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Hivdr prevention and Assessment Annual Country Report Outline


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HIVDR Prevention and Assessment Annual Country Report Outline


Sections V, VI, VII of the report contain three subsections: A. Current activities and results; B. Progress on integrating the activity into routine activities; and C. Plan for next year. Sections X and XI contain two subsections: A. Activities and Results; and B. Future Plans
If no activities have yet taken place under a specific section, describe plan for next year

I. Executive summary



II. Background

  • Country population

  • Estimated Number of persons living with HIV

  • Estimated Number of persons eligible for ART

  • Number, % of persons eligible for and currently receiving ART

  • Number, % of eligible persons planned for start of ART by end of next year

  • Number of ART delivery sites currently distributing ART

  • Number of ART delivery sites anticipated to open next year

  • List all partner(s) (international organizations, NGOs, etc.) involved in ART delivery and describe relationship of partner(s) to national program.

  • List and describe role of international partner(s) involved in ART drug procurement and distribution.

  • Describe ART coverage in private sector [list international partner(s) and role(s) in private sector capacity building, if applicable].

  • Describe geographic areas where ART widely available > 3 years (comment on ART provided in public sector, private sector, and black market)

  • Describe HIV surveillance: (HIV or AIDS reporting; target population for surveillance; prevalence of HIV infection among young people <25 years in VCT sites in the capital city or area where ART has been available the longest; prevalence of HIV infection among women age < 21 years in capital city or area where ART available the longest )  

  • List national guidelines for standard first line/second line therapy; alternates. List available drugs, formulations, and manufactures.

  • Describe current in country laboratory capacity for viral load testing and genotyping. If country has a WHO accredited laboratory, please state name of accredited laboratory, year of accreditation, and describe capacity.

  • Summarize challenges and lessons learned associated with ART delivery and scale-up in country

III. Purpose of Report


  • National statement: purposes of HIVDR prevention and assessment strategy

  • Target audiences for this report

  • How this report should be used

IV. HIVDR Working Group


A. Terms of reference:
Describe working group terms of reference

See Example in Appendix 1.

B. Working Group membership



This section should include a list of working group members including institutional affiliation and should clearly define individual and institutional roles, responsibilities and frequency of meetings.

V. HIVDR Early Warning Indicators (EWI)


Early Warning Indicators are ART site variables designed to be monitored in all (or a representative sample of) ART sites in a country. EWIs allow countries to make statements about ART program functioning both at the national level and at the ART site level. They monitor factors associated with HIVDR prevention (without requiring laboratory testing). An initial review of records systems in the country and what is actually recorded at sites in each system is performed initially to support initial selection of EWI to pilot. EWI are then piloted in a limited number of sites selected to represent various record systems and other important characteristics, and the plan for EWI monitoring is revised based on that pilot. After the pilot, a plan for monitoring EWI at all ART sites or at a large number of representative sites is made. Collection of EWI information should also be used to strengthen individual ART patient monitoring and programme monitoring in general.
EWI results provide countries with information to make evidence- based recommendations to effect necessary changes at site and program level. A brief description of the seven WHO recommended EWI is found in Appendix 2.

For a detailed description of EWIs, please refer to the latest WHO Early Warning Indicator Briefing

A. EWI Activities and Results


PILOT ACTIVITIES AND RESULTS

1. For the pilot year, describe the process by which feasibility of monitoring each of the seven EWI was assessed. In which sites were records initially evaluated before the pilot?


2. List the EWIs selected for piloting, which version of each EWI for which there is more than one version, period of time selected for each denominator, and the national target for each EWI. WHO provides suggested national targets (Appendix 2). If the national working group has defined different targets; this section should include not only the target definition but an explanation of rational for change of target. Each EWI to be monitored should be the same for each site.

a. Definitions This section should include the HIVDR working group definition of standard or otherwise acceptable ART regimens, and any other definitions used for country analysis.


3. Describe EWI pilot site selection process; that is, the basis on which ART sites were selected (which site characteristics are represented?)
4. For the year the EWI were piloted, list the pilot sites from which the EWI were collected initially, the areas of the country in which the sites are found, relevant demographic information on the patient populations served, and the percentage of patients receiving ART in the country who are treated at these sites. [This information may be provided in table format].

a. Describe the electronic or paper medical records, registers, and pharmacy records systems that were used at each site for the EWI abstraction.  (There is no need to describe forms or modules used at a site that were not used for pilot EWI abstraction.)

b. The field(s) or variable(s) in each site's records systems that was used for the numerator and denominator, and the method for abstracting the information
As an appendix to the report, include copies of the relevant medical and pharmacy records systems. For sites with electronic records systems, scan a copy of the file structure or data entry screens for electronic medical records, registers, and pharmacy systems into the report, and circle the relevant fields for the numerators and denominators of each EWI. For sites with paper-based systems, include a copy of the relevant paper forms into the plan and circle the relevant fields from which the numerator and denominator were abstracted.

5. Process of EWI Pilot Data extraction and Analysis


  • Describe composition of data extraction team [list individual names and institutions, and role of each]

  • Describe process data were extracted

  • Describe when data was extracted

  • EWI data analysis methods

  • Describe validation exercise used for EWI


6. EWI Pilot Results

  • Describe EWI pilot process, challenges, lessons learned

  • Assess ongoing feasibility of routine monitoring of each of the EWI piloted

    • Describe implications of the EWI pilot for general patient ART monitoring and ART programme monitoring

  • Describe alterations to EWI information collection plan based on pilot

  • For each EWI: summarize results for sites where information was available; report sites for which EWI information could not be collected and which data could not be collected at these sites

EWI results should be summarized and presented both by site and at the national aggregate site level. Examples of both are provided below. Describe results if available.

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