Guidelines for second generation HIV surveillance - World Health ...

More documents

Recommendations

Info

3.2.3. Provide technical support The development of a strong second generation surveillance system often requires technical support at different stages. As for most types of public health programmes, the ultimate goal is to build in-country technical capacity. Some support from international experts can be helpful for protocol development, training, data analysis or report writing. However, for issues of sustainability, it is worth investing time and other resources in training, mentoring or using other opportunities to transfer skills and knowledge to national counterparts. Familiarity with the local context as well as having an in-country presence also makes sound national expertise a more valuable resource in the long term. There are many ways to optimize the technical resources that are available to support surveillance incountry: • Develop rosters of resource persons with experience in specific aspects of surveillance to facilitate access between these individuals and surveillance sites. Many countries have a long history of second generation surveillance and local experts have developed the capacity to provide technical support for conducting surveillance activities. Efforts to engage local experts in formal roles to advise and support second generation surveillance is important for building a sustainable programme. • Invest in opportunities for national resource persons to work with external consultants during incountry visits. This will make remote support more effective; national consultants can benefit from new developments in methods and approaches, while external consultants will benefit from feedback and technical perspectives that consider local contexts. • Take advantage of courses offered through the increasing number of surveillance Knowledge Hubs such as Zagreb in Croatia (http://www.whohub-zagreb.org/) or Kerman in Iran (http://www.hivhub.ir/) to build in-country capacity (20,21). • Ensure that reports and resource materials developed by consultants are filed electronically and are easily accessible to future consultants, especially in-country resource people. Institutional memory about decisions on site selection, protocols and analysis plans are lost as individual managers shift positions, unless special effort is made to store these centrally. 3.2.4. Use external collaborators for surveillance activities In most cases, it is not practical for surveillance units to directly hire or reallocate staff to conduct large probability surveys such as behavioural surveillance surveys or integrated biological and behavioural surveys. This is also true for mapping studies that cover large geographical units. In these situations, a common approach is to contract the fieldwork and data analysis/report writing to a research agency or other organization with the capacity to conduct large surveys. Due to the high transaction costs of managing these types of contracts and in the interest of using standardized protocols, it is also common to engage one organization to conduct surveys across the country. National surveillance units administer the contracts centrally. Even when external agencies are contracted to conduct surveillance activities, it is critical for government surveillance units to maintain a high level of engagement during the various stages of the process. This will ensure that the manner in which surveillance is conducted meets the national technical and ethical standards, and the data address the critical surveillance needs identified. 36
As much as possible, this type of engagement should include: • input into the objectives and key indicators measured • approval of timelines (including sequence and staggering of field work across sites) • review of the protocols and data collection instruments developed by the contracted agency • monitoring visits to field sites • facilitating relationships with nongovernment organizations working with key populations at higher risk, especially marginalized groups such as sex workers, persons who inject drugs and men who have sex with men. • review and feedback on analysis plans, preliminary analyses and final reports. To achieve this level of engagement, organize a technical advisory group that includes in-country resource people with surveillance expertise. This group should meet periodically and review materials at different stages of the process. Evaluating a National Surveillance System The selection of an appropriate agency for conducting surveillance should consider a range of technical competence issues: • Does the agency have experience in conducting surveys with the target population of the surveillance activity • Does the agency have experience of working in the country or region and does the proposed staff speak the local language • Does the technical staff proposed have direct experience with the specific sampling methodology to be used • Does the analytical approach proposed match the survey design (for example, use of specialized software appropriate for analysing this type of data) • Are the technical staff located in-country or does the agency have easy access to technical expertise in the relevant areas (for example, laboratory specialists, advanced statisticians, behavioural scientists, others) When developing the terms of reference and contracts for agencies that will conduct surveillance activities, consider these key issues in addition to technical competence: • Are quality control measures in place (adequate supervision of field teams, caps on the maximum number of interviews conducted per day per interviewer, double data entry) • Are the timeframes for preparation, data collection and analysis/report writing efficient but reasonable for doing quality work Are they adequate for meeting external timelines, for example, planning cycles • Is field staff adequately and fairly paid • Are issues regarding record maintenance, data ownership and dissemination clearly defined • Are there clear links to the decision-making and planning cycle • Has all staff agreed to abide by codes of ethical conduct and to maintain data security 37
Page 1 and 2: UNAIDS/WHO Working Group on Global
Page 3 and 4: UNAIDS/WHO Working Group on Global
Page 5 and 6: Contents Acknowledgements 1. Introd
Page 7 and 8: 1. Introduction 1.1. What is second
Page 9 and 10: 1.4. What this update includes This
Page 11 and 12: • Data from interventions or prog
Page 13 and 14: Epidemic categories Low-level epide
Page 15 and 16: If data from proxy groups have been
Page 17 and 18: 2.2.2. Step 2: Estimate the size of
Page 19 and 20: Table 2.3. Summary of methods for e
Page 21 and 22: In generalized epidemics, distingui
Page 23 and 24: Figure 2.2. Stratification by regio
Page 25 and 26: Figure 2.4. HIV prevalence among AN
Page 27 and 28: 3. Design a comprehensive surveilla
Page 29 and 30: Tips for developing a national surv
Page 31 and 32: Low-level epidemic: brief explanato
Page 33 and 34: Surveillance activities for general
Page 35 and 36: Track key events where the burden o
Page 37 and 38: 3.1.4. Understand mortality trends
Page 39: • Prepare annual reports of the e
Page 43 and 44: Figure 4.2. Using HIV prevalence tr
Page 45 and 46: • Individuals may migrate to urba
Page 47 and 48: Probability surveys are the most ri
Page 49 and 50: Trends among young people or recent
Page 51 and 52: Figure 4.6. Asian Epidemic Model pr
Page 53 and 54: More precise risk behaviour data th
Page 55 and 56: Using data to plan programmes in In
Page 57 and 58: Figure 4.9. Results from Modes of T
Page 59 and 60: How to deal with data aggregation i
Page 61 and 62: Figure A.3. HIV sentinel surveillan
Page 63 and 64: Initiating second generation HIV su
Page 65 and 66: Networks (social, sexual) Outcome P
Page 67 and 68: 17. Patel SV et al. Filling a gap:
Page 69 and 70: Notes .............................
Page 72: For more information, contact: Worl

Guidelines for second generation HIV surveillance - World Health ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?