Case Study Details Health Improvements in Cote d’Ivoire
- John Spencer, MEASURE Evaluation
MEASURE Evaluation’s data, demand and use Case Study Series now includes details improvements in data demand and information use in Cote d’Ivoire. The Ivorian Ministry of Health (MoH) and MEASURE Evaluation worked together to improve data collection and analysis, information availability, and information use concerning HIV/AIDS. As a result, from 2006 to 2008, the number of people tested for HIV increased by 77 percent, and the number of people counseled increased by 72 percent.
“Through the use of data in the decision-making process, Cote d’Ivoire was able to spot a weakness in their VCT program and develop policy and programmatic responses that improved service delivery country-wide,” says Tara Nutley, MEASURE Evaluation’s technical lead for data demand and use. “Most significantly, through the continued commitment to information systems improvement and regular data review and use, they were able to see a marked increase in access to and use of services.”
The case study illustrates how recurring cycles of data analysis and information use can improve the quality of, and access to, health care. MEASURE Evaluation and the MoH began working together in 2004 to improve the routine HIV/AIDS information systems (RHIS). They decided to focus on building priority HIV indicators, developing HIV data collection tools, and adding HIV/AIDS information to existing RHIS data reporting forms.
Once developed, these HIV data collection tools and revised RHIS data collection forms improved data collection on HIV services at the facility level. With more effective and reliable systems in place, MEASURE Evaluation and the MoH began collecting data on mother-to-child- transmission (PMTCT), voluntary counseling and testing (VCT) and care and treatment.
Results from the data collection effort were compiled in a 2005 national report distributed to the MoH and key partners, including the World Health Organization, PEPFAR and PEPFAR implementing partners, and the Global Fund. The report found that Cote d’Ivoire needed major improvements in service delivery, and that VCT services were often unavailable or inadequately distributed.
In response to the report, the National HIV Care and Treatment Program created and launched strategies to improve VCT coverage. In 2008, the MoH conducted another round of analysis, to see if these strategies had successfully improved VCT coverage. The synthesis of these data found major improvements: All 18 health regions were offering VCT. Moreover, from 2005 to 2008, the total number of people counseled increased from 127,044 to 218,684, and the total number of people tested increased from 111,147 to 197,428.
“We can learn from this case study that a commitment to improving M&E systems and using the data produced by them in decision making will result in improved coverage of services and uptake of those services,” says Nutley. “It also takes time to establish the systems, use the data and see improvements, so the commitments need to be long lasting. In the case of Cote d’Ivoire, it took four years.”
