Using Data to Improve Quality, Efficiency and Coverage of VMMC Services Kelly Curran Jhpiego
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Transcript of Using Data to Improve Quality, Efficiency and Coverage of VMMC Services Kelly Curran Jhpiego
PEPFAR
Using Data to Improve Quality, Efficiency and Coverage of VMMC
Services
Kelly CurranJhpiego
AIDS 2014 – Stepping Up The Pace
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
TOTAL = 1,188,065~25% of all VMMCs supported by PEPFAR through 2013
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
Botswana: How Expenditure Analysis
Drove a Change in Service Delivery
Jan 2012-=Sept 2013 (in PY3) and Oct 2012-Sept
2013 (PY4)
Oct 2013-June 2014 (in PY5)
0
100
200
300
400363
200
Fixed sites with large provider teams in a low-demand setting meant sites operated well under capacity with high unit costs
Smaller teams providing outreach services services in surgical tents in rural areas Increased uptake and lowered unit costs
Average unit Cost regionallyIs less than US $100; in highCost settings like Southern AfricaWe aim for $160
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 SurgeryJu
n/Ju
l'12
Nov/D
ec'12
Mar
/Apr
'13
Jun/
Jul'1
3
Nov/D
ec'13
Apr/M
ay'14
0
1000
2000
3000
4000
5000
6000
Total MC
Campaign Performance
Rwanda: Using Program Data to Forecast Commodity Needs as PrePex™ Scales up
VMMCs done with Jhpiego support sincePrePexTM integration, February to June 2014
Percent of VMMC devices per size used in Jhipego VMMC-supported sites,
February to June 2014
Mozambique: Using Real Time, Web-based
Data to Increase Efficiency and Accountability
January February March April May June July August September October November December100
1,000
10,000
100,000
2010 2011 2012 2013 2014
VM
MC
s p
erf
orm
ed
, lo
g s
cale
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
Mozambique: Tracking VMMC Referrals from Home-based HTC
0
30,000
60,000
90,000
120,000
150,000 138,664
97,987
58,792
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.
12
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%)
VMMC clients who received a CD4 count during VMMC
services (all registered for ART clinic services): 45 (62.5%)
VMMC clients eligible for treatment: 40 (55.6%)
VMMC clients not eligible for treatment: 5 (7.0%)
VMMC clients who did not receive a CD4 count during VMMC
services and were asked to return later: 27 (37.5%)
VMMC clients who were traced: 11 (15.2%)
VMMC clients who were not traced: 16 (22.2%)
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: Tracking ART Uptake From VMMC
Mean CD4 count result
was 302 [195-685].
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 CurranDirector, HIV and Infectious DiseasesJhpiego, an affiliate of Johns Hopkins