Monitoring and evaluation Departmental Minutes held on 27th March 2022

Members present:
Agness Thawani Yollam Manda
Petros Tembo Pachawo Bisani
Dr Jacqueline Huwa Geledati Chiwaya
Joseph Kenneth Odala Sande
Rebecca Banda Maggie Chirwa
John Bosco Mwafilaso Bernadette Samala
Tamala Nyauti Mike Msiska
Charles Machika Bethsheba Chirwa
Apologies
Christine Kamamia Lyse Nkhoma
Vincent Ngwira Luciano Billion
Thomas Satumba Dumisani Ndhlovu
Lameck Kaonga

Minutes for the departmental meeting held on 7th March 2022 were adopted.
Updates from the team
1 Research
Dr. Jacqueline Huwa gave an update on the studies as follows,
Studies that are in preparation / under view

 Visitect AHD-tab shifting study – Submitted to NHSRC

 Cares NCAP study which has been approved by NHSRC
 LeDeA TB survey
 Innovations for screening and prognosis of HIV cancers
 DTG resist mutations study
Currently ongoing

 2WT Study
 DTG switch study
 Health hearts study
 Blanket protocol
Analysis /closed

 PrEP
 Dream
 Family Planning study
Other updates
5 abstracts have been submitted to the interest 2022 scientific conference of which 3 are
posters and 2 are posters and oral.
Submitted Lighthouse data to leDEA and Bwaila to submit later, received queries that were
addressed. The deadline for submission is April 2022.
A meeting with CDC on Blanket protocol was done with a promise of the CDC to review the
concept.
Challenges

 A delay in receiving VL results from PIH for the DTG switch study clients (national
wide concern) due to stock out of abbot reagents.
 Delayed in renovation for the space of the DTG study at Tisungane

2 DQA and SDA

Petros gave a comprehensive report of the Data Quality Assessment (DQA) and Service
Quality Audit (SQA) that took place on the 7 through 10 of March 2022 for all the prototype
and COE sites.
And this is the summary for all sites
SUCCESSES ON HTS, CLINIC, RETENTION, REPORT SERVICES

 EID is well managed in all sites

 Positive clients are linked to ART through physical escorting
 Index testing is being done in all sites except Maula. There is a great improvement on
Index in all sites in terms of Contacts elicitation, and good documentation in both
registers
 AGYW services are available within the facilities through certain components of the
services that are not provided on sites, e.g., Post GBV services and other socio-
economic services.

 Viral load is being well managed in all sites

 IPT is also being administered to newly initiated ART clients
 On retention, most of the facilities report an increase in cumulative registration by
the end of quarter 4, 2022, a drop of clients who died transferring out.
 Tracing for both missed and defaulter is done in all facilities, and documentation of
tracing attempts is done in some facilities. All facilities are doing well on updating
and documenting ART outcomes in both the tracing register and EMR.
CHALLENGES HTS, CLINIC, RETENTION, REPORT SERVICES

 OVC services not provided at LH

 Poor documentation in High Viral load registers
 Most clients have not taken their VL sample upon reaching their milestone at Macro,
Bwaila, and KCH
 IAC not fully documented at Lighthouse, Area 18, Lumbadzi, and KCH
 Clients are not taken their CD4 counts at Chileka, Chitedze, due to the unavailability
of CD4 machines at the site, while Lumbadzi has the machine with no reagents.
 Missing High VL follow-up results in some of the facilities.
 No Re-engagement SOP for the client to psychosocial and identifying barriers in
some facilities
 KCH had 3 out of 11 providers who are not trained on AIT.
 Some facilities had a decrease of clients returned into care.

WAYFORWARD HTS, CLINIC, RETENTION, REPORT SERVICES

 HTS providers were encouraged to timely document ART linkage outcomes, and to
link with the clinic team for any HIV-positive clients tested in the community who do
not show up for ART.
 HTS/CHS to discuss rolling out OVC services at LH HTS.
 To improve documentation and follow up on High viral load.
 Encourage tracers to fill the tracing outcomes in the registers on time.
 Informed to paste the SOP for re-engagement of the client to care on the wall.
 Requested staff at LH to use tracing registers to document tracing outcomes than
improvised hardcovers which is time-consuming in writing outcomes
 Encourage clients to give their real phone numbers and update their particulars
when relocated.
 Encouraged the team to generate incomplete visits, defaulter list, prescription
without dispensations list during every monthly data cleaning
 Encouraged the team to be generating a defaulter list under PEPFAR.
 Report to EGPAF on the poor reports generated from EMR, especially for PEPFAR
disaggregated and TX_ML reports
3 Data management updates by Pachawo
Data activities that are completed

 Kindergarten database development

 HIV Drug Resistance database development
 Viral load Tracking database development
 LIMS/EMR integration
 eMastercard training for retention officers at DSP
Data activities in progress

 EMRS data migration

 Data activities not yet started
 PrEP database development
 PowerApp development

Data activities have not started

PowerApp/Power BI data exchange is the only data activity that has not started but it will be
completed in April.

Research Data Management activities.

Lighthouse submitted data extraction for IeDEA while for Bwaila data it will be sent in April.
ODK data collection tool for 2WT was developed but they are continually updating it.
Other updates

 Support NCAP ODK data collection tool

 NLIMS data extraction.
 Routine and Adhoc data requests.
 Review of PRIMIS code and database.

4 Data Dissag Update from Rebecca

All quarterly and semiannual indicators will be entered in Datim for Q1_2022

HTS and PMTCT

 Data collection was done for the month of January and February and partly collected
for the month of March.
 Data entry is done for the month of January and February.

Index

 Data for January and February is entered and consolidated.

 Data entry for March 2022 started last week.
 Every time they go to the facility, they are also checking on the contacts who were
not tested the previous months within the reporting period.

Challenges
Some data for March is in Temwa’s computer which is currently being reviewed at IT after it
developed a fault. This may have implications on either the budget or data if the problem
takes long unresolved so may require reentry (extra time)
ACTION POINTS

 Data mentors to run all the EMR data cleaning queries so that they assess the
performance of the system in their sites.
 Data mentors to check if and how IAC sessions are being done at their facilities.
 Data mentors whose sites have negative TX new should run the TX_ML to see if it
will give the correct TX_ML report.
 Data mentors to speed up the entry of HTS data for the month of Jan through March
so that the data is compared with Datim data
 Rebecca to consolidate the HTS report for all the sites to use when comparing with
Dissag data.
 M and E to share with the clinic team the DQA, SQA report
 Data mentors to make sure that all the data collection tools are available and well
documented at the facility.
 Rebecca to check with the facilities if they have all the registers and SOPs.

Next meeting to be held on 14th April 2022.