This document discusses how routine health information systems (RHIS) can be improved to better monitor linkages between HIV/AIDS services and other health services. Integrating separate vertical program reporting systems into a single national RHIS could facilitate client referrals, continuity of care, and achievement of program goals. However, challenges include harmonizing different recording forms and integrating programs not designed to be combined. The discussion forum explores issues around monitoring individual clients versus aggregates, defining linkage indicators, and ensuring data quality when integrating systems.

1. How can RHIS improve the
delivery of HIV/AIDS services?
Kola Oyediran and Cristina de la Torre
RHINO Forum Webinar

2. Background
Increasing awareness that HIV services need to be
better linked and integrated with other health care
services.
•Facilitate transfer of clients and of information
across services
•Continuity of care
•Better health outcomes
•Achievement of program goals (e.g., 90-90-90)

3. HIV treatment cascade

6. Information needs about
linkages
Client management
•Need to track services received by patient and obtain
clinical data regarding those services
Program management
•Need to monitor strength and effectiveness linkages
across services
- % clients tested for HIV at TB treatment
centers
- % postpartum PMTCT clients successfully

7. Monitoring linkages
What kind of data do we need?
Individual-level data
Aggregate data

8. What does this mean for
the routine health
information systems we
have?
Need better integration of information
systems across programs

9. 9
Routine Health Information
System (RHIS)
• Health care in most developing countries characterized
by
• Multiplicity of vertical programs supported by a
myriad of donors
• Vertical programs maintain their own
uncoordinated information systems, which are in
conflict with the integrated health information
systems
• Requires massive data collection and reporting
• Limited use of the information for decision-making

10. 10
Benefits of Integration
• Improved access to and uptake of key HIV/AIDS and
SRH services
• Better access of people living with HIV/AIDS to SRH
services tailored to their needs
• Reduced HIV/AIDS related stigma and discrimination
• Enhanced program effectiveness and efficiency
• Reducing burden on the part of service providers in
keeping recording

11. 11
Opportunities for
Integration
• Number of countries have managed to integrate vertical
reporting systems with national RHIS
• High infectious disease burden with overlapping HIV and
TB epidemics
• Majority of the services are rendered within the health
facilities
• Donors are interested in integration for effective and
efficient utilization of resources
• Vertical information and RHIS mostly use data flow
mechanism

12. 12
Challenges of Integration
of Systems
• Program components not integrated thus
making reporting more difficult
• Harmonizing recording forms
• Inadequate manpower and skilled staff to
guide/handle the integrated system
• Restructuring of implementing agencies

13. 13
Discussion forum
Joint the forum:
www.rhinonet.org/rhino-forum-how-can-rhis-improve-the

14. 14
Forum discussion topics
• Monitoring linkages
• Individual vs. aggregate data
• Indicators to measure strength of linkages
• Uses of linkages data
• Integrating data from programs into a single
RHIS
• Quality of data
• Who generate the data

15. Guidance on monitoring
linkages
• Metrics for monitoring the cascade of HIV
testing, care and treatment services in Asia and
the Pacific (WHO, CDC, USAID, UNAIDS)
• Referral System Assessment and Monitoring
Toolkit (MEASURE Evaluation)
• Global Health Initiative Principle Paper on
Integration (GHI)
• Three interlinked patient monitoring systems for
HIV Care/ART, MCH/PMTCT and TB/HIV (WHO,
UNAIDS, UNICEF, The Global Fund)

16. MEASURE Evaluation is funded by the U.S. Agency
for International Development (USAID) under terms
of Cooperative Agreement AID-OAA-L-14-00004 and
implemented by the Carolina Population Center,
University of North Carolina at Chapel Hill in
partnership with Futures Group, ICF International,
John Snow, Inc., Management Sciences for Health,
and Tulane University. The views expressed in this
presentation do not necessarily reflect the views of
USAID or the United States government.
www.measureevaluation.org