Strengthening Routine Data Systems to Track the HIV Epidemic and Guide the Response in Sub-Saharan Africa

Abstract

The global HIV response has entered a new phase with the recommendation of treating all persons living with HIV with antiretroviral therapy, and with the goals of reducing new infections and AIDS-related deaths to fewer than 500,000 by 2020. This new phase has intensive data requirements that will need to utilize routine data collected through service delivery platforms to monitor progress toward these goals. With a focus on sub-Saharan African, we present the following priorities to improve the demand, supply, and use of routine HIV data: (1) strengthening patient-level HIV data systems that support continuity of clinical care and document sentinel events; (2) leveraging data from HIV testing programs; (3) using targeting data collection in communities and among clients; and (4) building capacity and promoting a culture of HIV data quality assessment and use. When fully leveraged, routine data can efficiently provide timely information at a local level to inform action, as well as provide information at scale with wide geographic coverage to strengthen estimation efforts.

Epidemiology of HIV Infection Among HIV-Exposed Infants, Nairobi County, Kenya, 2015

“…We conducted a comprehensive audit of PMTCT registry data to check for accuracy and completeness using a standard assessment tool to ensure that the data reviewed were of quality and met the expected threshold of 90% for it to be admissible for use. 5…”

Key informant perspectives on the challenges and opportunities for using routine health data for decision-making in Senegal

“…To address this issue, it was clear that the development of unique personal identifiers enabling patient tracking and linkage across multiple health services should be a priority. Indeed, some have proposed that in order to develop data systems that can efficiently support the HIV response in the complex context of declining resources and multiple actors, it will be important to develop unique personal identifiers [ 62 , 63 ]. The importance of investing in the adoption of unique patient identifiers is further reinforced when one considers the increasing integration of HIV health service delivery into other healthcare services such as TB and maternal and child health [ 64 ].…”

“…The importance of investing in the adoption of unique patient identifiers is further reinforced when one considers the increasing integration of HIV health service delivery into other healthcare services such as TB and maternal and child health [ 64 ]. Nonetheless, as others have cautioned, with the development of unique identifiers, it is imperative to involve the civil society in the process to address concerns regarding the potential for confidentiality breaches and human rights abuses [ 62 ].…”

Unmasking the vulnerabilities of uninfected children exposed to HIV

“…One example of such systems is in the Western Cape Province of South Africa, where individual health records are linked through use of a unique identifier from birth into adulthood,17 importantly with linking of the mother-child dyad,18 to track population outcomes. This approach uses the available detailed clinical data systems to improve individual clinical care and for public health surveillance, and provides insights on the risk factors needed to develop future public health interventions 19.…”