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Understanding and Implementing the Site Improvement Monitori

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Maureen Syowai

on 3 February 2015

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Transcript of Understanding and Implementing the Site Improvement Monitori

Site Improvement Monitoring Systems (SIMS)
Dr. Teresa, Dr Sunguti and Dr. Maureen
Understanding and Implementing the Site Improvement Monitoring Systems (SIMS) Tool
GOAL!
Improved quality of care!
An AIDS Free Kenya!
Mwebale nyo!
Outline
Background

Overview of the SIMS tool

Implementation strategy
Focusing Our Programs to Control the Epidemic & Achieve a Sustainable Response
Demonstrate Effective control of the HIV epidemic
Using data to inform programmatic decisions
Going where the epidemic is: populations with high incidence and risk of infection and geographic focus based on prevalence & disease burden
Rapid scale-up of combination prevention
Improve coverage for neglected populations:
Key populations
TB/HIV co-infected
Pediatrics
Young women and girls
PROGRAM FOCUS : Prioritizing Activities: Core, Near Core, Non Core
Budgetary Realities Require Focus on Critical Activities (Core) Focusing on Highest Impact Interventions
Combination Prevention (PMTCT, ART, Condoms, VMMC)
Prevention (effective/targeted)
OVC – holistic services for families
Neglected & Hard to Reach Populations
Pediatrics
Adolescent girls
Key populations – MSM & TG, FSW, PWID
Health Systems, especially human resources for health, supply chain, lab, and strategic information that will specifically required to support above activities

Overview of the SIMS tool
Separated into 23 domains consisting of:
Adult treatment
Care and Support
Blood Safety, Healthcare Waste Management and Injection safety
Food and Nutrition
Family Planning/HIV Integration
Gender
HTC
Key Populations
Methadone Maintenance Therapy
Laboratory
Point of care testing
Medication management

OVC
Pediatric Care and Treatment
PMTCT
Prevention
TB/HIV
VMMC
Site Management – Finance and Planning
Site Management – Performance Management
Site management – Policy and Practice
Site Management – QM/QI
Site Management – Monitoring and Reporting

Overview of the SIMS tool
Priority domains for ICAP-supported facilities:
Adult treatment
Care and Support
Blood Safety
,

Healthcare Waste Management and Injection safety
Food and Nutrition
Family Planning/HIV Integration
Gender
HTC
Key Populations
Methadone Maintenance Therapy
Laboratory
Point of care testing
Medication management

OVC
Pediatric Care and Treatment
PMTCT
Prevention
TB/HIV
VMMC
Site Management – Finance and Planning
Site Management – Performance Management
Site management – Policy and Practice
Site Management – QM/QI
Site Management – Monitoring and Reporting

PROGRAM FOCUS : Prioritizing Activities: Core, Near Core, Non Core
As PEPFAR’s Blueprint for Creating an AIDS-free Generation states, we must continue to prioritize strategically sound, science-based investments and
rapidly scale-up core HIV prevention, treatment and care interventions
. We must:

Deepen our focus on women and girls to better ensure gender equality in HIV services.
Continue every effort to end the homophobia, sexism, racism and poverty that continue to fuel this relentless epidemic.
Increase access and strengthen services for the key populations most at risk for HIV infection
Constantly and diligently track our progress and adjust our efforts based on the best possible data while maintaining our critical focus and momentum

The most compelling reason for us not to become complacent is that we have come SO far in a short period of time.
 
The good news is that we know what works. After three decades of investment and hard won gains in this epidemic we can developed effective treatments and implemented prevention programs that can truly move us toward an AIDS free generation.
 
However,
in difficult budget times. we must carefully focus on interventions that provide maximum impact
. It’s critical that we ensure a good return on every dollar spent.

Priority areas
Adult treatment
Patient tracking systems
Adherence support
ART monitoring
ART Supply chain
Reference materials
Care and Support
Cotrimoxazole
Patient tracking
ART eligibility
Facility linkage to community care and support services
PHDP services
CPT Supply chain
Healthcare Waste Management and Injection safety
Waste management
Injection safety
Food and Nutrition
Adult C&T nutrition
Pediatric growth monitoring
FP/HIV integration
Systems for FP/HIV integration
FP/HIV integration service delivery
HTC
Compliance with national alg
HT QA
HTC documentation
HTC referrals to HIV C&T
Site level PT
Supply chain for RTKs
HTC safety measures
Priority areas
Lab
Lab biosafety
Testing interruptions
Test SOPs
Quality testing monitoring
QMS
Results and information management
Point of care testing
Testing staff
Supplies, reagents and equipment
Procedures and policies
Quality assurance
Safety
Medication management
Supply chain management
Medication dispensing
Pediatric care and treatment
Pediatric ART eligibility
Pediatric ART monitoring
Supply chain reliability (pediatric ARVs)
Supply chain reliability (pediatric CTX)
Pediatric CTX
Dosing of pediatric ARVs
Enrollment of HIV-infected infants into ART services
Pediatric TB screening
Routine HIV testing for children
Adolescent support services
Pediatric facility referral to community care and support services

Priority areas
PMTCT
ART in PMTCT sites
CTX for pregnant women
PITC for maternity ward patients
ARVs at labor and delivery
EID
CTX for HEIs
Supply chain reliability for EID
Supply chain reliability (Adult ARVs)
Supply chain reliability (CTX)
Supply chain reliability (RTKs)
Patient tracking – mothers and infants for PMTCT
HTC referrals to HIV care and treatment
Prevention
Condom access and availability at point of service
Service referral and linkage system
TB/HIV
TB screening for adults and adolescents
IPT
TB infection control
Routine PITC for adult and adolescent TB patients
ART provision for HIV-positive adult and adolescent TB patients
Routine PITC for pediatric TB patients
ART provision for HIV-positive pediatric TB patients
Facility linkage to community care and support
Supply chain reliability (HIV RTKs)
TB diagnostic evaluation cascade
VMMC
Informed consent
Adverse event management
VMMC follow-up
HTC referrals to HIV care and treatment
Site Management – Performance Management
Staff Performance Assessment
In-Service Training
Supportive Supervision
Site management – Policy and Practice
Stigma and Discrimination
Community Governance
Confidentiality
Priority areas
Site Management – QM/QI
HIV QM/QI System
Assessment and Utilization of Performance Data in QI activities
Site Management – Monitoring and Reporting
Registers
Patient/Beneficiary Records
Data Quality Assurance
Results Reporting

Implementation strategy
The “usual” approach to CDC site visits
The “proposed” approach to CDC site visits
COUNTY GOVERNMENT
USAID
Technical Support through PMT
A+K SMT
Guide project staff on SIMS key indicator evaluation
SIMS committee
Plan for implementation at the county level
Program Officers
Evaluate service delivery; address gaps
M and E:
CQI/Performance tracking with sharing of the dashboard summary
Approach to the SIMS tool
Implementation
Evaluate service delivery
Score indicators and summarize on the dashboard
Green: Surpass expectations
Light green: Meets expectations
Yellow: Needs improvement (3 months feedback)
Red: Needs urgent remediation (1 month feedback)
Full transcript