PEPFAR-to-MoH Data Alignment An overview Webinar One July 20, 2017
PEPFAR/MoH Data Alignment Cable (1) 1. Ambassador Deborah L. Birx of The Office of the Global AIDS Coordinator and Health Diplomacy (S/GAC) formally asks that posts report or request from their host country Ministries of Health HIV program results for the most recent 12-month period for key indicators including: (1) number of people tested for HIV and were positive; (2) through Prevention of Mother-to-Child Transmission (PMTCT) program, number of women tested for HIV and were positive and on HIV treatment; (3) number of people newly initiating HIV treatment; (4) number of people currently on HIV treatment; and (5) number of people and percentage retained on HIV treatment. 2. Ambassador Birx met with your host country s Minister of Health (MoH) at the World Health Assembly (WHA) in May. During this meeting she discussed your host country s positive trajectory and possibility of reaching UNAIDS 90/90/90 targets before 2020 for all population ages and genders. Together, we will continue to drive programmatic change with increased efficiency and impact through identification of new programmatic solutions to get to 90/90/90. 3. Given that PEPFAR continues to support HIV activities even when not investing directly at the site level (e.g., training of health care workers), it is essential to have a full view of program investments, outputs, and outcomes for national support to the MoH and program response at both site- and abovesite levels. Sharing and using site-level data between PEPFAR and MoH for comprehensive program planning and monitoring of site- and above-site level activities are essential to ensure all of our limited resources are efficiently used to reach program goals.
PEPFAR/MoH Data Alignment Cable (2) 4. Please support your PEPFAR team in accomplishing this work by providing or requesting that the MoH provide the most recent, 12-month period of the key indicators required to jointly monitor the HIV program to reach 90/90/90: (1) number of people tested for HIV and were positive; (2) through Prevention of Mother-to-Child Transmission (PMTCT) program, number of women tested for HIV and were positive and on HIV treatment; (3) number of people newly initiating HIV treatment; (4) number of people currently on HIV treatment; and (5) number of people and percentage retained on HIV treatment. 5. We will work with your country teams beginning July 12, 2017 to support the organization and importation of these data, including expanded health information system support and data visualization. This will be a multi-step process, including: (a) rapid review of current MoH health information systems; (b) mapping indicators and sites; (c) importing data into the DATIM database; and (d) identification and technical support to areas needing strengthening for routine data availability and use. 6. We understand countries are in various stages of health information systems implementation and subsequent data use for real-time program improvement. This data collection exercise will also help identify where PEPFAR can support countries in areas of real-time data collection and use in the shortterm and long-term. Participating Countries: Botswana, Cote d Ivoire, Haiti, Kenya, Lesotho, Malawi, Namibia, Rwanda, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe
High Level Schedule Jul 11 Tuesday Diplomatic cable released Jul 12 Wednesday Kick-off communication, country self-assessment form, and webinar series invitations released Jul 19 Wednesday Comprehensive data alignment activity resource package sent to country teams Jul 20 Thursday Webinar One: Activity and resource package overview; orientation to self-assessment tool Jul 20 Thursday Country team sets up meetings with MoH staff to review activity, complete selfassessment, and plan for the indicator mapping and organizational hierarchy/facility alignment activities Aug 2 Wednesday Country self-assessment form submission deadline Aug 3 Thursday Webinar Two: Organizational hierarchy/facility alignment, Aug 15 Tuesday DATIM facility list locked and organizational hierarchy/facility alignment begins Aug 17 Thursday Webinar Three: Organizational hierarchy/facility alignment and indicator mapping Aug 31 Thursday Webinar Four: Data submission and preparation for hands-on work at PEPFAR Data and Systems Applied Learning Summit (PALS) September 11-15 / 18-22 PALS in Johannesburg** Sep 22 Friday Indicator Mapping Completed Sep 22 Friday Facility Mapping Completed Oct 16 Monday MoH Results Data Submission Open Nov 15 Wednesday MoH Results Data Submission Close 4
Data Alignment Webinar Series Webinar One: Activity and resource package overview; orientation to selfassessment tool Webinar Two: Organizational hierarchy/facility alignment, Webinar Three: Organizational hierarchy/facility alignment and indicator mapping Webinar Four: Data submission and preparation for hands-on work at PEPFAR Data and Systems Applied Learning Summit (PALS) 5
PEPFAR Data and Systems Applied Learning Summit Please note that PEPFAR and Ministry of Health Data Alignment activity will be a topic of discussion during the PEPFAR Summit in South Africa Session 1: September 11-15 Session 2: September 18-22 During the summit, activity-specific courses and country-specific hands-on technical assistance will be provided As indicated in the summit registration materials, please ensure that you send appropriate USG and MoH staff to the summit There will be hands on exercises for countries that request additional support
Resource Package Guidelines, instructions, and templates, and other tools are available at DATIM Support https://datim.zendesk.com Data Import and Systems Administration PEPFAR/Ministry of Health Data Alignment Resources (https://datim.zendesk.com/hc/en-us/sections/115001052206) You can find resources on the following topics: PEPFAR/MoH Data Alignment Overview Indicator Mapping Indicator Definitions Facility Reconciliation Activity Calendar Roles and Responsibilities Activity Self-Assessment Results Data Submission Webinar Recordings
Support Points of Contact / Questions SI Advisors for the respective participating countries are the primary HQ-based point of contact for this activity. Note that Country Chairs and Country Leads should also be included in communications related to this activity. We have formed a dedicated systems sub-team within S/GAC to provide technical support your SI Advisor will be you liaison for working with this team.
