The Uganda Experience S MS. S o u t h. W e s t e r n. R e g i o n

Transcription

1 S MS The Uganda Experience S o u t h W e s t e r n R e g i o n

2 Outline Background USAID co-ordination team Procedures Successes Challenges Lessons learnt and recommendations Discussions

3 Background USAID Uganda started implementing SIMS1.0 using a paper based tool in Transitioned to SIMS 2.0 in 2015 initially paper based and later an electronic version was introduced. Staff trained in using the electronic version app in 2016 by the HQ team. Currently Implementing SIMS3.0.

4 S MS Overview of Procedures Develop annual schedule for quarterly visits - Site/community selection using sims action planner ( high volume) SIMS Team selection and Logistics - Develop a SIMS team - Assign team leads to each. - Prepare logistics for the visit (tools, hotel, transport etc) SIMS site visit - Meet with DHO and IP - Team head to site with IP and District staff - Orient and brief site staff - Plan for follow up visits for poorly performing sites - Team lead co-ordianates the team ( travel itinerary, IP and site staff ) - Tablets prepared for field use -SIMs conducted in collaboration with site Staff -Post SIMS debrief - Site level action plan

5 Procedures overview of site assessment Orient Site staff about SIMs - Site consent - Assign CEEs to groups based technical expertise - Divide up to conduct assessments Assessment of CEEs - Using the tool, interview site staff, review patient charts, SOPs and score. - Complete paper dashboard with tablet scores -Check for tablet data entry completeness before submission Site Debrief. - Results per CEE are shared with site staff by the different technical groups - Highlight areas that scored red and yellow - Site staff are given a copy of the dashboard and requested to work with IP to develop - an action plan to address identified gaps - -

6 S MS Data flow, management and use Data analysis: The HQ team manages the Sims data cleaning and analysis with the use of GHSMA data visualization tool. This tool is then shared with the country mission team. Mission teams work with the visualization work book to manage and monitor IP performance. - GHSMA work book shared with Mission - Submitted into DATIM -SIMs Dashboard -Excel Pivots ( Utilized by OU,ICPI etc) - Data submitted to GHSMA - Data cleaning and management by USAID headquarter team USAID Tablets All tablets submit data

7 Extract from GHSMA Visualization work book showing performance of all USAID mechanisms, SET: Commodities Period: FY16, Q2, 3, 4 FY17 Q1, 2,3 Dark Green Light Green Yellow Red Supply Chain Management [ALL FACILITIES-COMM] Medication Dispensing [ALL FACILITIES-COMM] Supply Chain Reliability (Adult ARVs) [ALL FACILITIES-COMM] Supply Chain Reliability (Cotrimoxazole) [ALL FACILITIES-COMM] Supply Chain Reliability (Pediatric ARVs) [ALL FACILITIES-COMM] Supply Chain Reliability (Pediatric Cotrimoxazole) [ALL FACILITIES-COMM] Supply Chain Reliability (Rapid Test Kits) [ALL FACILITIES-COMM] % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

8 SIMS Dashboard visuals ICPI SIMS dashboard ICPI Dashboard Country team excel pivot table/charts. Panorama Sims analysis County team excel Pivot/charts

9 ICPI : SIMS Dashboard to analyze performance and identify areas for improvement

10 Utilization of SIMs data to inform HTS program quality HTS program data- Datim output FY17 Q3 SIMS score for HTS specific CEEs, 2016 Q Q3 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Compliance with National Testing Algorithm and Strategy HTC Referrals to HIV Care and Treatment Quality Assurance of HIV Testing Services Dark Green Light Green Yellow Red Site Level HIV Proficiency Testing

11 SIMS data corroborates with program data in trends for TB_STAT performnace76% (Q1 2016) to 89% (Q3 2017) 95% Transition to DHIS2 is improving TB_STAT data quality resulting in accurate performance reporting TB_STAT trend (DHIS2) SIMS FY 17 Q3 showing high PITC for Adult and pediatric TB Patients % TB Cases tested for HIV 90% 85% 80% 75% 70% 65% Transition from parallel TB National TB DHIS2 training Ongoing DHIS2 mentorship TB_STAT trend Adult PITC Pediatric PITC 60% 2015 Qtr Qtr Qtr 3 DQA done 2015 Qtr Qtr Qtr Qtr Qtr Qtr Qtr 2 Linear (TB_STAT trend) 2017 Qtr 3 MoH-led DHIS2 training for TB indicators began in August

12 SUCCESSES Utilizing SIMS data to interpret programmatic trends and improve the quality of the PEPFAR program Improved adherence to SOPs and guidelines has ensured compliance to global HIV program standards. Improved M&E and DQA processes at site level have to increased data quality and reporting rates to the national health information system. SIMS has improved the institutionalization of dashboards as measure of HIV program standards at the district and sub-national level.

13 SUCCESSES Increased staff presence in the field hence direct contact with beneficiaries and better understanding of the challenges in programming. USAID/Uganda has in the process of SIMS implementation developed tools for assessment of other disease technical areas using SIMS model. Family Health tool was developed to assess facility performance on Malaria, Reproductive Health, Family planning hence making quarterly SIMS assessment an integrated process. SIMS data is periodically referred to get better understanding of technical area performances The team is more organized in terms of processes of undertaking to conduct SIMS assessment which has improved productivity

14 Customized SIMS to improve VL suppression and coverage at site level Q3 SIMS Plus VL site improvement - 28 VL Campaign Checklist for Facilities 120% 100% 80% 60% 40% 20% 0% SIMS FEEDBACK Establishing VL focal teams, reviewing files for eligible clients, and integrating VL into patient education are working well Core essential elements Need improvement on VL dashboard review and collaboration with CBOs

15 Customizing SIMs to improve MCH and Malaria platform Used SIMS to create a similar tools to assess Maternal Health and Malaria at the same facilities where HIV SIMS is being implemented These tools are still paper based and we are working on transforming to an electronic format.

16 Challenges Staffs constraints and competing priorities that makes it difficult to constitute teams to conduct SIMS assessment. Ten hour rule by ICASS has made it difficult to conduct assessments at far off sites Paper tools / documents and storage issues is still a challenge. Difficult but possible to have interagency dataset. The country team should be trained to take over data management and analysis of SIMS data

17 Lessons learned Field presence is important since it provides teams with the opportunity to have direct interactions with IP s and facilities. SIMS platform can be used to foster other non PEPFAR initiatives like Family Health activities, periodic program monitoring Data requests and utilization has improved hence strengthening program management and SIMS data utilization. USAID/Uganda has developed Family Health Tool that is used to assess other disease areas (Malaria, Family Planning, Maternal Child health) besides HIV. This has improved collaboration across teams.

18 Future plans/recommendation Standardize the SIMs data collection tools across agencies for easy of data integration and use. Explore the use other advanced analytic tools like power BI.

19 Questions? Thank you