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Data Quality Assessment (DQA) for the Partnership for HIV-Free Survival (PHFS) Report: Uganda

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Data Quality Assessment (DQA) for the Partnership for HIV-Free Survival (PHFS) Report: Uganda THE REPUBLICTHE REPUBLIC OF UGAN UGANDADA MINISTRY OF HEALTH MINISTRY OF HEALTH Data Quality Assessment (DQA) for the Partnership for HIV-Free Survival (PHFS) Report: Uganda May 2015 FANTA III FOOD AND NUTRITION TECHNICAL A SSISTANCE This report is made possible by the generous Recommended Citation support of the American people through the The Ministry of Health. 2015. Data Quality support of the Office of Health, Infectious Diseases, Assessment (DQA) for the Partnership for HIV-Free and Nutrition, Bureau for Global Health, U.S. Survival (PHFS) Report: Uganda. Agency for International Development (USAID), USAID Uganda, and the U.S. President’s Contact Emeregency Plan for AIDS Relief (PEPFAR), under terms of Cooperative Agreement No. AID-OAA-A- Ministry of Health 12-00005, through the Food and Nutrition Plot 6, Lourdel Road, Nakasero Technical Assistance III Project (FANTA), managed P.O. Box 7272, Kampala, Uganda by FHI 360. T 256-340874/23563/9 Telefax 256- 231584 The contents are the responsibility of FHI 360 and Telex 256-61372 HEALTH UGA do not necessarily reflect the views of USAID or the [email protected] United States Government. www.health.go.ug Publisher Food and Nutrition Technical Assistance III Project (FANTA) FHI 360 1825 Connecticut Avenue, NW Washington, DC 20009-5721 T 202-884-8000 F 202-884-8432 [email protected] www.fantaproject.org Acknowledgments The Ministry of Health would like to sincerely thank all the stakeholders that participated in all the activities that culminated in this report. Special thanks are extended to the U.S. Agency for International Development for the continued material and technical support. We are also indebted to the Institute for Healthcare Improvement, the U.S. President’s Emergency Plan for AIDS Relief, the U.S. Centers for Disease Control and Prevention, and MEASURE for their support for the Partnership for HIV-Free Survival (PHFS) initiative. We extend our sincere gratitude to all PHFS implementing partners including the Food and Nutrition Technical Assistance III (FANTA) Project; The AIDS Support Organization (TASO); the Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) Project; the Applying Science to Strengthen and Improve Systems Project (ASSIST); and the Strengthening TB and HIV/AIDS Responses in East Central Region of Uganda (STAR-EC) and Strengthening TB and HIV/AIDS Responses in Southwest Region of Uganda (STAR-SW) Projects, as well as community members who participated in the survey and field testing of the tools and the PHFS Monitoring and Evaluation technical working groups and review committees for their contributions from the time of inception of the indicators through the data collection processes. Dr. Jane Ruth Aceng Director General Health Services i Contents 1 Introduction ................................................................................................................................... 1 1.1 The Partnership for HIV-Free Survival .................................................................................. 1 1.2 Implementation of PHFS in Uganda ....................................................................................... 2 1.3 Elimination of Mother-to-Child Transmission of HIV in Uganda (eMTCT) ........................ 3 1.4 Nutrition Assessment, Counseling, and Support Implementation in Uganda ........................ 3 1.5 Quality Improvement Framework for Uganda ........................................................................ 3 1.6 Rationale for the Data Quality Assessment ............................................................................ 4 1.7 Objectives of the Data Quality Assessment ............................................................................ 4 2 Methodology .................................................................................................................................. 5 2.1 Survey Design ......................................................................................................................... 5 2.1.1 Data Sources ................................................................................................................................. 5 2.1.2 Data Collection Instruments/Tools and Procedures...................................................................... 5 2.1.3 Data Entry and Analysis ............................................................................................................... 6 2.1.4 Ethical Considerations .................................................................................................................. 7 2.2 Assessment Limitations .......................................................................................................... 8 3 DQA Findings ................................................................................................................................ 9 3.1 Data Validation (Accuracy) .................................................................................................... 9 3.1.1 Verification of Reported Numbers ............................................................................................... 9 3.1.2 Review of Source Documents (Availability, Accuracy, Completeness) .................................... 10 3.2 Analysis of Data Quality by Health Facility Type (Availability, Completeness, Accuracy) 11 3.2.1 Availability by health facility level ............................................................................................ 11 3.2.2 Completeness by Health Facility Level ...................................................................................... 11 3.2.3 Accuracy by Health Facility Level ............................................................................................. 11 3.3 Functioning of the M&E system ........................................................................................... 11 3.3.1 Functioning of the M&E System (Analysis by District) ............................................................ 12 3.3.2 Functioning of the M&E System (Analysis by Facility Type) ................................................... 14 3.3.3 M&E System Performance Dashboard by Health Facilities....................................................... 14 4 Recommendations ............................................................................ Error! Bookmark not defined. 5 Conclusion ................................................................................................................................... 16 LIST OF TABLES Table 1. Health Facilities Assessed by Facility Level and District ......................................................... 5 Table 2. Selected PHFS Indicators for Data Quality Assessment .......................................................... 6 Table 3. Criteria for Assessing the M&E System Components .............................................................. 7 Table 4. Availability and Completeness of Registers and Accuracy of Reported Data by Facility Type ...................................................................................................................................................... 11 Table 5a. District Level Functioning of the M&E System ................................................................... 12 Table 5b. District Level Functioning of the M&E System ................................................................... 13 Table 5c. District Level Functioning of the M&E System ................................................................... 13 Table 6. Health-facility-level functioning of the M&E System ............................................................ 14 ii LIST OF FIGURES Figure 1. Map of Uganda Showing the Six Districts for PHFS Intervention.......................................... 2 Figure 2. Deviation between Reported and Observed Data on Two ART Indicators ............................. 9 Figure 3. Availability and Completeness of Registers and Accuracy of Data Reported ..................... 10 Figure 4. Overall Functioning of the M&E System in the 42 Health Facilities .................................... 12 iii Abbreviations and Acronyms AIDS Acquired Immunodeficiency Syndrome ANC Antenatal Care ART Antiretroviral Therapy ARV Antiretroviral ASSIST Applying Science to Strengthen and Improve Systems Project CDC U.S. Centers for Disease Control and Prevention DQA Data Quality Assessment EID Early Infant Diagnosis eMTCT Elimination of Mother-to-Child Transmission of HIV FANTA Food and Nutrition Technical Assistance III Project HCIII Health Center Level III HCIV Health Center Level IVHIV HIV Human Immunodeficiency Virus HMIS Health Management Information System IYCF Infant and Young Child Feeding M&E Monitoring and Evaluation MOH Ministry of Health NACS Nutrition Assessment, Counseling, and Support OTC Outpatient Therapeutic Care PCR Polymerase Chain Reaction PHFS Partnership for HIV-Free Survival PMTCT Prevention of Mother-to-Child Transmission of HIV QI Quality Improvement RDQA Routine Data Quality Assessment SPRING Strengthening Partnerships, Results and Innovations in Nutrition Globally STAR-EC Strengthening TB & HIV/AIDS Responses in East Central Region of Uganda STAR-SW Strengthening TB and HIV/AIDS Responses in Southwest Region of Uganda TASO The AIDS Support Organization TF/SF Therapeutic or Supplementary Feeding Support USAID U.S. Agency for International Development WHO World Health Organization iv 1 Introduction The Ministry of Health (MOH), together with U.S. Agency for International Development
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