The PEPFAR/MoH Data Alignment Activity The components of the Activity Self-Assessment An exercise to help Country Teams and SGAC determine the level of effort required to perform Indicator Mapping, Org Hierarchy Alignment, and Results compilation and submission. Indicator Mapping An activity to identify the indicator and data element from one system that precisely matches the definition of an indicator and data element in another Facility Reconciliation A process to align DATIM organizational hierarchy to MoH Master Facility List. MoH Results Submission The final step in the activity to compile the Results File, which will contain the Ministry s annual results for the relevant indicators by facility.
The Self-Assessment Survey Objective: Determine Level of Effort and feasibility both in country and at OGAC What is the anticipated level of effort involved with performing this activity? Are National Indicators well documented? How well aligned are the PEPFAR and MoH Indicators? Has MoH participated in data alignment or exchange with donors? Is there existing Indicator Mapping between MoH and entities like PEPFAR? Is there a Master Facility Registry? Is there a National HMIS? Are there any unforeseen difficulties in achieving this objective? Determine feasibility of the timeline Help to anticipate the level support we can provide The Self-Assessment was circulated to all countries on 7/12 and can also be accessed on DATIM Support in the Resource Package (https://datim.zendesk.com/hc/en-us/articles/115003605543-activity-self-assessment)
The Self-Assessment It contains 4 sections corresponding to the steps outlined in the Process Description above to be worked through in collaboration work with relevant MoH staff. 1.Facilities 2.Indicators 3.Results and Use of Data 4.Additional Questions
Subject Area Statement The Assessment Tool Less Effort More Effort Selection - click and choose from 1-4 Comments The assessment questions are a combination of free-text entry for open-ended questions and ranking questions Select a range between 1-4 from the dropdown for ranking perceived level of effort. For purposes of this assessment, a score of 4 means minimal effort is expected and 1 indicates high level of effort. For each response, we encourage country teams to provide clarifying comments or relevant additional detail in the "Country Comments" column. 12
PEPFAR-to-MoH Data Alignment Indicator Mapping Overview
Indicator Mapping The process of aligning or matching indicators is what we refer to as the indicator mapping process This entails identifying the indicator and data element from one system that precisely matches the definition of an indicator and data element in another The level of complexity may vary based on the level of disaggregation and what is being collected by MoH In order to map indicators from two disparate systems, they must Agree on indicator definition Agree on disaggregation Agree on level of collection (only facility level results for our purposes)
Data Alignment Indicators Six Indicators PMTCT_ART PMTCT_STAT PMTCT_STAT_POS HTS_TST HTS_TST_POS TX_CURR TX_NEW TX_RET Disaggregations Totals <15 Female <15 Male <15 SexUnknown 15+ Female 15+ Male 15+ SexUnknown AgeUnknown Female AgeUnknown Male AgeUnknown SexUnknown
Indicator Mapping The mapping will ideally consist of a one-to-one link o MoH s [CurrentOnTreatment <14] = PEPFAR s [TX_CURR <15] Some mappings might involve a calculation o [Age 0-11] + [Age 12-14] = [Age <15] Some indicators may not currently be able to be mapped o If the definition does not match 100% to PEPFAR s definition o If results are not collected at the facility level o If the results are not considered official MoH data
Indicator Mapping An indicator mapping template will be provided, along with detailed instructions of how to populate and submit the file once completed
PEPFAR-to-MoH Data Alignment Facility Reconciliation
PEFAR/MoH Facility Reconciliation To meet the PEPFAR data reporting requirement of 2017 to report data from non- PEPFAR supported sites, we need to make sure that all the new facilities that data will be reported for are included in the DATIM organizational hierarchy for the OU. In order to report a data element from a specific facility, we have to make sure that the facility is included in the DATIM organizational hierarchy for that Operating Unit (OU). The PEPFAR/MoH Facility reconciliation is a required activity to ensure that all MoH facilities not supported by PEPFAR in the country are captured in DATIM. No facility in DATIM, no data for it in DATIM.
