Assessment of a national monitoring and evaluation system for rapid expansion of antiretroviral treatment in Malawi
Assessment of a national monitoring and evaluation system for rapid expansion of antiretroviral treatment in Malawi
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DOI：
10.1111/j.1365-3156.2006.01800.x
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发表时间：
2007-03-01
影响因子：
3.3
通讯作者：
Libamba, Edwin
中科院分区：
文献类型：
--
作者：
Lowrance, David;Filler, Scott;Libamba, Edwin
监测和评估国家抗逆转录病毒疗法（ART）项目至关重要，但尚未建立国家ART患者监测系统的常规标准化评估。马拉维开展了一项雄心勃勃的扩大抗逆转录病毒疗法的工作，到2006年6月，已有57 000多名患者开始接受抗逆转录病毒疗法。我们评估了国家的ART监测和评估系统在马拉维，以确保应对疫情的监测效率和有效性，收集的数据是useful.METHODS的评价，在2005年8月进行，一般遵循更新的指南，评估公共卫生监测系统（CDC）和临时病人监测艾滋病毒护理和ART（WHO）的指南。采用定性方法进行评估，包括12次ART现场访问，在每个站点与ART诊所协调员，临床工作人员和数据管理员进行标准化的关键知情人访谈。结果：卫生部艾滋病毒/艾滋病股设计的国家监测和评价系统成功地实现了其目标，并促进了国家应对艾滋病毒的重要方面。数据收集工具和系统的几个基本变化将有助于更有效地长期评估ART计划，并支持改善患者护理。随着抗逆转录病毒治疗站点和患者数量的不断扩大，目前的手动纸质系统可能不堪重负。识别和实施一个可行的电子数据系统，将保持和提高数据质量和数据记录和报告的效率，提高病人的护理是一个优先事项。结论ART监测和评估系统的评估可以优化国家ART计划的有效性，并应考虑在其他资源有限的国家迅速扩大ART。
OBJECTIVES Monitoring and evaluation of national antiretroviral therapy (ART) programs is vital, but routine, standardized assessment of national ART patient monitoring systems has not been established. Malawi has undertaken an ambitious ART scale-up effort, with over 57 000 patients initiated on ART by June 2006. We assessed the national ART monitoring and evaluation system in Malawi to ensure that the response to the epidemic was being monitored efficiently and effectively, and that data collected were useful.METHODS The evaluation, performed in August 2005, generally followed the Updated Guidelines for Evaluating Public Health Surveillance Systems (CDC) and Interim Patient Monitoring Guidelines for HIV Care and ART (WHO). Assessment was conducted with qualitative methods, including twelve ART site visits, with standardized key informant interviews with ART clinic coordinators, clinical staff, and data managers, at each site. Meetings were also held with key governmental stakeholders, including Ministry of Health and National AIDS Commission.RESULTS The national monitoring and evaluation system devised by the Ministry of Health HIV/AIDS Unit is successful in achieving its objectives, and facilitates important aspects of the national response to HIV. Several basic changes in the data collection tools and system would facilitate more effective long-term assessment of the ART program and support improved patient care. As the number of ART sites and patients continues to expand, the current manual paper-based system may be overwhelmed. Identification and implementation of a feasible electronic data system that would maintain and improve data quality and the efficiency of data recording and reporting and enhance patient care is a priority.CONCLUSIONS The assessment of ART monitoring and evaluation systems can optimize the effectiveness of national ART programs, and should be considered in other resource-constrained countries rapidly scaling up ART.