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Preventing HIV among Guyana’s Key Populations: Guidelines

Preventing HIV among Guyana’s Key Populations: GuidelinesThese guidelines are designed to outline the public health response to HIV among key populations (KPs) in Guyana. The specific objectives are to:

  • Define the populations of interest
  • Define the combination prevention package for KPs
  • Update guidance on the operationalization of interventions
  • Define programme monitoring and evaluation (M&E) for KP prevention activities

The focus of these guidelines is on HIV prevention for KPs and priority populations. To meet the HIVision 2020 goal of eliminating HIV in Guyana, a multi-pronged approach that goes beyond prevention will be required. These guidelines highlight the approaches needed before care and treatment are given and linking with treatment for people who have HIV.

Family Planning Indicators Assessment and Data Quality Audit in Selected Health Facilities across Nigeria

Family Planning Indicators Assessment and Data Quality Audit in Selected Health Facilities across NigeriaPromoting family planning (FP) is an important strategy for preventing high-risk births and infant deaths, reducing unplanned pregnancies and unsafe abortions, and decreasing the burden of infant and maternal mortality globally. To be successful, FP programs must use information systems to accurately track FP use and trends. Although use of District Health Information Software, version 2 (DHIS2) to manage and aggregate health information is becoming the norm across Nigeria, issues still confound the operationalization, availability, accuracy, consistency, timeliness, completeness, and integrity of FP data at health facilities and in DHIS2 by extension. The purpose of this study was to assess FP data quality in select health facilities in Nigeria.

The study used a mixed-methods approachA total of 114 (103 public and 11 private) health facilities in six states (Bauchi, Delta, Enugu, Kano, Osun, and Nasarawa) were selected across Nigeria.

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Engendering Evidence-Based Policy for Young People’s Reproductive Health in India

Engendering Evidence-Based Policy for Young People's Reproductive Health in IndiaYoung people, defined by the World Health Organization as people 10–24 years old, account for more than a quarter of India’s population (2014). The country has the opportunity to harvest economic and social gains from its young, working-age population if it invests in human capital development and overcomes such challenges as poor education and healthcare, gender discrimination, and lack of access to adolescent and youth reproductive health care.

This paper presents evidence for policymakers on the strengths and weaknesses of the health policy framework; service delivery mechanisms; and knowledge, attitudes, and practices of 10- to 24-year-olds related to reproductive health in India.

The research incorporated exploratory and descriptive approaches, using qualitative and quantitative data from primary and secondary sources.

Understanding “the Last 90” in Guyana’s HIV Treatment Cascade: A Facility-Based Assessment of the Viral Loads of Key Populations

Understanding “the Last 90” in Guyana’s HIV Treatment Cascade: A Facility-Based Assessment of the Viral Loads of Key PopulationsAccording to the National Guidelines for Management of HIV-Infected and HIV-Exposed Adults and Children (Ministry of Public Health [MOPH], 2015), viral load testing began in Guyana in 2009. It is indicated for adults at six months after initiation of antiretroviral therapy (ART) and every six to 12 months thereafter for clients who are virally suppressed. This supports what the midterm evaluation of Guyana’s HIVision 2020 reports is the ultimate goal of the HIV treatment cascade (the steps a client takes from testing through viral suppression): “viral load suppression” (MOPH, 2017). One strategy outlined in the document is to “increase the proportion of people with HIV (on HAART [highly active antiretroviral therapy]) who have viral load suppression to 90% by 2020.” That strategy is in line with other global goals to ensure that 90 percent of people enrolled in care have a viral load that is below standard limits or even undetectable. Implementing the strategy in Guyana is particularly important in the era of treatment as prevention, to ensure that the virus is undetectable in clients and therefore untransmittable.

The most recent HIV treatment cascade analysis for Guyana, from 2016, reports that 68 percent of people on ART are virally suppressed (MOPH, 2017). These cascade data come from routine reports from health facilities. Although the information is valuable, it is incomplete, because that same cascade reports that 83 percent of clients on ART have a current viral load test.

MEASURE Evaluation—a project funded by the United States Agency for International Development (USAID) and the United States President’s Emergency Plan for AIDS Relief (PEPFAR)—realized that filling this gap would be essential to a full understanding of the HIV cascade in Guyana. If the sample of clients who were missing VL measures could be assumed to represent all clients missing VL measures, then we could leverage estimates of viral suppression from a sample of clients who were missing VL data to obtain a more accurate, representative estimate of viral suppression among a larger population in the care and treatment program. Answering these questions would contribute to USAID’s goal of controlling the HIV/AIDS epidemic and the global 90-90-90 targets that PEPFAR has adopted.

