><ul><li>Maintain linkage over time </li></ul></ul><ul><ul><li>Feedback into the database </li></ul></ul>
    11. 11. Challenges on data use <ul><ul><li>Low level commitment on quality data capture </li></ul></ul><ul><ul><ul><li>Response: RDQA conducted a training to improve data quality and conducted monthly meetings with MOH staff in charge of data </li></ul></ul></ul><ul><ul><li>Inadequate knowledge of data use by the MoH/project staff </li></ul></ul><ul><ul><ul><li>Response: Monthly meetings to discuss data trends and implications for the project/interventions </li></ul></ul></ul><ul><ul><ul><li>Response: Workshop on data use being organized for March 2009 to develop data use tools </li></ul></ul></ul>
    12. 12. Facilitators of data use <ul><ul><li>Availability of GIS software and internal capacity to use maps to plot data for monthly data use meetings </li></ul></ul><ul><ul><li>Internal technical forums organized by the project to discuss technical issues </li></ul></ul><ul><ul><li>All project staff involvement in M&E </li></ul></ul>
    13. 13. Programme Improvements <ul><li>The following 2 maps are used to show how data was used for decision making: </li></ul><ul><ul><li>Map 1: Comparison of CT uptake in April 07 and April 08 </li></ul></ul><ul><ul><ul><li>Presented to project staff during Sept 08 technical meeting to stimulate discussion </li></ul></ul></ul><ul><ul><li>Map 2: Comparison of CT uptake between April 08 and Nov 08 post-intervention </li></ul></ul><ul><ul><ul><li>Shows post-intervention results on issues raised during staff meeting </li></ul></ul></ul>
    15. 15. What does the map tell us? <ul><li>Out of the 17 sites initiated in April 07, 10 sites had demand creation at the community </li></ul><ul><li>3 of the 10 sites showed decrease in CT uptake between April 07 and April 08, while 3 showed large increases (>100% increase) </li></ul><ul><li>Of the 7 ‘control’ sites, 3 showed large increases while the rest either stagnated or showed reverse trends </li></ul>
    16. 16. What was the problem? What solution? <ul><li>Demand creation team organized CT outreaches, but data was never captured in the MoH registers since MoH does not allow registers to leave a HF </li></ul><ul><ul><li>MoH agreed that we could use photocopies of registers during outreaches and transfer data to the register </li></ul></ul><ul><li>In sites where MOH staff used hardcover registers to capture data during outreaches, data were never transferred to the main register </li></ul><ul><ul><li>Use of volunteers to transfer data to the register after outreaches </li></ul></ul><ul><ul><li>Monitoring whether transfers are done and discussing trends during supervisory visits </li></ul></ul><ul><li>PITC services were weak and if offered, the data was never captured </li></ul><ul><ul><li>Orientation of HCWs on PITC conducted and registers made available at the PITC sites </li></ul></ul>
    17. 17. Comparison of CT uptake between April and November 2008
    18. 18. What do the maps tell us? <ul><li>6 of the 10 intervention sites showed large increases in CT uptake (>100% increase) </li></ul><ul><li>Of the 7 ‘control’ sites, only 1 showed a large increase, while 4 showed reverse trend </li></ul>
    19. 19. Comparing average CT uptake over time
    20. 20. What can we conclude? <ul><li>Maps are a powerful tool for displaying large amounts of information quickly </li></ul><ul><li>Maps provide a discussion point from which staff can identify strengths and weaknesses in project delivery </li></ul><ul><li>Maps are a way of mainstreaming data use within a project, which is critical for programme improvement </li></ul>
    21. 21. Replication – Yes we can! <ul><li>Resources Needed </li></ul><ul><ul><li>Electronically organized data that can be geo-tagged </li></ul></ul><ul><ul><li>GIS data source </li></ul></ul><ul><ul><li>GIS software (freeware or purchased) </li></ul></ul><ul><li>GIS training </li></ul><ul><ul><li>Materials are customized with your data </li></ul></ul><ul><ul><li>Training focuses on linking your data to GIS datasets </li></ul></ul><ul><ul><li>Local GIS support after training </li></ul></ul><ul><li>Support for mapping activities </li></ul><ul><ul><li>Demand for maps in decision making </li></ul></ul><ul><ul><li>Time and funding allocated for mapping data (including training) </li></ul></ul>