1 / 13

Molly Strachan, ICAP Tanzania M&E Technical Meeting Johannesburg, South Africa July 28, 2010

Enhancing the culture of multi-disciplinary workshops on using data for decision-making: Tanzanian efforts to improve completeness of CD4 assessments. Molly Strachan, ICAP Tanzania M&E Technical Meeting Johannesburg, South Africa July 28, 2010. Outline. CD4 Data Challenges in Tanzania

reed
Download Presentation

Molly Strachan, ICAP Tanzania M&E Technical Meeting Johannesburg, South Africa July 28, 2010

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Enhancing the culture of multi-disciplinary workshops on using data for decision-making: Tanzanian efforts to improve completeness of CD4 assessments Molly Strachan, ICAP Tanzania M&E Technical Meeting Johannesburg, South Africa July 28, 2010

  2. Outline • CD4 Data Challenges in Tanzania • Data sharing meeting concept • Data sharing meeting agenda • Meetings • Results • Conclusion

  3. Proportion of patients with CD4 count at baseline, 6, and 12 months after ART initiation (subset of ART patients*) Percent of patients with CD4 count n=33,216 n=17,789 n=11,579 n=19,026 n=11,927 n=13,294 n=15,193 n=36,904 159,836 n=908 Source: ICAP URS March 2010 Notes: * Data only included for patients who were followed for 12 months.

  4. Percentage of patients with CD4 count in 6 and 12 month cohort , Jan-Mar 2010 21% 49% 24% 69% 43% 73% 40% 45% 38% 24% 23%

  5. Lab Register Lab Slips In Patient File CTC2 Card NACP Database Example from CD4 Data Flow Analysis at 4 ICAP sites in Kagera SITE 1 80/80 64/80 68/8065/80 100% 80% 85% 81.3% SITE 2 28/28 0/28 13/28 1/28 100% 0% 46.4% 3.6% SITE 3 294/294 266/294 254/294 265/294 100% 90.5% 86.4% 90.1% SITE 4 356/356 296/356 205/356 195/356 100% 83.1% 57.6% 54.8%

  6. Data Sharing Meeting Concept • Started in 2008 as 2-day meeting to review all data per region; held on a semi-annual basis • Purpose: Increase data use towards improvement of program quality and planning • Participants: regional and district AIDS coordinators, health mgmt teams, site staff + ICAP regional team (M&E + program) • ICAP presents regional data, district present data for their district and sites • Strengths and weaknesses discussed and action plans developed

  7. Data Sharing to Strengthen & Improve CD4 Testing • Kagera (May 11; x attended), Kigoma (May 31; 82 attended), Zanzibar (July 2), Pwani (TBD) • Agenda: • Review national guidelines on CD4 testing • Share best practices from other partners and countries • Data Feedback: Regional and district trends, district trends for 6 month F/U (award to highest performing district) • Presentation of CD4 database • Group work (by district): SWOT analysis & action plan • Way Forward: Short and Long term solutions

  8. Changamoto(Challenges) Data flow & recording/reporting Broken CD4 machines Reagent & supply stockouts Weak systems for disbursing funds to sites TESTS AREN’T GETTING ORDERED Priority to new enrollees (baseline) Sample transportation (delays, no $, logistical issues) PLHAs not informed of need for test Lack of knowledge that follow up CD4 is needed Unreliable power/water to run CD4 machines Treatment supporters may pick up drugs at time CD4 is required

  9. Proposed Short term Solutions

  10. Proposed Long Term Solutions • Districts to develop logistics systems to disburse funds to sites • Sites to prepare their annual plans and budgets and include sample transportation and other needs (CD4 machines, other equipments, solar power etc)

  11. Conclusions: General • Multi-disciplinary meetings prove a successful forum for program improvements using an evidence-base • Enabled ICAP to illustrate that if sites can test a high proportion of patients at baseline there’s no reason for lower proportions at follow up • Focusing on one topic enabled teams to develop actionable workplans to address program weaknesses • Highlighted need for focussed follow up support by ICAP clinical teams on key elements of patient care

  12. Conclusions: Capacity Building • Increased political support for improving quality of care by regional and district leaders • Kagera Regional Medical Officer: • Called for comparison of trends for upcoming quarter to last quarter to note improvements • Kigoma Regional Medical Officer: • Highlighted importance of adequate budgeting and district work planning to ensure consistent supplies and funding at sites • Zanzibar Program Manager: • Noted usefulness to help improve services • Called for regular data sharing meetings to share strategies for addressing challenges • Built capacity for cohort reporting • Sites compiled cohort data (complex). • Data sharing meeting reinforced proper steps to prepare cohort report which may strengthen follow through on submitting this report to NACP

More Related