Aligning vertical interventions to health systems: a case study of the HIV monitoring and evaluation system in South Africa.
Aligning vertical interventions to health systems: a case study of the HIV monitoring and evaluation system in South Africa.
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将垂直干预措施与卫生系统相结合：南非艾滋病毒监测和评估系统的案例研究。
DOI：
10.1186/1478-4505-10-2
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发表时间：
2012-01-26
影响因子：
4
通讯作者：
Fonn S
中科院分区：
文献类型：
--
作者：
Kawonga M;Blaauw D;Fonn S
与许多低收入和中等收入国家一样，南非建立了专门的艾滋病毒监测和评价系统，以跟踪国家应对艾滋病毒/艾滋病的情况。然而，尚未对公共卫生部门的执行情况进行评估。由于卫生服务管理的责任在于地区（国家以下）一级，本研究旨在评估艾滋病毒监测和评价系统在多大程度上与地区一级的整体卫生系统监测和评价功能相结合。本研究介绍了艾滋病毒M&E系统的实施，确定在何种程度上，它是与区卫生信息系统（DHIS）相结合，并评估影响艾滋病毒M&E整合的因素。该研究在南非的一个卫生区进行。通过与方案和保健设施管理人员进行关键线人访谈以及审查提供艾滋病毒服务的保健设施的监测和评价记录，收集了数据。数据分析评估了艾滋病毒数据收集、整理、分析和报告程序与卫生保健信息系统相结合的程度。艾滋病毒监测和评价系统是自上而下的，规模过大，占用了大量的精力和资源，主要用于制定抗逆转录病毒治疗指标。艾滋病毒预防指标的制定过程与卫生和健康信息系统相结合。然而，艾滋病毒治疗指标的编制过程绕过了DHIS，抗逆转录病毒治疗指标没有分发给地区保健管理人员。与指定用途资金有关的具体报告要求、政治驱动的必要性以及对DHIS能力的不信任是这种筒仓方法的关键驱动因素。绕过DHIS的并行系统意味着错失了加强全系统监测和评价能力的机会。将艾滋病毒监测与评估（工作人员、系统和流程）纳入卫生系统监测与评估职能，将调动指定用途的艾滋病毒资金，以提高DHIS制定高质量和及时的艾滋病毒指标的能力，这将使计划和卫生系统监测与评估职能受益。这为最大限度地发挥方案系统的协同作用和将加强卫生系统的现有艾滋病毒政策的意图转化为具体行动提供了一种切实可行的方式。
Like many low- and middle-income countries, South Africa established a dedicated HIV monitoring and evaluation (M&E) system to track the national response to HIV/AIDS. Its implementation in the public health sector has however not been assessed. Since responsibility for health services management lies at the district (sub-national) level, this study aimed to assess the extent to which the HIV M&E system is integrated with the overall health system M&E function at district level. This study describes implementation of the HIV M&E system, determines the extent to which it is integrated with the district health information system (DHIS), and evaluates factors influencing HIV M&E integration. The study was conducted in one health district in South Africa. Data were collected through key informant interviews with programme and health facility managers and review of M&E records at health facilities providing HIV services. Data analysis assessed the extent to which processes for HIV data collection, collation, analysis and reporting were integrated with the DHIS. The HIV M&E system is top-down, over-sized, and captures a significant amount of energy and resources to primarily generate antiretroviral treatment (ART) indicators. Processes for producing HIV prevention indicators are integrated with the DHIS. However processes for the production of HIV treatment indicators by-pass the DHIS and ART indicators are not disseminated to district health managers. Specific reporting requirements linked to ear-marked funding, politically-driven imperatives, and mistrust of DHIS capacity are key drivers of this silo approach. Parallel systems that bypass the DHIS represent a missed opportunity to strengthen system-wide M&E capacity. Integrating HIV M&E (staff, systems and process) into the health system M&E function would mobilise ear-marked HIV funding towards improving DHIS capacity to produce quality and timely HIV indicators that would benefit both programme and health system M&E functions. This offers a practical way of maximising programme-system synergies and translating the health system strengthening intents of existing HIV policies into tangible action.
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影响因子：
9.7
作者：
Luck, Jeff;Chang, Carol;Lumpkin, John
通讯作者：
Lumpkin, John
DOI：
10.1097/qad.0b013e32833d45c5
发表时间：
2010-09-10
期刊：
AIDS (London, England)
影响因子：
--
作者：
Cornell M;Grimsrud A;Fairall L;Fox MP;van Cutsem G;Giddy J;Wood R;Prozesky H;Mohapi L;Graber C;Egger M;Boulle A;Myer L;International Epidemiologic Databases to Evaluate AIDS Southern Africa (IeDEA-SA) Collaboration
通讯作者：
International Epidemiologic Databases to Evaluate AIDS Southern Africa (IeDEA-SA) Collaboration
影响因子：
3.2
作者：
Atun, Rifat;de Jongh, Thyra;Adeyi, Olusoji
通讯作者：
Adeyi, Olusoji
影响因子：
5.4
作者：
Bossert, T
通讯作者：
Bossert, T
影响因子：
3.3
作者：
Lowrance, David;Filler, Scott;Libamba, Edwin
通讯作者：
Libamba, Edwin