The aim of the evaluation of an HIV surveillance system is to ensure that the system is monitoring effectively the course of the HIV epidemic. Evaluation enables us to estimate the utility of the system for decision-making, treatment, care and prevention and further HIV research. Evaluation of a surveillance system is a significant learning tool and forms a basis for improving the existing system. Field experiences in conducting HIV surveillance system evaluation indicate that it requires good planning, clear objectives, and a process appropriate for the epidemic context and the level of development of an HIV surveillance system.
Several papers published by WHO and UNAIDS analysed the quality of HIV surveillance systems according to several attributes, including 1) frequency and timeliness, 2) appropriateness of populations under surveillance, 3) consistency of the sites/locations and groups measured over time, and 4) coverage/representativeness of the groups.
A general framework for evaluating a public health surveillance system developed by the US CDC consists of the following steps:
- engaging stakeholders
- identifying and clarifying objectives
- describing the system
- describing the system performance
- conclusions and recommendations
An assessment of how the surveillance system is performing is the key element of the evaluation. It consists of a description of the following attributes of the system: simplicity; flexibility; data quality; acceptability; sensitivity; positive predictive value; representativeness; timeliness and stability.
The course will in particular reflect on the new WHO/UNAIDS guidance document, currently under development, which presents a new framework for evaluation addressing the full range of SGS activities.i The proposed evaluation framework is comprehensive in providing guidelines that consider both the surveillance system as a whole and its individual components. This framework is based upon the lessons learned from assessing, updating, and revising HIV surveillance systems in a variety of regions and contexts.
This course addresses three major areas:
- (I) evaluation of HIV surveillance;
- (II) writing nationa/ regional surveillance reports; and
- (III) communicating surveillance results to different users' groups.
The course will outline the principles and methods of evaluation of each major component of HIV surveillance (case reporting, community-based and facility-based HIV surveillance and data dissemination and use). Lectures will address in particular evaluation in terms of the performance of the system, assessed primarily through data quality, representativeness and stability.
Exercises based on real surveillance data and case examples will be used to illustrate the challenges in evaluation and data interpretation.
During lectures on data presentation, participants will learn how to present data to different audiences such as programme managers, policy makers, communities and the media.
Participants will be able to choose between two group exercises: one that will consist of work on development of a protocol for the evaluation of HIV surveillance, and the other that will work on development of the proposal for the national/ regional surveillance report. Participants will present their protocols on the last day of the workshop.
- Obtaining useful and high-quality HIV surveillance data
- Evaluation of HIV surveillance systems in terms of design and key components
- Evaluation of HIV case reporting and reporting of AIDS deaths
- Evaluation of community-based HIV surveillance
- Evaluation of facility-based HIV surveillance
- Evaluating the analysis, dissemination and use of surveillance data
- Implementation issues that influence surveillance data quality
- Principles of effective data use
- Steps in producing national HIV report
- Presentation of data for different audiences
- Presenting data to specific user groups
- Writing up of press releases
The course consists of lectures, exercises and presentations. Exercises will use real examples of surveillance data with the aim to gain skills in data interpretation and using data for planning of interventions. The group work will consist of development of a proposal for evaluation of a national/ regional HIV surveillance system, or a regional/ national surveillance report.
HIV programme managers, surveillance officers, public health professionals.
The course takes place in five days.
Course lecturers and facilitators
- Ivana Bozicevic, MD, MSc, DrPH, WHO Collaborating Centre for Capacity Development in HIV Surveillance, School of Medicine, University of Zagreb
- Professor Aleksandar Štulhofer, PhD, Faculty of Humanities and Social Sciences, University of Zagreb
- Jurja-Ivana Čakalo, MD, WHO Collaborating Centre for Capacity Development in HIV Surveillance, School of Medicine, University of Zagreb
- Guest lecturer from WHO