Why site information in DATIM? It is the Where dimension. The accuracy of the reported data in each OU is dependent on correct classification of sites and Org Hierarchy structure such that regional aggregate reporting is complete and reflective of the actual services delivered.
Organizational Hierarchy Representation of how PEPFAR subnational unit (SNU) geographic areas, administrative areas and clinical facility sites are arranged with respect to each other in DATIM. A graphical depiction of the organizational hierarchy in DATIM Level 1 Level 2 Level 3 Level 4 Level 5 Level 6 Figure 1. - Organizational Hierarchy depiction and the org hierarchy levels for Botswana Key Concepts
Organizational Hierarchy Level The logical representation of each tier in the organizational hierarchy tree based on DATIM s geographic unit of analysis. Dictates site classification. Key Concepts
DATIM Site Hierarchy The entry for each facility in DATIM shows the child-parent relationship. The organizational hierarchy is a conceptual abstraction of the child-parent relationship as a tree structure. At the root of the tree will be your OU. Underneath it, there could be several levels of sub-structures that reflect the structure of service delivery in your country. Key Concepts
Clinical Facility Site The Organizational Unit Type of interest to this effort is the Clinical Facility Site. It represent sites in MoH where facility-level services are administered. They are always the lowest geographical level in the organizational hierarchy. These org units never have children sites. Key Concepts 24
What you need from MoH Getting a list of all MoH recognized health facilities that provide Treatment (TX), PMTCT, and HTS Services. The list is inclusive of PEPFAR supported sites. 25
Where to get it from? 1. MoH Master Facility List if OU has one 2. List of facilities compiled by MoH USG MoH counterpart should contact the authoritative agency and get a list of all facilities if the OU has an MFL. In as much as possible, we encourage all to get as much attributes as possible for the facilities. At minimum, we require you obtain facility information with its parent hierarchy and other attributes. 26
The Process Obtain the MoH list Obtain the list of facilities for your OU in DATIM. This is done for you automatically when you use our Assistant Tool. Use our tool to make sure all MoH facilities are included in the DATIM organizational hierarchy for your OU. The goal is to include all facilities that provide ART and HCT services in your OU. The new list or set that will come out of the reconciliation process will be inclusive of all lists. 27
Facility Reconciliation Process Flow MoH s Master Facility List (MFL) Country s DATIM Org Unit Hierarchy Facility Reconciliation Tool Reconciled MFL DATIM 28
MoH Results File The Results File is the final step in this process, consisting of the compiled MoH facility level results data A template and instructions will be provided, but here are the underlying requirements The file will be formatted in Comma Separated Values (CSV) and use a flat file layout (one facility and data element per row) The file will use the MoH s Facility Codes in accordance to the Facility Reconciliation The file will use the MoH s Data Element Codes in accordance to the Indicator Mapping It will contain the full year results data collected for Fiscal Year 2017 (October 1, 2016 - September 30, 2017) The Transformation Team will be leveraged to facilitate any needed calculations as were defined in the Country s submitted Indicator Mapping
Transformation Team A Transformation Team will be established and tasked with providing support and oversight of the Indicator Mapping, Facility Reconciliation and MoH Results File submitted by the participating PEPFAR country teams The team will be reviewing and normalizing the submitted files, ensuring data integrity and that they conform to the defined formats This may involve: manual manipulation of files validating correct usage of codes as defined by country performing calculations utilizing provided mapping tables and periodic engagement with SI Advisors and Points of Contact from country teams to resolve discrepancies When possible, the Transformation Team will resolve issues on their own without engaging the field Only possible when the changes do not alter the intended meaning of what was submitted
Submitting your data All three of the deliverables will be submitted by USG s In-Country Team, most likely to be facilitated by PCO or the SI Team Once the Facility Reconciliation has been completed, the final mapping will be submitted through the reconciliation tool itself, per the provided instructions The Indicator Mapping and MoH Results File will be submitted to S/GAC through SharePoint
Data Alignment Webinar Series Webinar One: Activity and resource package overview; orientation to selfassessment tool Webinar Two: Organizational hierarchy/facility alignment, Webinar Three: Organizational hierarchy/facility alignment and indicator mapping Webinar Four: Data submission and preparation for hands-on work at PEPFAR Data and Systems Applied Learning Summit (PALS) 32