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Introduction, Overview, Objectives, and Next Steps

Comprehensive Training to support the National Integrated TB/HIV Information System Implementation. Introduction, Overview, Objectives, and Next Steps. Introducing the facilitation team / National Integration Team (NIT). Mamello Letsoko – TIA Precious Lefohle – TIA Lungile Mahlalela – TIA

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Introduction, Overview, Objectives, and Next Steps

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  1. Comprehensive Training to support the National Integrated TB/HIV Information System Implementation Introduction, Overview, Objectives, and Next Steps

  2. Introducing the facilitation team / National Integration Team (NIT) • Mamello Letsoko – TIA • Precious Lefohle – TIA • Lungile Mahlalela – TIA • Lubabalo Banzana – MEA • Dumisile Simelane – MEA • Dr Riona Govender – COO branch, NIT lead • NevillaSomnath – NTP RIMES, NIT lead • Barbara Franken – Progr Manager • Gregory Kuzmak – Progr Manager • Moeketsi Finger – TA TIER-HPRS • Claudine Hennessey – TA DCS TIA = THIS Implementation Associate MEA = M&E Associate NIT_Support@health.gov.za www.tbhivinfosys.org.za

  3. Immediate expectation • All TKIs have TIER.Net v1.12 on their computer • All TKIs have the dummy dispatch loaded

  4. Ice breaker What has been your most positive experience in integrating the TB & HIV information systems? Express this in one word, one sentence, or in a picture. Then stick it on the wall • 3 minutes

  5. Where are we now? (1) • Historically weak ART M&E systems maintenance and utilisation • Recent focus has been on THIS integration implementation • Varying ownership of process by provand (sub)distrmanagers • Varying adherence to NDOH guidance and prescriptions on THIS integration • Now critical to shift focus from implementation to THIS maintenance

  6. Where are we now? (2) • Re-focus on maintenance must be grounded in the integrated TB/HIV data management SOP • Coupled with increasing focus on data demand and utilisation – a ‘maintained’ system is one where available data is used • THIS stakeholders must re-align with targeted focus on maintenance and institutionalisation

  7. It’s more than just a name! • TKI – THIS Key Implementer • DIT – District Integration Team • PIT – Provincial Integration Team • NIT – National Integration Team

  8. Terminology - who is an ‘Admin Clerk’? Disparate use of terms across provinces NIT uses ‘admin clerk’ as umbrella term May be referred to in slides as ‘AC’

  9. Training Overview Agenda Objectives Expectations

  10. Broad strokes outline of training agenda • TIER.Net v1.12 updates – TB and HIV modules • Weak compliance with NDOH guidance • Data management for differentiated models of care • THIS guidance for district hospitals and mobile clinics • THIS transition - from implementation to maintenance(SOP) • Data quality, data demand and data utilisation • TIER-HPRS linkage • TB/HIV data centralisation

  11. Training objectives • To capacitate Provincial and District Integration Teams (PITs and DITs) and THIS Key Implementers (TKIs) on: • Revisions to the TIER.Net software • Improved maintenance of THIS • Creating a culture of data demand and data utilisation

  12. Expectations of provincial and (sub)district teams: • Disseminate the learnings from this training including the relevant materials and documents to all relevant staff at provincial and (sub)district offices and facilities, in a manner that is clear, timeous and appropriate • Provide ongoing support and feedback to facilities, to ensure adoption of all guidance and prescriptions, and monitor ongoing compliance

  13. Expected adherence to NDOH prescripts • Letter to HOD references imperative of adherence to training prescriptions

  14. Institutionalisation is critical • Significant amount of information to be relayed • Information cannot be relayed in a cursory manner - institutionalisation is critical • Providing context and rationale • Clarifying misunderstandings • Supporting adoption and change • Ongoing support and feedback

  15. Software revision

  16. Rationale for revisions to TIER.Net software • Improve utility of software to support clinical governance and patient management • Enhance ability to identify and address leakage across the cascades • Remain aligned with clinical and programmatic guidelines and priorities • Bug fixes and system optimisation • Address user feedback – we’ve heard you!

