Objectives for Developing Sustainable Capacity

This project will be integrated into the work programs of the national Ministry of Health (MoH) in each country, in order make the tools relevant, and to build capacity to develop further analytic tools in the future.

In the first year, three professional staff within the MoH of each of Malawi, Tanzania and Zambia will be recruited to work on these data in each country. These staff will learn how to apply the methods and tools that have been developed and to disseminate strong, rigorous results, within their own MoH, to international players, and through publishing in peer-reviewed journals. This will widen understanding of the analytic techniques and reporting tools, and will provide a strong platform for further analysis in country, as well as providing the basis for further work in other countries with similar data.

The analysis strategies that have been developed by London School of Hygiene & Tropical Medicine (LSHTM) analysts will be applied by the MoH staff, under supervision of statisticians from local universities, staff from LSHTM, and suitably experienced data managers/analysts familiar with the data in the country. Analysis and dissemination workshops will be held in country to look at different ways the tools could be used within the country, and how results vary across sub-national boundaries. Analyses will aim to answer questions on the following topics:

  • Access to and coverage of services such as HIV care, antiretrovial therapy (ART), prevention of mother to child transmission and HIV testing and counselling (HTC) services.
  • Mortality, morbidity and retention on ART treatment of service users.
  • Coverage of HTC in the general population, with the proportional coverage from different testing strategies, such as voluntary counselling and testing, provider-initiated counselling and testing, antenatal clinic testing, and couple testing.

One of the main impediments preventing greater use of routine data from clinics is the perception that the data may be of poor quality. The best way to improve quality is by using the data, and by giving feedback. The SEARCH team will work with MoH to develop suitable dissemination and further applications in each country.

Building links

Furthermore, the project will build links between MoH and local academic institutions in each country, which will ensure proper training for the MoH staff. This will build sustainability of the training program, so that it can be replicated in the future, and strengthen the collaborative links in-country to train more people in statistical and epidemiological analyses, which is greatly needed in these countries. LSHTM staff will supervise the transfer of tools and skills to staff within MoH and develop collaborations between MoH and epidemiologists at local universities.

We eventually aim to have a group of people within MoH in all three countries who will form the basis of an Analysis Unit. These people will be able to identify the indicators to measure HIV programme performance and questions that need to be answered, and to extract and analyse data to provide the results. These people will link with collaborators, both in local universities, and with international researchers to help them adapt the tools and methods from this project to other research questions. Results from these analyses will be used in strategic and operational planning, to improve the performance of the HIV programs, and to compare results across partners within the programmes.

Read more about the SEARCH fellows recruited in Tanzania.