Author:
Habte Dereje,Zemenfeskudus Samuel,Endale Mulugeta,Zeidan Mohammed,Getachew Daniel,Woldemichael Dejene,Wesene Aklilu S.,Teklebirhan Esayas,Eyayu Fitsum,Zewdie Raey,Yirga Daniel,Amdino Worknesh,Melaku Zenebe,Abayneh Sisay A.
Abstract
Abstract
Background
Ethiopia Population-based HIV Impact Assessment findings showed that in Addis Ababa, only 65.2% of people living with HIV (PLHIV) know their status. We present the enhanced HIV/AIDS data management and systematic monitoring experience in Addis Ababa City Administration Health Bureau (AACAHB).
Methods
AACAHB established a command-post with leadership and technical team members from the health bureau, 10 sub-city health offices, and non-governmental stakeholders. The command-post improved governance, standardized HIV program implementation, and established accountability mechanism. A web-based database was established at each health facility, sub-city, and AACAHB level. Performance was scored (green, ≥75%; yellow, 50–74%; red, < 50%). The command-post reviewed performance on weekly basis. A mentorship team provided a weekly site-level support at underperforming public and private health facilities. At facility level, quality of data on recording tools such as registers, and individual medical records were maintained through continued review, feedback mechanisms and regular consistency check of data. Percentage and 95% confidence interval were computed to compare the improvement in program performance over time.
Results
After 6 months of intervention period, the monthly New HIV case finding in 47 health facilities increased from 422 to 734 (1.7 times) and treatment initiation increased from 302 to 616 (2 times). After 6 months, the aggregate scoring for HIV testing at city level improved from yellow to green, HIV case finding improved from red to green, and treatment initiation improved from red to yellow. An increasing trend was noted in HIV positive case finding with statistically significant improvement from 43.4% [95% Confidence Interval: 40.23–46.59%] in May 2019 to 74.9% [95% Confidence Interval: 72.03–77.6%] in September 2019. Similarly, significant improvement was recorded for new HIV treatment from 30.9% [95% Confidence Interval: 28.01–33.94%] in May 2019 to 62.5% [95% Confidence Interval: 59.38–65.6%] in September 2019.
Conclusions
Regular data driven HIV program review was institutionalized at city, sub-city and health facility levels which further improved HIV program monitoring and performance. The performance of HIV case finding and treatment initiation improved significantly via using intensified monitoring, data driven performance review, targeted site-level support based on the gap, and standardized approaches.
Publisher
Springer Science and Business Media LLC
Reference22 articles.
1. Federal HIV AIDS Prevention and Control Office (FHAPCO). HIV/AIDS National Strategic Plan for Ethiopia, 2021–2025. Addis Ababa: FHAPCO; 2020.
2. Deribew A, Biadgilign S, Deribe K, Dejene T, Tessema GA, Melaku YA, et al. The burden of HIV/AIDS in Ethiopia from 1990 to 2016: evidence from the global burden of diseases 2016 study. Ethiop J Health Sci. 2019;29(1):859–68.
3. Central Statistical Agency (CSA) and ICF. Ethiopia demographic and health survey 2016. Addis Ababa, Ethiopia, and Rockville: CSA and ICF; 2016.
4. Ethiopian Public Health Institute (EPHI). HIV related estimates and projections for Ethiopia. Addis Ababa: EPHI; 2019.
5. Kibret GD, Ferede A, Leshargie CT, Wagnew F, Ketema DB, Alebel A. Trends and spatial distributions of HIV prevalence in Ethiopia. Infect Dis poverty. 2019;8(1):90.