Evaluating the systems used to monitor HIV populations accessing therapy and care in low-income and lower-middle-income countries

Abstract

The scale-up of delivery of antiretroviral therapy (ART) in low-income and middle-income countries has been coupled with the collection of data aimed at monitoring the welfare of the HIV-positive and treated populations in those countries. We aimed to compare the data items collected and reported and the degree of harmonization achieved following the publication of WHO tools for collection and reporting of these data in 2006, and of two United Nations General Assembly Special Session (UNGASS) indicators relating to the health of patients on ART in 2008. Retrospective examination of monitoring tools used in four countries in 2008 and 2010. We examined and compared the type of information collected and reported from treatment and care programmes in Malawi, Uganda, Tanzania and Ukraine. We also assessed the effect of the publication of the WHO-recommended data capture and reporting tools and the UNGASS-recommended indicators on harmonizing data in these four countries 2 years following the publication of each of these tools and indicators. : Although the majority of WHO-recommended data items were included in patient record cards, clinic ART registers and in reports submitted to the ministries of health in the countries by 2010, there remains little concordance between the four countries examined on the specific items included in patient records and monitoring reports. Furthermore, numerous additional items, which differ by country, and which are not included in WHO recommendations, are still recorded and reported. The differences and diversity of data reported across countries continues to challenge our ability to make international comparisons and to assess programme performance.