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Implementing the revised TB/HIV indicators and data harmonisation at country level Christian Gunneberg MO WHO

Implementing the revised TB/HIV indicators and data harmonisation at country level Christian Gunneberg MO WHO Planning workshop to accelerate the implementation of HIV/TB collaborative activities in selected African countries November 13th-14th , 2008, Addis Ababa, Ethiopia. I will cover.

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Implementing the revised TB/HIV indicators and data harmonisation at country level Christian Gunneberg MO WHO

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  1. Implementing the revised TB/HIV indicators and data harmonisation at country level Christian Gunneberg MO WHO Planning workshop to accelerate the implementation of HIV/TB collaborative activities in selected African countries November 13th-14th , 2008, Addis Ababa, Ethiopia

  2. I will cover • TB side indicators and R&R system • HIV side indicators and R&R system • Data harmonisation

  3. Revision of TB/HIV indicators WHO TB/HIV M&E guide We reduced the number of indicators from 20 to 12 including 2 new ones.

  4. % HIV STATUS KNOWN % HIV +ve TB/HIV CASE DETECTION FREE CONDOMS CPT PROVISION % TB/HIV in HIV CARE ART PROVISION

  5. Case detection indicator THIS INDICATOR WILL ALLOW MEASUREMENT OF PROGRESS both of TB/HIV activities and TB programme performance

  6. Notes: The TB Indicators are the variables being recorded: No change. • Report on quarterly/annual TB cohorts as denominator. • Include people living with HIV, who have known their status for a long time. • Include people living with HIV who are on ART /CPT prior to TB treatment. • Would recommend putting HIV care registration number on Register in HIV test column (not a current requirement). • Would allow data reconciliation + to know % in HIV care

  7. QUARTERLY CASE DETECTION REPORTS

  8. QUARTERLY TREATMENT OUTCOME REPORTS

  9. Revision of TB/HIV indicators WHO TB/HIV M&E guide We reduced the number of indicators from 20 to 12 including 2 new ones.

  10. TB STATUS AT LAST VISIT STARTED TB TREATMENT NEWLY ENROLLED ON IPT INFECTION CONTROL PRACTICES HEALTH WORKERS WITH TB

  11. New indicator: • Infection control: health workers with TB: Number of health care staff working in facilities providing care for people living with HIV, who develop TB in one year , expressed as a proportion of the total number of health care staff working in facilities providing care for people living with HIV during that same year THIS HAS BEEN FIELD TESTED IN MALAWI. SPECIAL NATIONAL SURVEY.

  12. Revision of TB/HIV indicators Next steps General email & web based consultation process: (November to December 2008) Finalise document December 2008 Publish early in 2009

  13. The HIV/TB M&E Challenge:Health facility implementation Country Level ART services TB treatment and HIV testing services PLHIV to be on pre ART register & receive HIV care (ICF/IPT/CPT) here

  14. A little Supermarket surveyIntegrated but separated

  15. Revision of HIV recording and reporting formats to measure TB/HIV indicatorsAIMS: report on • TB status assessment • TB treatment provision • IPT provision • On HIV patient forms • On HIV Pre ART & ART Registers • On quarterly cross-sectional reporting forms

  16. Facility based HIV care/ ART card

  17. TB information on HIV care card

  18. PRE/ART registers already contain TB tx and IPT columns • Adjust to record month year & TB registration numbers • Now also to record TB status at monthly/quarterly visits

  19. Pre-ART register: TB status follow up

  20. ART RegistersTB status at last visit.

  21. Cross-sectional quarterly report

  22. DENOMINATOR= CURRENT ON ART PREVIOUS Q + STARTING TX Previous Quarter

  23. Revision of HIV recording and reporting formats to measure TB/HIV indicators Next steps Still undergoing consultation and pilot testing Then will need roll out and scale up.

  24. Countries using adaptations of the generic HIV care/ART patient monitoring tools Moldova Ukraine Djibouti Somalia Sudan Yemen India Indonesia Myanmar Nepal Sri Lanka Viet Nam Côte d’Ivoire Ethiopia Kenya Lesotho Mozambique Namibia Nigeria Senegal South Africa Swaziland Tanzania Uganda Zambia Zimbabwe Guyana for 2007 annual progress report,50% of countries reported on continuation of ART at 12 months

  25. INDICATOR ISSUE • How to implement roll out the revised HIV recording and reporting formats including the HIV/TB indicators • How many countries are using adaptations of the WHO recommended R&R formats?

  26. DATA HARMONISATION

  27. Data harmonisation between partners HIV+TB patients. Pepfar 2 to 5 x NTP to WHO equivalent 1/3 rd of all TB notifications needs further exploration . eg data sources (4 countries)

  28. Data harmonisation between partners • QUESTION • How can WHO assist countries in establishing national review meeting processes to ensure that TB/HIV data collected is comparable and consistent, accurate, comprehensive and based on the country Ministries of Health data source and reporting cycle, and that technical/donor partners support that process?

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