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Insights into HIV Care Service Comprehensiveness and Laboratory Capacity at ICAP-supported Facilities: Findings from PFaCTS 2013. Caitlin Madevu-Matson (cm3315@columbia.edu) Charon Gwynn (crg2128@columbia.edu) SI-NY. PFaCTS.

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slide1

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

Caitlin Madevu-Matson (cm3315@columbia.edu)Charon Gwynn (crg2128@columbia.edu)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
slide4

CARE & TREATMENT PFaCTS

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

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
slide10

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%
o utline2
PFaCTS implementation

Current characteristics

Context

Facility

Clinic

Comprehensiveness of HIV Care Service

Summary

Implications

Outline
slide20

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
slide37

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
slide38

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
slide39

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
slide75

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/