Monitoring HIV testing and treatment in the Caribbean
Cardno Emerging Markets, Healthcare Practice, Arlington, United States
Issues: For Global Fund grants, routine verification by the Primary Recipient (PR) and Local Fund Agent (LFA) does not confirm that reported results match clinic level results and whether all valid data has been included. Data is given to the PR by the sub-recipients (SRs), which are independent countries.
Description: Following review of data and reporting at the PR level, the LFA traveled to identified sites in 3 countries for a regional grant- secretariats, clinics, laboratories and pharmacies - to verify reported data. Cross verification of data in primary records at the clinic, laboratory and pharmacy level and recount-type from primary records to aggregated reports at the national level combined with spot-checks of testing equipment and supplies and pharmaceutical availability.
Lessons learned: Accuracy of reporting on clients receiving ARVs ranged from 66.7% to 100%. Accuracy of reporting on people receiving VCT, including results, ranged from 11.5% to 400%. The roles of the different actors in the GF grant and their methodology for data collection, consolidation and reporting are not consistent across countries. Each country has unique characteristics that affect its ability to report accurate data in a timely fashion. Many results go unreported, not only those for tests or ARVs not funded by the grant, but more significantly tests that are not reported, as sites either do not submit their data at all or not on time. In the absence of strengthened data collection, consolidation and reporting systems, reported results from this grant cannot accurately be used as a proxy for total population tested or on ARVs.
Next steps: Capacity building assistance in monitoring and evaluation of HIV/AIDS testing and treatment programs must
a) educate providers on the rationale behind accurate data collection and reporting
b) address unique characteristics of the operational and physical environment that can enhance or impede data collection and reporting.
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