Qualitative analysis of a new web-based system for monitoring and evaluation of HIV/AIDS, El Salvador 2009

  • Mengel M
  • Armero J
  • Job F
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Abstract

Background: In February 2009, the Ministry of Health (MoH) of El Salvador launched SUMEVE, a unitary web-based system for monitoring and evaluation of HIV/AIDS. SUMEVE collects data on every person seeking testing or treatment for HIV/AIDS. In May 2009 we performed an early, qualitative analysis to verify whether the system was operating as designed. Methods: We selected a convenience sample of 5/30 collection centres and 6/30 laboratories at regional and central level and performed a qualitative analysis assessing the system's resources and functioning, following CDC (Atlanta)'s "Updated Guidelines for Evaluating Public Health Surveillance Systems". Standardized interviews with SUMEVE-professionals were conducted to explore the system's strengths, weaknesses, opportunities and threats (SWOT-format). Results: Patient data are entered on paper forms when HIV rapid testing is requested at primary health-care facilities and forwarded with the HIV test results to the collection-centres for entry into the online database. 97% of primary health care facilities and 100% of HIV laboratories are reporting to SUMEVE, producing exhaustive data and showing wide system acceptability. Timeliness varies 1- 7 days between generating and digitizing notification forms for instant analysis. SWOT analysis shows as strengths a comprehensive legal framework for SUMEVE which is part of the National HIV/AIDS plan. Registration by name avoids double notification. Results are regularly published on MoH website. Data confidentiality is guaranteed by password-restricted access. The system has a flexible modular design allowing to amend and remove indicators. Identified weaknesses were: lacking reliable internet connection at two of the centres and that notification forms there could not be stored confidentially. As opportunities, we identified advocating renewed political commitment of the current government to guarantee the stability of SUMEVE and take actions in benefit of vulnerable groups identified by SUMEVE. No current threats to the system performance could be identified. Conclusion: SUMEVE is operating as planned on all levels, collecting exhaustive data of at least 97% of primary health care facilities. Identified weaknesses are being improved. SUMEVE is the only surveillance system to direct public health interventions for HIV/AIDS. We recommend performing a re-evaluation after one year to assess the value of the SUMEVE for planning and executing intervention measures.

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Mengel, M., Armero, J., & Job, F. (2010). Qualitative analysis of a new web-based system for monitoring and evaluation of HIV/AIDS, El Salvador 2009. International Journal of Infectious Diseases, 14, e75. https://doi.org/10.1016/j.ijid.2010.02.1655

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