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Introducing a data-driven district-level planning process to strengthen HIV programming, with a vision to achieve 95-95-95 in the state of Andhra Pradesh, India

Title
Introducing a data-driven district-level planning process to strengthen HIV programming, with a vision to achieve 95-95-95 in the state of Andhra Pradesh, India
Presenter
Asha Hegde
Authors
N. Sundari (1), H. Patel (2), C. Laxmeshwar (2), C. Murugudu (2), J. Lalband (2), K. Kumar (2), A. Phalke (2), U. Sharma (3), M. Nyendak (3), D. Joshi (3), D. Canagasabey (4), A. Hegde * (2)
Institutions
(1) Andra Pradesh State AIDS Control Society, Vijayawada, India, (2) PATH, Mumbai, India, (3) Centers for Disease Control and Prevention, New Delhi, India, (4) PATH, Washington, DC, United States

BACKGROUND: Regular analysis and use of programmatic data for planning has the potential to optimize service delivery and program outcomes. Under the CDC-funded Strengthening Strategic Information Management System (SIMS) Project, PATH supported the Andhra Pradesh State AIDS Control Society (APSACS) to roll out a granular data-driven district-level planning process to improve district-level HIV programming to achieve the first 95.
DESCRIPTION: Continuous quality improvement mentors trained and mentored seven District AIDS Prevention and Control Units (DAPCU) to analyze routine data from national HIV information systems reported by service delivery sites/providers (e.g., Integrated Counseling and Testing Centers, link workers); highlight gaps in reaching targets; develop and implement an action plan; and review progress against action plan (see figure).
The DAPCUs implemented this process from August through December 2021. We compared performance data from this period to data from August through December 2020 to understand if this process led to improved performance against HIV testing indicators.


LESSONS LEARNED: There was an observed increase in achievement (table) for annual HIV testing targets (39.7% versus 20.5%; p<0.001) and partner testing (45.0% versus 40.4%; p<0.001). There was no change observed in linkage to treatment (97.7% during both time periods).
Data-driven monthly discussions with DAPCUs and site-level teams enabled mid-course adjustments and informed district-level decisions. Monthly review meetings provided a valuable opportunity for cross-learning; exchanging experiences with peer groups; and refining data required to measure and evaluate specific activities.


Percentage achievement for annual HIV testing targets
Percentage linkage to treatment
Percentage of partners of newly-diagnosed HIV positive people tested
August-December 2020
20.5%
(81,109/394,643)
97.7%
(2,169/2,221)
40.4%
(877/2,169)
August-December 2021
39.7%
(156, 671/394,643)
97.7%
(3,035/3,105)
45.0%
(1,365/3,035)

CONCLUSIONS: Application of the data-driven district-level planning process led to improved performance in HIV testing (number of people tested and percentage of partners tested), leading the APSACS to now expand its use across all districts of Andhra Pradesh. Data-driven decentralized program planning is essential to ensuring that programs at all health system levels progress towards epidemic control targets.

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