The results of the study will help inform MOPH programs both for HIV-positive clients who are KP members and those who are not. It will illuminate gaps in data and show how viral load estimation can be improved at the health facility and national levels.

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Monthly Malaria Bulletins Contribute to Improving Data Use for Malaria Control in Mali

Monthly Malaria Bulletins Contribute to Improving Data Use for Malaria Control in MaliAs a close partner of the National Malaria Control Program (NMCP) in Mali for the past 10 years, MEASURE Evaluation has supported malaria control and prevention activities that have made a difference in collective efforts to combat the epidemic. Together, MEASURE Evaluation and the NMCP have improved the quality of malaria data available, in part by strengthening the capacity of NMCP staff in monitoring and evaluation.

Although the disease is preventable and curable, consistent and high-quality malaria data to guide program implementation and to measure achievements are in short supply. In response to the acute need for reliable malaria data at national and subnational levels, the NMCP, with the support of MEASURE Evaluation, created a monthly malaria bulletin to provide nationwide updates. This brief describes how the bulletin is helping improve data use for malaria control.

Access the brief in English or French.

Strengthening Health Information Systems in Nigeria—Building an OVC Information System

Strengthening Health Information Systems in Nigeria—Building an OVC Information SystemMEASURE Evaluation, which is funded by the United States Agency for International Development, has been working in Nigeria since 2005 to improve the availability of high-quality data to support decision making at all levels of the health system. This work fulfilled two main objectives:

1) Support the Department of Health Planning, Research and Statistics of Nigeria’s Federal Ministry of Health to develop a master facility list to improve data quality and ultimately lead to better coordination of health services

2) Work with the Federal Ministry of Women’s Affairs and Social Development to develop a directory of orphans and vulnerable children (OVC) service providers and build capacity to use OVC data collection tools for the National OVC Management Information System (NOMIS)

We have mapped the HIS strengthening interventions to support each objective in two separate fact sheets. Each fact sheet superimposes on the HISSM depictions of MEASURE Evaluation’s activities in the enabling environment and information generation areas to support HIS performance in meeting the specific objective. By displaying key interventions across the HISSM, we see their strategic interaction, and how this combination of interventions works together to strengthen data quality and data use at all levels of the health system.

This fact sheet documents MEASURE Evaluation’s work to support development of a directory of orphans and vulnerable children (OVC) service providers and capacity building to use OVC data collection tools for the National OVC Management Information System (NOMIS).

View the related document Strengthening Health Information Systems in Nigeria—Developing a Master Facility List

Monitoring Outcomes of PEPFAR Orphans and Vulnerable Children Programs in Kenya: Round 2

In 2014, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) introduced the monitoring, evaluation, and reporting (MER) essential survey indicators (ESIs) to help track changes over time in the well-being of orphans and vulnerable children (OVC) project beneficiaries and their households.

In 2018, the OVC team of PEPFAR in Kenya requested assistance from the United States Agency for International Development (USAID) and the USAID- and PEPFAR-funded MEASURE Evaluation project to conduct three panel studies and one cross-sectional survey for three ongoing PEPFAR OVC projects in western Kenya: Making Well-Informed Efforts to Nurture Disadvantaged Orphans & Vulnerable Children (MWENDO), a USAID-funded project of Catholic Relief Services; the Timiza 90 project of the United States Centers for Disease Control and Prevention (CDC); and the Walter Reed Program/Henry M. Jackson Foundation Medical Research International (WRP/HJFMRI) HIV project funded by the United States Department of Defense. This was the second round of data collection. MEASURE Evaluation completed the first round in 2016. One of the implementing partners whose beneficiaries were assessed in 2016 was AIDS, Population and Health Integrated Assistance Plus Program, Western Kenya (APHIAplus). APHIAplus has since ended, and its beneficiaries now receive services from the MWENDO project.

In the three panel studies (one for each project) the same beneficiary households who were interviewed in 2016 were again interviewed. The main objective for the repeat survey was to evaluate the progress of the OVC projects over the two-year period. In addition, an independent cross-sectional survey (conducted for MWENDO only) was designed to provide a snapshot of the current status of MWENDO beneficiaries in areas not included in the 2016 survey. Fieldwork for the surveys was undertaken in October and November 2018.

The following materials present our findings.

Reports and Posters