Confronting Challenges in Monitoring Evaluation: Innovation inthe Context of the Global Plan Towards the Elimination of New HIV InfectionsAmong Children by 2015 and Keeping Their Mothers Alive

摘要

The Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan), which was launched in 2011, set a series of ambitious targets, including a reduction of new HIV infections among children by 90% by 2015 (from a baseline year of 2009) and AIDS-related maternal mortality by 50% by 2015. To reach these targets, the Global Plan called for unprecedented investments in the prevention of mother-to-child HIV transmission (PMTCT), innovative new approaches to service delivery, immense collective effort on the programmatic and policy fronts, and, importantly, a renewed focus on data collection and use. We provide an overview of major achievements in monitoring and evaluation across Global Plan countries and highlight key challenges and innovative country-driven solutions using PMTCT program data.Specifically, we describe the following: (1) Uganda’s development and use of a weekly reporting system for PMTCT using short message service (SMS) technology that facilitates real-time monitoring and programmatic adjustments throughout the transition to a “treat all” approach for pregnant and breastfeeding women living with HIV (Option B+); (2) Uganda’s work to eliminate parallel reporting systems whilestrengthening the national electronic district health information system; and(3) how routine PMTCT program data in Nigeria can be used to estimate HIVprevalence at the local level and address a critical gap in local descriptiveepidemiologic data to better target limited resources. We also identify severalongoing challenges in data collection, analysis, and use, and we suggestpotential solutions.