Transcript HIV Patient ART Monitoring Meeting

HIV Patient ART Monitoring
Meeting:
International Conference Centre,
Geneva
29-31 March 2004
Defining the variables
Aims of the meeting
• To discuss and identify those core variables to be
collected for optimum patient management for
ART monitoring in various settings (including
PMTCT and Care for Women and Children
programs)
• some of these would also allow for the evaluation
and feedback of programs at various levels of the
country’s health care system and harmonization of
demands across relevant research or donor
organizations operative in resource poor settings
Objectives of the meeting (1)
1. to discuss and agree on minimum variables to be
collected at patient level for
a)
patient management;
b)
programme evaluation at
facility,
regional (provincial),
national,
and global levels
Objectives of the meeting (2)
2. to discuss and agree on patient based
variables which will be useful in providing
a link with the monitoring and evaluation of
other programs:
a) ART resistance
b) drug supplies
c) TB, other chronic care
Objectives of the meeting (3)
• to discuss and provide recommendations on
mechanisms for collecting data at patient
level
Objectives of the meeting (4)
• to discuss and provided recommendations on
mechanisms of reporting and providing feedback
at the level of
• health centre
• district
• Provincial
• national
• international
Objectives of the meeting (5)
• to discuss and provided recommendations
on mechanisms systems to be used or
developed including
• paper
or
• electronic systems.
How do we think we can achieve
these objectives?
• The meeting has brought together a number
of experts in the field
• We would like you to split up into 3 work
groups
Group 1: patient group
Group 2: program group
Group 3: drug supply group
Patient Group
• Outcome: consensus on the minimum data set for
monitoring clinical care for patients on ART in
health facilities
• Tasks: to identify and discuss variables for patient
management: ideal, minimum and realistic
• to identify low level indicators which can also be
used for monitoring drug resistance
• to discuss how these data could be collected
within each clinical unit, including who and how
these data will be collected
• to discuss and agree on the next steps for
implementation at local, country and global levels.
Program Group (1)
• Outcome: consensus on the minimum data set and
system required for ART Program Monitoring at
various levels (facility, district, national, and
global)
• Tasks: identify the variables to monitor the
programs, and their relationships with variables
collected at health facility level
• to discuss how and how often these data should be
transferred to higher level facilities including a
critical review of the applicability of new
technologies (e.g. software, smart cards, cell
phones) in addition to paper based systems.
Program Group (2)
• how and how often these data will be analysed, by
whom at which level and including a critical
review of the applicability of various methods and
means
• how and how often result of these analyses will be
fed back to relevant levels
• to formulate recommendations on integration with
the national HMIS with emphasis on records
management including security and
confidentiality, use and applications for M&E and
surveillance.
• to agree on the next steps for implementation at
local, country and global levels.
Drug Supply Group (1)
• Outcome: consensus on the minimum data set and
system required for ART Drug Supply Monitoring
at various levels (facility, district, national, and
global)
• Tasks: identify the variables to monitor the drug
supply programs, and their relationships with
variables collected at health facility level
• to discuss how and how often these data on drug
supplies will be transferred to higher level
facilities including a critical review of the
applicability of new technologies (e.g. software,
smart cards, cell phones) in addition to paper
based systems.
Drug Supply Group (2)
• To discuss how and how often these data on drug
supplies will be analysed, by whom at which level
and including a critical review of the applicability
of various methods and means
• to discuss how and how often result of these
analyses will be fed back to relevant levels
• to formulate recommendations on integration with
the national HMIS with emphasis on records
management including security and
confidentiality, use and applications for M&E and
surveillance.
• to agree on the next steps for implementation at
local, country and global levels.
Variables ART Patient Monitoring
•
•
•
•
demographic, including unique identifiers
clinical,
laboratory,
treatment regimens
HIV-related
non-HIV , the extent of which may vary
• use of services
inpatient services, especially inpatient days
outpatient services, especially outpatient visits
• functional indicators
….so we can evaluate and improve
where possible the
•
•
•
•
Effectiveness
Efficiency
Equity
Acceptability
of the ART programs put into place
…but this is the only way
…we are going to be to assess on an ongoing basis
how successful the initiatives have been which
have been instituted to contain the HIV pandemic
and which additional interventions or systems are
required
Practical points:
• Lists have been drawn up of who will go into
which of the three groups
• While we are not going to compel you to comply
with this, we would like the groups to be of
similar sizes
• A member of each groups has been asked to act as
rapporteur
• In addition, can each group please appoint its own
facilitator and person(s) who will take extensive
notes.
Thank you again
….for attending and taking part in this
important exercise………
That's All Folks!