The first objective is to collate, validate and publish methods and tools used in the analysis of HIV service data. We aim to develop generic tools that could be used in any country. Three service delivery areas will be covered by this project:
- HIV care and treatment clinics (CTC).
- Programmes to prevent mother to child transmission of HIV (PMTCT).
- HIV testing and counselling services (HTC).
This phase of the project will start with electronic consultation and then a face-to-face meeting in each country between the data owners (HIV programme heads and National Statistical Office for DHS data), data users (policy makers in MoH), and technical advisors and analysts (LSHTM and local university statisticians and epidemiologists) to agree on the aims and indicators, and the accountability and procedures of the project.
The key questions to be asked include:
- What events are being reported by the different services (access to care, access to ART, PMTCT delivery, HIV testing and counselling)?
- How are these events being reported?
- How can the reporting of these events be improved (by collecting more data items, or by improving the quality of the data collected, or by exploiting available indexes to link data between different datasets)?
The statistical indicators developed will include counts of new people accessing and continuing to use the services each year, and measures of the health and survival status of service users.
The deliverables fall under two distinct activities.
Data inventory and documentation
The first activity is specific to the structure of the general subset of data that is required for the analysis, which may differ from one country to another. We will provide a data dictionary for the dataset, detail internal checks that should be run on the data, document the analysis programs that could be used to obtain the results, and prepare the data for the calculation of specific indicators. As part of this process, gaps in the data will be noted, so that improvements to the data collection and organisation can be developed after discussions with local agencies responsible for the implementation of the HIV programmes.
This activity is already well underway, and you can find the output of this work here.
Generate analytical datasets
The second activity is to create and use the analysis dataset. This requires extraction tools, and documentation of the methods and processes by which the data are collected and extracted. We will develop analysis tools in Stata, and later in R, to run on the extracted data, and to make tables of the results.
This work will be undertaken in collaboration with WHO and UNAIDS. We will develop guidelines for HIV health management information systems data extraction from different sources, data quality checks, data manipulation and output specifications. Where possible, automatic data correction procedures will be used to eliminate minor inconsistencies. To address more fundamental errors, we will create procedures for sending queries to clinics and data managers for resolution.
Across Malawi, Tanzania and Zambia
This work will be informed by our understanding of the data from the Tanzanian HIV care and treatment database. However, we will make the tools to be used on other country data, and to use on other HIV service data (for example, prevention of mother to child transmission, and testing and counselling data). That is, a general subset of the data will be defined to obtain specific indicators and analytical objectives, analysis tools will be defined and documented for each data subset, and extraction tools will be developed and documented.