  17. Software revision process not straightforward • Iterative process of discussing all potential updates, deciding what to include in which version, fleshing out specs, and communicating with developers • Driven by NIT, but complicated by developer entertaining requests from other sources (donors, partners, other countries, etc) • Not necessarily authorised by NIT • Multiple cycles of testing different iterations of the software

  18. TIER.Net principles and reminders • TIER.Net does NOT INSTRUCT clinical governance, service delivery, or programmatic management - rather it supports these aspects • As a tool, it is only as good as the extent to which it is managed, curated and maintained • As defined in the SOP and other critical guidance materials • Technical solution is not a silver bullet • Software is evolving • Robust and evidence-based feedback supports this growth

  19. What is NOT included in this training PrEPsub-module DR-TB TIER.Net – webDHIS TB export

  20. PrEP sub-module • V1.12 introduces a Pre-Exposure Prophylaxis sub-module • PrEP services are currently rendered in ~ 50 – 70 sites • NDOH PrEP Team will provide training to those facilities This sub-module should not be used unless NDOH PrEP Team has provided direction on its implementation and use

  21. Update on TIER.Net DR-TB module • Recent decision taken by DDG and COO to commence digitising DR-TB data in TIER.Net • Process to map this out is yet to commence

  22. TIER.Net / webDHIS TB export • National vision for integrating TB and HIV information systems • ART and DS-TB data will be exported from TIER.Net into webDHIS at sub district level

  23. TIER.Net / webDHIS TB export (2) • TB export functionality to webDHIS was planned for TIER.Net v1.12 • Not straightforward process • Software revision and alignment processes are lengthy • Likewise NIDS 2019 revision process is lengthy • Timeframes for the two are not aligned

  24. TIER.Net/webDHIS TB export (3) • Unable to secure material consensus within NTP on proposed TB data elements and indicators in NIDS 2019 • Unable to obtain pre-NHISSA authorisation for inclusion in webDHIS • Testing to ensure robust export between TIER and webDHIS has yet to take place

  25. TIER.Net - webDHIS TB export – way forward • Upon approval of NIDS 2019 development work will resume to finalise DS-TB export functionality in TIER.Net v1.13 • Deployment of v1.13 will align with launch of NIDS 2019 – April 2019

  26. Planning exercise for the next steps

  27. Planning exercise and presentation • Critical to have an exercise that brings all learnings together – and that kickstarts districts’ planning for the way forward • Each district is asked to compile a 15-20 minute PowerPoint presentation, relating to all aspects from the 4 days of training • Template with a set of guiding questions will be provided • To be presented on Fri morning

  28. Guiding questions for presentation 1. How will you work with facilities to ensure that learnings and guidance on updated v1.12 functionality are institutionalised? 2a. How will you seek to improve adherence to key NDOH guidance (i.e. lab results management, data management for differentiated care, SOP, etc.)? 2b. Describe what you plan to do differently, as previous attempts at providing guidance appear to have not resonated

  29. Guiding questions for presentation (cont.) 3a. What will you do in your district and along the health system cascade, to engender a data demand and use culture? 3b. How will you leverage the tools, guidance, and frameworks discussed in the training to support a culture of data demand and utilisation?

  30. Guiding questions for presentation (cont.) 4. How will you engage data producers and data users differently? 5. What TB/HIV-specific program improvementswould you expect from institutionalising a DDU culture? 6. Given the shift from implementation to maintenance, how do you envision that the role of PITs, DITs, SDITs will change? What does a re-envisioned TOR look like?

  31. Guidelines for maintaining a positive training environment

  32. Guidelines for positive training environment (summary from hand-out) • Interactive space to actively engage, absorb, learn • Safe space for: • Asking and answering questions, • Sharing ideas and experiences that may benefit others • Constructive, robust and informative discussions • Respectful space where normal rules of courtesy are observed • Phones on silent • No side conversations • Adhere to times as per the agenda

  33. Thank you Thank you NIT_Support@health.gov.za www.tbhivinfosys.org.za

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