1. Using programme M&E data for Surveillance in Nepal: Challenges and Opportunities
Name of Author(s): Biwesh Ojha(1)

2. Background-1
HIV Testing and Counseling service was first started in Nepal in 1995 by National Centre for AIDS and STD Control (NCASC)
HIV Testing and Counseling is the entry point for overall HIV and AIDS care services. It is provided free of cost to the key population at higher risk, including general population from all over the country

3. Background-2
Routine data are those data which are reported in routine basis from existing service delivery points (HTC, ART, PMTCT reported by the 7th of next months)
Nepal currently adopts Second generation surveillance (SGS) system for surveillance activities
Strengthening the use of programme monitoring and evaluation data is one of key principles for strengthening the SGS system in Nepal (National Surveillance Guideline 2012)

4. Background-3 Second generation surveillance system in Nepal
Data Management, analysis and used for action
Case reports
HIV surveillance
Behavioral surveillance
STI surveillance
Size estimation of key population at higher risk
programme monitoring and evaluation
Second generation surveillance system in Nepal

5. Background-4
Nepal is regularly conducting Integrated Bio-Behavioral Surveillance surveys on key population at higher risk from 2002 Conducting IBBS requires huge amount of resources (Money, time, Human resource)

6. Objectives
This paper aims to compare the trend of HIV prevalence from the IBBS to Routine reporting(HTC) of People who Inject drug (PWID) from Kathmandu and Pokhara over last three years This paper also aims to analyze the challenges and opportunities using regular M & E data.

7. Methodology
Last three years regular HTC data (Case report) from 6 sites of Kathmandu and 3 sites of Pokhara was captured
IBBS findings from Kathmandu and Pokhara were observed
Comparison of IBBS prevalence with regular HTC data was done

8. Findings

9. Comparison of prevalence of HTC and IBBS Pokhara
Year
HIV Prevalence from HTC
IBBS Prevalence
2009
0.7
3.4
2011
0.4
4.6

10. Comparison of prevalence of HTC and IBBS of Kathmandu
Year
HIV Prevalence from HTC
IBBS Prevalence
2009
15.8
20.7
2011
3.2
6.3

11. Discussion

12. Both comparison shows the difference in HIV prevalence of HTC and IBBS Surveys This demarks the existing gap either from regular reporting data or Some error may have occurred while selecting the samples for IBBS surveys

13. Challenges of routine M & E data
Irregular reporting from the sites
No unique identification code to each client thus may lead to double counting of cases
Incomplete reporting
Passive case reporting
The success of a passive reporting system depends on how many HIV-infected individuals have access to HIV testing, get tested, obtain care at a health facility, and get reported

14. Opportunities of routine M & E data
Cost effective
Provides disaggregation information (Sex, Age, Risk group, District) to know the epidemic and its response at local, national level
Use of data for HIV estimation
Can measure the trend of HIV prevalence
Can provide information on the current and future need for ART and prevention services

15. Thank you