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Insights into HIV Care Service Comprehensiveness and Laboratory Capacity at ICAP-supported Facilities: Findings from PFaCTS 2013. Caitlin Madevu-Matson ([email protected]) Charon Gwynn ([email protected]) SI-NY. PFaCTS.

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Insights into HIV Care Service Comprehensiveness and Laboratory Capacity at ICAP-supported Facilities: Findings from PFaCTS 2013

Caitlin Madevu-Matson ([email protected])Charon Gwynn ([email protected])SI-NY


Pfacts
PFaCTS

  • Structured repeated assessment of facilities to describe the scope, diversity, capacity and comprehensiveness of ICAP-supported programs

  • Captures information not available from routine indicators :

    • Context: Location, type

    • Facility characteristics: Related services, e.g. ANC, MC

    • Clinic and lab components: Staffing configuration and training, patient support services, laboratory quality essentials

  • Data used for program planning, monitoring and evaluation

    • Reports and webinars

    • URS

    • Analyses with other data sources


Pfacts implementation
PFaCTS Implementation

  • Care and Treatment PFaCTS

    • 7 rounds, 2007 - 2013

    • 80 questions

  • Laboratory PFaCTS

    • 2 rounds, 2011 - 2013

    • 162 questions

  • Assessment tools

    • Core questions maintained from previous round, tool revised with clinical and programs units

  • Data collection

    • Assessments completed with health facility personnel

    • Questionnaires reviewed by in-country ICAP clinical and M&E units

  • Data validated through checks and results uploaded to URS


Objectives

  • Present results from Care and treatment PFaCTS Round 7

  • Describe the comprehensiveness of ICAP-supported programs


O utline

PFaCTS implementation

Current characteristics

Context

Facility

Clinic

Comprehensiveness of HIV Care Service

Summary

Implications

Outline


Definitions
Definitions

Facility

Clinic


C ompleteness of pfacts reporting over time
Completeness of PFaCTS reportingover time


C ompleteness of pfacts reporting over time1
Completeness of PFaCTS reportingover time

96%

75%


O utline1

PFaCTS implementation

Current characteristics

Context : country, location and type

Facility : services provided outside the CT clinic

Clinic : services provided in the CT clinic

Comprehensiveness of HIV Care Service

Summary

Implications

Outline


Countries contributing to PFaCTS Round 7

  • 96% (1017/1062) of facilities with ICAP-supported care and treatment services completed PFaCTS Round 7

  • In country completeness ranged from 79% to 100%






Availability of key patient support services (n=1017)



Outreach activities by type of personnel
Outreach activities by type of personnel


Secondary p revention service availability
Secondary prevention service availability


O utline2

PFaCTS implementation

Current characteristics

Context

Facility

Clinic

Comprehensiveness of HIV Care Service

Summary

Implications

Outline


HIV Care

Comprehensiveness

Components

Questions

  • Does ICAP support comprehensive HIV care programs?

  • Has comprehensiveness of HIV care programs changed over time?

  • Is there variability in the changes?





O utline3

PFaCTS implementation

Current characteristics

Context

Facility

Clinic

Comprehensiveness of HIV Care Service

Summary

Implications

Outline


CT Summary (1)

  • Overall, ICAP facilities maintained high survey completeness

  • High on-site availability of essential HIV care services

    • Counseling and testing

    • PMTCT

    • TB treatment

    • ART adherence counseling

    • Outreach

    • Nutritional counseling

    • Secondary prevention


CT Summary (2)

  • The comprehensiveness of essential HIV care services at all ICAP-supported facilities increased rapidly in 2009 and seems to have stabilized

  • Higher proportion of facilities have comprehensive services in

    • Facilities supported by ICAP for longer time

    • Public primary and secondary/tertiary compared to private/other


Implications for HIV care and treatment

  • ICAP-supported facilities provide comprehensive services even though most facilities are rural and public primary facilities

  • Scale up and expansion of ICAP support to new areas may mean not all facilities will be equipped to offer comprehensive services

  • Combine PFaCTS results with routinely collected program and clinical data

    • Confirm if availability of comprehensive services is beneficial for program and patient outcomes

    • Advocate for wider implementation of comprehensive service delivery models



Outline
Outline

  • Rationale & Objectives

  • General findings

  • Capacity score

  • Summary& Implications


Laboratory pfacts1
Laboratory PFaCTS

  • Captures information on the scope, diversity, and capacity of ICAP-supported laboratories

  • Provides information on laboratory quality essentials (QEs)

    • Infrastructure and equipment

    • Human resources

    • Quality assurance activities

    • Facility safety

    • Supply chain management

  • Two rounds of PFaCTS conducted to date (2011 & 2013)


Rationale for laboratory pfacts
Rationale for Laboratory PFaCTS

  • At the facility level:

    • Measure capacity and progress toward accreditation

    • Gap analysis and development of laboratory specific improvement plan

  • At the program level:

    • Identify gaps in implementing QEs across supported labs

    • Prioritization and strategy development



Objectives
Objectives

  • To summarize findings from Lab PFaCTS 2013

  • To compare laboratory capacity between years and by key characteristics


Outline1
Outline

  • Rationale & Objectives

  • General findings

  • Capacity score

  • Summary& Implications










Outline2
Outline

  • Rationale & Objectives

  • General findings

  • Capacity score

  • Summary& Implications



Laboratory capacity score
Laboratory Capacity Score

Total Points = 100



Capacity scores by country and year
CAPACITY SCORES BY COUNTRY AND YEAR

*Restricted to laboratories completing both 2011 and 2013 Pfacts rounds.


Capacity scores by facility and location
CAPACITY SCORES BY FACILITY AND LOCATION

*Restricted to laboratories completing both 2011 and 2013 PFaCTs rounds.


Outline3
Outline

  • Rationale & Objectives

  • General findings

  • Capacity score

  • Summary& Implications


Summary
Summary

  • ICAP supports a wide range of capacity building activities in the countries where we work

  • Technical support areas identified include QA/QC, human resources and infrastructure

  • Capacity at ICAP laboratories

    • highest at secondary and tertiary and urban facilities

    • increased between 2011 and 2013


Implications
Implications

  • Laboratory PFaCTS can be used to identify and address technical support area needs

  • Use of capacity scoring allows for a comprehensive approach to monitoring capacity from routinely collected PFaCTS data


Pfacts data use
PFaCTSData Use

  • Analysis of key PFaCTS variables can identify areas for targeted technical assistance as well as achievement of program successes

  • Innovative approaches in the use of PFaCTS data help us better understand the programs we support






Acknowledgements
Acknowledgements

  • Country M&E, Laboratory and Clinical Teams

  • Bereket Alemayehu, Yingfeng Wu, Suzue Saito, SI Specialists



For more information

  • PFaCTS resources

  • To view the questionnaires and reports for all rounds, visit the ICAP Data Dissemination page and select PFaCTS.

    • http://icapdatadissemination.wikischolars.columbia.edu/Welcome

  • To access more PFaCTS results, log into the URS

    • https://urs2.icap.columbia.edu/


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