There are 23.5 million people living with HIV in sub-Saharan Africa, and this has triggered an impressive response to prevent new infections and to treat people living with HIV. With assistance from international organisations, health systems in many African countries are now leading the way to deliver prevention programmes targeting behaviour change, offer medical circumcision, scale up HIV testing and counselling, and deliver antiretroviral therapy (ART). Around these programmes, health management information systems (HMIS) are being developed for monitoring and evaluation, and to ensure that effective and cost-effective services are being implemented and rolled out. Since the initiation of ART, and its subsequent scale up, both HMIS data and patient-level data have been routinely collected in many countries. However, there are no standardised methodologies to extract the data, use the results to improve programmes in the field, and understand the impact of these programmes on the health of people living with HIV.
Health management information systems across three countries
Previous research has shown that HIV services can transform the lives of people living with HIV, enabling them to continue regular work and maintain family commitments while living with HIV. However the scale of the HIV epidemic in sub-Saharan Africa raises the question of how national programs can maximise the impact of their services, provide transparency about the benefits, and equity in delivering services to people living with HIV.
In Malawi, Tanzania and Zambia, national HMIS are available and opportunity exists to explore these data to assess the impact that services have on those that access it. This will necessitate developing and documenting data extraction and analysis tools, so that national and international players can identify and use opportunities to improve service delivery.
Integration into the Ministries of Health
The SEARCH 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, a priority will be to identify and recruit three members of staff to work on these data in each country. The participating staff within the MoH 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.
Furthermore, the project will build links between MoH and local academic institutions in each country, which will ensure a 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. The overall objective of this project is for the MoH to use their results to improve the HIV programmes and policies within their countries.
Read more about our objectives.
SEARCH is just one project aiming to improve the use of routinely-collected data and train researchers. Read about related work.