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Using Data to Improve Quality, Efficiency and Coverage of VMMC Services Kelly Curran Jhpiego. Jhpiego, an affiliate of Johns Hopkins University. W orking to improve maternal, reproductive and child health, HIV, TB and malaria services in 43 countries
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Using Data to Improve Quality, Efficiency and Coverage of VMMC Services • Kelly Curran Jhpiego
Jhpiego, an affiliate of Johns Hopkins University • Working to improve maternal, reproductive and child health, HIV, TB and malaria services in 43 countries • Implementing VMMC programs in 11 of 14 priority countries with funding from CDC, DOD, USAID and BMGF
Jhpiego-Supported VMMCsAs of June 30, 2014 Botswana = 23,240 Lesotho = 61,036 Swaziland = 19,465 South Africa = 29,036 Malawi = 35,675 Namibia = 24* *Program began June 2014 Rwanda = 76,441 Ethiopia = 45,310 Kenya = 104,936 Zambia = 150,328 Mozambique = 257,299 Tanzania = 385,275 TOTAL = 1,188,065 ~25% of all VMMCs supported by PEPFAR through 2013
Botswana: How Expenditure Analysis Drove a Change in Service Delivery Unit Cost Taking Services to Clients
Botswana: Innovating to Meet Clients’ Needs in a Low Population Density Setting Introducing PrePex™ as an Alternative to Conventional Surgery Campaign Performance
Rwanda: Using Program Data to Forecast Commodity Needs as PrePex™ Scales up Percent of VMMC devices per size used in Jhipego VMMC-supported sites, February to June 2014 VMMCs done with Jhpiego support since PrePexTM integration, February to June 2014
Mozambique: Using Real Time, Web-basedData to Increase Efficiency and Accountability
Mozambique: Online VMMC Information System Produces Real-time Program Data Tracks: • Adverse events by provider and facility to monitor client outcomes and identify supervision and/or refresher training needs • Uptake by facility to identify need for additional demand creation activities and/or reallocation of clinical staff to sites which need additional capacity • Commodity use to support forecasting and ensure accountability
Mozambique: Ensuring Quality by Continuously Tracking Adverse Events by Health Facility
Tanzania: Using Geographic Information Systems to Finish the Catch-Up • Successful and mature program that has nearly reached its original goals • Most young men and adolescent boys in towns and large villages already reached • To maintain the same productivity and ensure equity the program must be implemented in more sites per campaign than in previous years
Tanzania: Using Geographic Information Systems to Finish the Catch-Up • The layered maps helped the team to select 24 outreach sites for the campaign – most of which had a catchment population of 5,000 or more males aged 10-49. • As a result of this enhanced targeting, the program was able to serve 25,816 males in rural communities in six weeks, as compared to 14,476 in the same time frame in the previous year.
Tanzania: Program Invested in Real-time Online Maps Connected Directly to the VMMC and Facility Databases with Information on Roads, Facilities, Population Served, Catchment Areas, Clinical Staff and Their Contact Info, Water and Electricity
VMMC clients found positive at MC site: 72 (100%) Lesotho: Tracking ART Uptake From VMMC VMMC clients who received a CD4 count during VMMC services (all registered for ART clinic services): 45 (62.5%) VMMC clients who did not receive a CD4 count during VMMC services and were asked to return later: 27 (37.5%) Mean CD4 count result was 302 [195-685]. VMMC clients who were not traced: 16 (22.2%) VMMC clients not eligible for treatment: 5 (7.0%) VMMC clients eligible for treatment: 40 (55.6%) VMMC clients who were traced: 11 (15.2%) VMMC clients who received a CD4 count and were enrolled in care and treatment: 4 (5.5%) VMMC clients who did not receive a CD4 count and were not enrolled in care and treatment: 7 (9.7%) Out of 446 clients who tested HIV positive in the hospital, 72 (16%) were tested at the VMMC site.
Lesotho: Documenting the Increased Uptake of HTC and ART among Men Tested and Linked from VMMC • A total of 1,906 clients were tested for HIV at VMMC clinic at Mafeteng hospital between February and December 2012 • 1,035 clients were tested for HIV in other services in the hospital during the same period • Testing in the VMMC clinic represented 65% of all males tested at Mafeteng hospital http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0083614
Thank you • Ke a leboga • Murakoze • Obrigada • Asante sana • Ke a leboha Kelly Curran Director, HIV and Infectious Diseases Jhpiego, an affiliate of Johns Hopkins Kelly.curran@jhpiego.org