Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Assessing HIV Service: Use and Information Systems for Key Populations in Namibia

Presented by Brittany Schriver Iskarpatyoti at the 2016 AEA conference.

  • Login to see the comments

  • Be the first to like this

Assessing HIV Service: Use and Information Systems for Key Populations in Namibia

  1. 1. Assessing HIV Service Use and Information Systems for Key Populations in Namibia Brittany Schriver Iskarpatyoti, MPH MEASURE Evaluation University of North Carolina, Chapel Hill October 27, 2016 American Evaluation Association
  2. 2. The Request Namibia Mission: Assess Key Populations HIV Case Management Program
  3. 3. The Context: Namibia Southern Africa Independence in 1990 Population: 2.3 million PLHIV: 210,000 Adult HIV prevalence: 13.3% Higher in KPs
  4. 4. The Context: Program • IP: Society for Family Health (SFH) 2 local clinical partners: • Walvis Bay Corridor Group (WBCG) • Namibia Planned Parenthood Association (NAPPA) • 6 program sites • Case management approach (as of October 2015) Katima Mulilo Keetmanshoop Windhoek Walvis Bay/ Swakopmund Oshakati Oshikango
  5. 5. The Context: Program Other/private providers MoHSS and other testing sites Outreach sites KP-led orgs/CHWs WBCG and NAPPA clinics CASE WORKER Non-KP: Link to general services Assessment KP HIV+: Enroll in CM and link to care KP HIV-: Enroll in CM and follow for sero-conversion All KPs (known) All HIV-positive All HIV-negative with any risk factor • Violence/ GBV • Transactional sex • Poor condom use • Alcohol/substance abuse • Sexually transmitted infection • Discordancy • Young, female • No support • Homelessness/ transient locations • Untreated/unstable mental illness
  6. 6. The Original Proposal Assess CM approach to link HIV positives to treatment, retention and viral suppression (PEPFAR 2nd & 3rd 90’s) using program data
  7. 7. Challenge: Data Plan: Use program data Can we rely on program data as is? • New program, new data • Unclear quality RHIS/HIS data • Multiple sources (HTC, ART, pharmacy, patient files) • Unclear quality • Unclear interoperability
  8. 8. Data Assessment New Plan: Assess the data available and the feasibility of accessing and triangulating program data with: • Patient files and health passports, • The national HIV testing and counseling (HTC) register • The national ART patient management system (e.g. Electronic Patient Management System [ePMS]) and/or • The national pharmacy database (e.g., Electronic Tool [EDT])
  9. 9. Data Assessment
  10. 10. Challenge: Denominator Possible to assess all three ‘90’s? • No official KP size estimate to determine first ‘90’ • Dearth of information on key populations in Namibia • IBBS conducted recently—data not available Plan: Assess linkage to treatment, retention, and viral suppression
  11. 11. Size Estimate New Plan: Estimate the size of key populations to establish a denominator for determining the reach of KP programs (the 1st ‘90’).
  12. 12. Size Estimate 1. Identify priority areas 2. Within priority areas, locate public venues where KPs meet sexual partners 3. Visit, map, and characterize each venue 4. Create size estimates of KPs in the sampled area The Priorities for Local AIDS Control Efforts (PLACE) method
  13. 13. Challenge: PrEP Plan: Assess HIV- positive individuals The Namibian MoH has agreed to roll-out pre-exposure prophylaxis (PrEP) to HIV- negative individuals most at risk of HIV. This will include KP served by SFH. Can we include HIV- to assess PrEP?
  14. 14. Multiple Cohorts New Plan: Key populations identified by or referred to case managers will be enrolled in one two cohorts: HIV-positive or HIV-
  15. 15. Multiple Cohorts HIV-positive • Analyzed for linkage to treatment, retention, and viral suppression HIV-negative • Analyzed for rates of sero-conversion Cohorts monitored by case managers for 12-18 months
  16. 16. Leveraging Opportunities • New tools for measuring the HIV cascade among key populations • Facilitated HIV prevention data planning among priority populations
  17. 17. 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 ICF International, John Snow, Inc., Management Sciences for Health, Palladium, and Tulane University. The views expressed in this presentation do not necessarily reflect the views of USAID or the United States government.