Strengthening Public Health Systems and Services -
Epidemiology and Strategic Information
Through the President's Emergency Plan for AIDS Relief (PEPFAR), CDC is building the capacity of resource-constrained nations to strategically collect and use information for program accountability and improvement. CDC collaborates with U.S. government PEPFAR partners, host governments, Ministries of Health, non-governmental organizations, U.S.-based universities, and the private sector to achieve this goal.
Building Surveillance Capacity
To build a better understand the relationships among population, HIV prevalence, and existing services, CDC:
-
Builds in-country capacity to design, implement, and evaluate HIV/AIDS-related surveillance systems and surveys; and assists and trains countries on how to analyze, disseminate, and use HIV/AIDS data.
-
Develops tools, guidelines, recommendations, and policies to translate research for improved planning and program implementation.
-
Evaluates and implements novel approaches for conducting surveillance and surveys.
Strengthening Information Systems
Recognizing that the collection, storage, analysis, and use of high-quality data are essential to HIV prevention, care, and treatment programs, CDC:
-
Supports efforts to improve broader national health information systems through strengthening of HIV/AIDS-related information systems.
-
Partners with key stakeholders to identify and promote the use of global standards in health information systems to ensure consistent indicators to enable sharing across systems, and to ensure that data are protected.
-
Promotes the use of quality data for decision-making through scientific and methodologically sound evaluations and assessments of health information systems.
Ensuring Evidence-based Programming
To assist countries to assess and improve HIV/AIDS programs through effective monitoring and evaluation (M&E) at the local, regional, and national levels in, CDC:
-
Increases country capacity to monitor, evaluate, and report on process, outcomes, and impact of HIV/AIDS programs.
-
Helps to lead public-health evaluations under PEPFAR, which ensure interventions are scientifically sound and delivered as effectively and efficiently as possible.
-
Provides technical assistance on the development and implementation of planning and reporting systems.
In
Vietnam, paper-based record-keeping systems for lab results are common.
Unfortunately, paper-based systems increase the chance of error, and finding old
results is virtually impossible.
At the same time, Vietnam is emerging as a software developer, so when CDC
decided to computerize several key databases of voluntary counseling and testing
centers, it worked with a Vietnamese company to design a system to record
biographical data, HIV test results, referrals made, and treatment offered.
The result was a product well-suited to meet Vietnam’s specific
data system needs. The Ministry of Health was pleased with the program and asked
to have it installed at every counseling and testing site in the country.
CDC
and the Honduras Ministry of Health recently studied key behavior indicators
linked with HIV in four cities plus rural coastal villages in Honduras. For the
first time in the Central America region, Audio Computer-Assisted
Self-Interviewing (ACASI) was used to gather quantitative information on
representatives of three at-risk populations: commercial sex workers (CSW),
men who have sex with men (MSM), and the Garifuna population (the
Afro-Honduran descendants of West African slaves). ACASI provided greater
anonymity for participants and allowed for a higher level of trust in the
results.
This process involved the target populations by sharing
expectations and responsibilities with community groups and holding regular
meetings to keep the participating populations informed of progress and
challenges. The behavioral surveillance survey (BSS) created sustainable
capacity in the region by transferring tools and technical knowledge to
local health professionals.
CDC
partnered recently with the Zanzibar AIDS Control Programme (ZACP) to
conduct a respondent driven sampling (RDS) survey in Unguja, Zanzibar. It
was the first time the ZACP used RDS to survey at-risk populations.
Effective surveillance focuses on the segments of national or community
populations that have important roles in HIV transmission, but conventional
surveillance data collection strategies are not feasible among so-called
hidden populations. In concentrated epidemic settings, such as in Zanzibar,
these groups generally consist of CSW, injecting drug users (IDU), and MSM.
The RDS methodology identifies a “seed” in the target population who
identifies and recruits peers, who in turn recruit others to participate in
the study. Researchers keep track of recruits and their numbers of social
contacts. A mathematical model weights the sample to compensate for
non-random collection.
Last reviewed: August 27, 2008
Content Source:
Global AIDS Program (GAP)
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention