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Presentation to the Capacity Building Summit, Birchwood Conference Center,

From data to action: Using Service Performance Assessment and Improvement (SPAI) process to promote utilization of HIV & AIDS data generated through Lot Quality Assurance Sampling (LQAS) survey . Experiences from East central Uganda. Authors: Odong Tonny , Denis Businge todong@starecuganda.org.

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Presentation to the Capacity Building Summit, Birchwood Conference Center,

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  1. From data to action: Using Service Performance Assessment and Improvement (SPAI) process to promote utilization of HIV & AIDS data generated through Lot Quality Assurance Sampling (LQAS) survey .Experiences from East central Uganda Authors: OdongTonny, Denis Businge todong@starecuganda.org Presentation to the Capacity Building Summit, Birchwood Conference Center, Johannesburg, South Africa. 21st March 2013

  2. Background to STAR- EC • A five years (2009-2014) program funded by USG through USAID • Implemented by JSI Research & Training Institute Inc.(JSI) in collaboration with Ministry of Health-Uganda • Serves about 9% of the country’s population (Approx. 3.1m people) • Works through district based structures and Civil Society Organizations (CSOs) • Operates in 9 Districts of East Central Uganda The 9 districts served: Bugiri, Buyende, Namutumba, Namayingo, Mayuge, Iganga, Luuka, Kamuli & Kaliro Program goal: To increase access to, coverage of, and utilization of quality and comprehensive HIV&AIDS and TB prevention, care and treatment services

  3. Description of context • Many community based HIV & AIDS and TB programs / projects often gathers a lot of data • These data are generated from multiple sources such as; • - Routine disease surveillance • - Health facility records • - Surveys • Annually, STAR – EC conducts survey using Lot Quality Assurance Sampling ( LQAS) technique • The first survey focusing on TB and HIV & AIDS indicators was conducted in 2009 and this generated a lot of data

  4. Description of context . • However, most lay program implementers have limited capacity to make meaning out of the available data • Thus the use of data to influence key decisions is severely affected • In 2010, Management Sciences for Health (MSH) / STAR- E LQAS project introduced SPAI process in East Central Uganda as a technique to promote data utilization • STAR – EC applied this technique on 2010 LQAS survey results Methodology

  5. Key steps undertaken in SPAI process • District based program implementers ( who formed SPAI team) were convened for 5 days residential workshop. • The list of all indicators that were investigated during 2010 LQAS survey was provided to the team • The team thoroughly reviewed the indicators and identified those that were poorly performed as well as the sub- counties affected • The affected indicators and sub- counties were later prioritized for performance improvement

  6. Key steps cont….. Example of how indicators and sub- counties were prioritized Priority sub- counties for intervention

  7. Key steps cont…. • The team later conducted constraint analysis by discussing the factors leading to poor uptake of HIV Testing and Counseling (HTC) services in the affected sub counties • The next step involved target and objective setting of the desired health situation that the district needs to achieve ( e.g. achieve 70% population tested for HIV) • Next, the team developed Performance Improvement ( PI) strategy by looking at critical activities and means to deliver them. E.g. training of health workers, creation of more out reaches for HTC services, effective mobilization for HTC services, supplies- timely requisition of HIV test kits, better records management, infrastructural development etc. • Lastly, the team developed performance improvement and monitoring plans

  8. An extract of PI plan generated during SPAI process

  9. Results STAR-EC LQAS results: 2010-2012

  10. Challenges • SPAI process requires trained facilitators to guide the lay program implementers • SPAI can best be conducted in a workshop setting thus need for funds to run the workshop • Activities and strategies proposed needs to be implemented using the available resources in the district but program implementers tend to think of external funding

  11. Lessons Learned • SPAI is a good approach that; • - Enable lay program implementers to discuss and analyze data • - Identify health service gaps & set priorities • - Come up with action plans to address the gaps • - Promotes service uptake through data utilization • Collaboration between implementing partners is critical to introduce good practices in HIV intervention Conclusion Data generated through LQAS surveys and other means are relevant only if the data can be used to effect change.

  12. Acknowledgement • Government of Uganda (GoU) • USAID • JSI / STAR- EC • MSH/STAR- E LQAS • EC district SPAI teams & Program implementers

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