1. Use of Routine Feedback Reports to Site and District Staff in Cote d’Ivoire Hermann Brou Annual Meeting, M&E satellite meeting Johannesburg, July 28, 2010 1

2. Context  Our program started in October 2007  As of the end of June 2010: 112 supported sites located in 13 health districts 8,729 PLWHA enrolled in care 4,740 patients ever started ART 2

3. ICAP-CI M&E Team M&E Director Abidjan M&E Assistant Abidjan Database Manager Abidjan Data officer Daloa Data Clerks Sites - District Bouafle - District Sinfra - District Zuenoula - District Konahiri Data Officer Daloa Data Clerks Sites -District Daloa - District Issia - District Vavoua - District Seguela - District Mankono Data Officer Daloa Data Clerks Sites - District Gagnoa - District Oume - District Divo - District Lakota M&E Assistant Daloa 3

4. ICAP-CI Technical team Site Multidisciplinary team ICAP-CI Information System HIV Care & Treatment service Site Data Clerk Health District Direction CSE ICAP-CI, M&E unit Regional office  Abidjan office Other clinical services/clinics (Lab, ANC, etc) Community activities MOH (DIPE, PNPEC) PEPFAR – CI ICAP - NY → Data report flow → Feedback 4

5. When Do We Make Feedback & For Whom?  To ICAP-CI Technical team Monthly feedback: report s on all programmatic areas Quarterly analysis: trend, achievement of targets  To Health district / site Monthly feedback: 20 keys indicators about Testing & Counseling, PMTCT, Care & Treatment, TB/HIV Ex: # of pregnant women tested HIV+ VS # of pregnant women received PMTCT prophylaxis Semi-annual meeting: to assess achievements, identify difficulties and develop or modify strategies 5

6. Monthly Feedback to District / Site: How is It Provided? 6  In paper or electronic format An overall table for all 20 keys indicators and charts Specific analysis on a selected theme (sometime) Automatically generated by aggregate database (Daloa office) Printed copies transmitted to staff and pasted in site  For more details, technical advisor or officer call providers Systematically for 2 nd line ART regimen and TB patients tested HIV+

7. Routine Feedback to Site: Care & Treatment 7  Tracking of ART prescription: Ensure prescriptions are consistent with national guidelines, especially for second-line therapy  CD4 count: Following-up and monitoring of CD4 counts at 6 months, 12 months  Discontinuation of ART: Percent of patients lost- to-follow up

8. Routine Feedback to Site: PMTCT 8  For HIV-infected pregnant women: Percent of those who received PMTCT prophylaxis Percent of those enrolled in care  For HIV exposed children: HIV test within 12 months If HIV-infected, initiation of ART

9. Routine Feedback to Site: TB/HIV 9  In care and treatment: percent of patients enrolled in care who are screened for TB for patients suspected TB-infected, what is done?  At TB clinics: percent of TB patients who received counseling for HIV test tracking of patients co-infected with TB/HIV (Cotrimoxazole prophylaxis and enrollment in care)

10. Routine Feedback to Site: PLWHA Enrolment in Care (all sites) 10

11. Challenges 11  Train site staff to analyze data  Establish functional multidisciplinary team MDT) at all sites, especially ART sites ICAP staff attend to first meeting Monitoring MDT meeting (number of meetings, participants,…) Support MDT costs meeting  Improve quality of data collected Develop of SOPs for DQA Implement DQA in collaboration with district staff

12. Thank You 12