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Using routinely
collected PMTCT data
to identify HIV
epidemic hotspots at
sub-national levels;
lessons learned from
the HP...
Agenda
Background
 Overview of HPP’s scope of work
 Approach to analysis
Opportunities and challenges of using routinely...
Global Fund 2013
 strategic resource allocation
and programming at the
country level
PEPFAR 2014
 Right Thing, Right Pla...
HPP: Scope of work
Source: Dr. Frank Tanser/University of KwaZulu-Natal
Approach
Estimate HIV positivity using PMTCT testing
data at each hea...
Low cost, readily available
Provides comparable estimates with population
based surveys
More representative at sub-nati...
PhotoSource:HealthPolicyProject,Ghana
Facility-based health
management information
systems
DHIS 2.0 rolled out in more
t...
Routinely Collected PMTCT Data
Representative at Granular Levels
1 ANC SS site versus >150 PMTCT sites, Homa Bay County, K...
Using routinely collected PMTCT data, we can:
 Monitor trends in HIV testing at PMTCT clinics over time
 Estimate # PLHI...
Trends in HIV Positivity Over Time:
KwaZulu-Natal Province
23.8
21.3
20.5
19
20
21
22
23
24
25
Jan-Dec 2012 Jan-Dec 2013 J...
Estimated PLHIV in KwaZulu-Natal,
South Africa, by District, 2014
Estimated HIV Prevalence in
Kwa Zulu-Natal, South Africa, 2014
Estimated HIV Prevalence in
Eastern Cape, South Africa 2014
Supply and distribution
of health clinics meeting
demand?
Patients on ART and Estimated
PLHIV Not on ART, Dec. 2014
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
On ART...
Data quality, availability, ownership variable across
and within countries
Lack of availability of disaggregated data by...
“Donors and international
technical agencies should
prioritize efforts to strengthen
routine reporting, data
collection an...
 USAID
 OGAC
 The Global Fund to Fight AIDS, Tuberculosis and Malaria
 South Africa National AIDS Council
 University...
Photo by Eftekharul Alam Kingshuk, National AIDS/STD Programme, Bangladesh
Questions?
www.healthpolicyproject.com
Thank You!
The Health Policy Project is a five-year cooperative agreement funded by the U.S. A...
Using PMTCT data to identify HIV epidemic hotspots at sub-national levels; lessons learned from the Health Policy Project
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Using PMTCT data to identify HIV epidemic hotspots at sub-national levels; lessons learned from the Health Policy Project

Presented by Anita Datar, Futures Group at MEASURE Evaluation Geographic Information Systems (GIS) Working Group Meeting.

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Using PMTCT data to identify HIV epidemic hotspots at sub-national levels; lessons learned from the Health Policy Project

  1. 1. Using routinely collected PMTCT data to identify HIV epidemic hotspots at sub-national levels; lessons learned from the HPP Anita Datar June 2015
  2. 2. Agenda Background  Overview of HPP’s scope of work  Approach to analysis Opportunities and challenges of using routinely collected PMTCT data for geographic targeting  Why use routinely collected PMTCT data?  How does routinely collected PMTCT improve our understanding of variations in HIV burden at sub-national levels? Way Forward  What investments are needed to ensure sustainability at sub- national levels?
  3. 3. Global Fund 2013  strategic resource allocation and programming at the country level PEPFAR 2014  Right Thing, Right Place, Right Time A Call for Action: Taking a Geographic Approach Source: PEPFAR 3.0, http://www.pepfar.gov/documents/organization/234744.pdf Source: Joint United Nations Programme on HIV/AIDS (UNAIDS). 2014. Local Epidemics Issues Brief. Geneva: UNAIDS. Available at http://www.unaids.org/sites/default/files/media_asset/JC2559_local-epidemics_en.pdf.
  4. 4. HPP: Scope of work
  5. 5. Source: Dr. Frank Tanser/University of KwaZulu-Natal Approach Estimate HIV positivity using PMTCT testing data at each health facility Use HIV positivity to estimate HIV prevalence at each facility Interpolate to estimate HIV prevalence for all areas between health facilities Calculate estimated numbers of people living with HIV (PLHIV) at various boundary levels Determine estimated treatment coverage using numbers of PLHIV and numbers on antiretroviral therapy (ART)
  6. 6. Low cost, readily available Provides comparable estimates with population based surveys More representative at sub-national levels Why use routinely collected PMTCT data?
  7. 7. PhotoSource:HealthPolicyProject,Ghana Facility-based health management information systems DHIS 2.0 rolled out in more than 47 countries Data use improves data quality Low-cost, Readily Available
  8. 8. Routinely Collected PMTCT Data Representative at Granular Levels 1 ANC SS site versus >150 PMTCT sites, Homa Bay County, Kenya
  9. 9. Using routinely collected PMTCT data, we can:  Monitor trends in HIV testing at PMTCT clinics over time  Estimate # PLHIV  Estimate HIV prevalence and create interpolated surface  Estimate HIV prevalence and compare to facilities  Examine # of patients on ART and compare with estimated PLHIV in need of treatment Improved understanding of HIV variation at subnational levels
  10. 10. Trends in HIV Positivity Over Time: KwaZulu-Natal Province 23.8 21.3 20.5 19 20 21 22 23 24 25 Jan-Dec 2012 Jan-Dec 2013 Jan-Dec 2014 HIVPositivity(%) 90-90 - 90
  11. 11. Estimated PLHIV in KwaZulu-Natal, South Africa, by District, 2014
  12. 12. Estimated HIV Prevalence in Kwa Zulu-Natal, South Africa, 2014
  13. 13. Estimated HIV Prevalence in Eastern Cape, South Africa 2014 Supply and distribution of health clinics meeting demand?
  14. 14. Patients on ART and Estimated PLHIV Not on ART, Dec. 2014 0 100,000 200,000 300,000 400,000 500,000 600,000 700,000 On ART Estimated PLHIV not on ART 90-90-90
  15. 15. Data quality, availability, ownership variable across and within countries Lack of availability of disaggregated data by age and gender Duplication of HIV testing Limited to those that visit PMTCT clinics Extrapolating PMTCT data to describe general population Challenges and Limitations
  16. 16. “Donors and international technical agencies should prioritize efforts to strengthen routine reporting, data collection and analytic capacity at the national and sub-national levels.” Way Forward Source: amfAR, The Foundation for AIDS Research; and AVAC, Global Advocacy for HIV Prevention. 2014. Data Watch: Closing a Persistent Gap in the AIDS Response. Washington, DC and New York: amfAR and AVAC.
  17. 17.  USAID  OGAC  The Global Fund to Fight AIDS, Tuberculosis and Malaria  South Africa National AIDS Council  University of KwaZulu-Natal  HPP Team Acknowledgments
  18. 18. Photo by Eftekharul Alam Kingshuk, National AIDS/STD Programme, Bangladesh Questions?
  19. 19. www.healthpolicyproject.com Thank You! The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. The project’s HIV activities are supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). It is implemented by Futures Group, in collaboration with Plan International USA, Avenir Health (formerly Futures Institute), Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA).

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