Monitoring and Evaluation for Quality Improvement

The Global Strategic Information Group at GHS helps PEPFAR countries understand and use clinic, district, regional, and country-level data collected to ensure high coverage, linkage and retention in the continuum of care by strengthening monitoring and evaluation (M&E) systems for quality improvement.

Our M&E and quality improvement activities focus on understanding the types of data collected in local, regional and country-level systems, and how the data can be used to improve patient outcomes through targeted quality improvement activities.

We support countries and partnering agencies in sustainably strengthening M&E and in continuous quality improvement of systems to enable the collection, rigorous analysis and interpretation of high-quality data for health programs.

Activities

Data Analysis and Use

We work with country partners in using data from antiretroviral therapy (ART), prevention of mother-to-child HIV transmission and tuberculosis cohorts to improve retention of patients in HIV care and treatment programs. We train CDC and other in-country strategic information staff about routinely monitoring ART outcomes and using the data for program course correction. We have developed robust care cascades for understanding program gaps and program impact. We provide data to support PEPFAR’s pivot to areas and populations with greatest burden as countries start testing and treating. We leverage program data to measure outcomes and impact of PEPFAR programs. We have conducted this work in India, Kenya, Namibia, Nigeria, Tanzania and Uganda.

Data quality and service quality assessments (DQA and SQA)

We develop and implement capacity-building methods and tools for national, organizational and site-specific DQAs and SQAs. These DQAs and SQAs track the reporting and use of PEPFAR-required indicators for and provide context for quality of services:

  • Antiretroviral therapy (ART)
  • Prevention of mother-to-child transmission (PMTCT) of HIV
  • Healthcare service delivery

Our data quality improvement activities validate reported data, improve the Centers for Disease Control's accountability and oversight of its implementing partners, identify and make recommendations for improving data reporting and management systems, build capacity at the Ministry of Health to understand methods for assessing and improving data quality. We have conducted these projects in Cameroon, Ethiopia, Kenya, Mozambique, Nigeria, South Africa, Uganda and Zambia.

Data visualization

We develop processes, tools and manuals for integrating different sources of data to identify epidemiological trends with an emphasis on building host-country technical capacity in data visualization using figures and maps through geographical information systems (GIS). We have conducted these projects in Botswana, Namibia, South Africa, Tanzania, Uganda and Zambia.

Monitoring public health interventions

We develop synchronous reporting systems that enable stakeholders to monitor the implementation of a public health intervention in real time (for example, the rapid scale-up of Option B+). Reporting is done via mobile phones (SMS). We also develop job aids to ensure data quality and accurate reporting. These systems are automated to produce weekly (or any other interval) reports that can be accessed through web-based dashboards.

Continuous quality improvement

In partnership with HEALTHQUAL, GSI supports the process of continuous quality improvement (CQI) for HIV-related service delivery. These activities include mapping of CQI strategies, developing data collection tools, supporting field data collection and integrating online dashboards to view and download pre-analyzed reports and raw datasets. In addition, we have developed metrics and methods for measuring quality improvement mid- and long-term outcomes for both strategic information and program services.

Public health triangulation

We pioneered an analytical approach known as “triangulation,” which integrates multiple data sources for guiding programmatic decision-making to address public health problems. We developed a resource guide and have conducted Triangulation workshops with host country institutions including Kenya, Mozambique, Namibia, Rwanda, Tanzania, and Ukraine.