1. Outline Session
7:00 FRSA0701
Welcome and introductions : WHO general approach to cascade analysis framework : From Cascade Analysis to Action  Jesus M Garcia Calleja, WHO, Switzerland 
07:10 FRSA0702
Cascade analysis and use of data in Zimbabwe  Dr Regis CHOTONational ART Coordinator , Ministry of Health and Child Care, Zimbabwe, Zimbabwe 
07:20 FRSA0703
Cascade analysis and use of data in India  Dr Manish BAMROTIYA, National AIDS Control Organisation, Ministry of Health & Family Welfare, India 
07:30 FRSA0704
Cascade analysis and use of data in Tanzania  Claud John KUMALIJA, Head of HMIS, Ministry of Health Community Development Gender Elderly and Children, United Republic of Tanzania 

2. International AIDS Conference Amsterdam 22-27 July 2018
Monitoring the 3 90’s, the next frontier: from surveys to routine data to build cascade monitoring at local level
Dr. Jesus M Garcia Calleja
WHO/HIV Dept.

3. People, Program gaps, Priorities

5. HIV testing and care continuum (2017)
Source: UNAIDS/WHO estimates

6. HIV testing and care continuum by WHO region (2017)
% to
PLHIV who know their status (%)
Percent of People living with HIV receiving ART
People virally suppressed among all PLHIV (%)
N/A
N/A
Source: UNAIDS/WHO estimates

7. Increase in people receiving ART over time
Source: UNAIDS/WHO estimates

8. HIV Patient Monitoring: new recommendations, guidance and tools

10. Shift in strategic information
Set up sustainable and routine data systems
Use data to identify programme gaps
1. Update information systems to capture harmonized HIV indicators
2. Support unique identifiers for de-duplication
3. Develop and strengthen HIV case reporting
4. Support community based data collection, including for key pops
Adjust the response
5. Improved modelled estimates to include routine data at more granular levels
6. Disseminate and display data, including programme gaps, in an accessible format
7. Promote HIV accountability through enhanced reporting systems
8. Fast track HIV response to locations and populations with service delivery gaps
9. Link monitoring data with expenditure data to identify efficiencies

11. Health information system
Does your country have a functioning HIS that is electronic, paper-based or both?
10% of countries have fully functional electronic HIS. Most have partially paper-based No
Both : Electronic
and Paper based
Electronic
Paper
Europe ECA 1 6 3
Asia and Pacific 16 2
East and Southern Africa 13
LAC 21
MENA 4
West Central Africa 14
Total 5 75 9 12

12. Unique IDs: Data are linked using a national unique personal identifier
41 of 76 countries link data using national unique ID used
67 of 98 countries have a method for removing duplicate information for treatment services NO
YES
EECA 3 10
Asia and Pacific 7 8
East and Southern Africa 9 5
LAC
MENA 2 4
West Central Africa 6
Total 35 41

13. HIV Case Surveillance: Among 62 (of 110) countries where HIV is notifiable disease, the percent where a standard case report form exists for newly diagnosed cases
Countries where HIV is notifiable have case surveillance systems NO
YES
EECA 1 10
Asia and Pacific 11
East and Southern Africa 7
LAC 22
MENA
West Central Africa 3
Total 2 60

14. Key populations and cascades : Are treatment cascade data available for key pops?
Key pop cascade data are available in many concentrated epidemic countries, not in SSA NO
YES
EECA 3 10
Asia and Pacific 6 11
East and Southern Africa 12 4
LAC 18 7
MENA
West Central Africa 5
Total 47 46

16. Cascade analysis user’s manual
Cascades are frameworks for monitoring gaps in programme services needed to achieve goals and health outcomes.
Cascades consist of a results chain or a series of sequential events in which each event is linked to achieve a health outcome

17. Analysis and use of facility data for action
Comprehensive curriculum for national, district and programme managers
Highlights
Unique multi-programme and multi- partner integrated approach
Supported by Global Fund, GAVI, NORAD, Bloomberg and others ++
Based on international standards
Curriculum for users of data
Implementation of the curriculum in DHIS in collaboration with UiO
Next steps/priorities
Support to scale to countries (e.g. Global Fund RFP for establishing network of expertise)

19. County-level cascade analysis to identify and fill programme gaps in the 90-90-90 targets, Kenya

20. are closed over time - Jamaica
Using the cascade to show how programme gaps
are closed over time - Jamaica

21. Using data to improve programs
Zimbabwe – KPP analysis to fill gaps in young CSWs

22. Using data for program improvement

23. Thank You