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Strengthening health systems through HIV monitoring and evaluation in Sub-Saharan Africa

Ekouevi, Didier Ka,b,c; Karcher, Sophied; Coffie, Patrick Aa,d

Current Opinion in HIV and AIDS: July 2011 - Volume 6 - Issue 4 - p 245–250
doi: 10.1097/COH.0b013e3283479316
Cohort analysis of clinical and treatment outcomes: Edited by Carolyn Williams, Matthew Law and François Dabis

Purpose of review In this review, we describe the challenges faced by using clinical cohorts to perform Monitoring and Evaluation (M&E) and the possible solutions for increasing and strengthening health systems in low-income and middle-income countries.

Recent findings HIV scale-up has facilitated the transition from paper-based medical records to electronic medical records at hundreds of sites in most of the countries in sub-Saharan Africa and the implementation of national HIV databases. However, National M&E systems in resource-limited settings tend to be chronically challenged by persistently incomplete reporting and inaccurate data, which undermines their usefulness. In low-income and middle-income countries, new information technologies such as Web-based systems and mobile phone networks are expanding rapidly. Their use will improve data quality and, therefore, reduce participant dropout and improve reporting rates. These systems have the potential to allow real time access to summary reports and to integrate data from other settings such as maternal and infant health clinics.

Summary The efforts to address the AIDS pandemic in sub-Saharan Africa will require enhanced information systems. Stronger systems are needed to deliver primary healthcare for those with and without HIV, and it is also essential to build and take advantage of synergies across health information systems.

aProgramme PACCI, Abidjan, Côte d'Ivoire, France

bINSERM U-897, France

cDépartement d'Epidémiologie, Faculté Mixte de Médecine et Pharmacie, Université de Lomé, Togo, France

dInstitut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université Victor Segalen, Bordeaux, France

Correspondence to Didier Koumavi Ekouevi, MD, PhD, Programme PACCI, 18 BP 1954 Abidjan 18, Côte d'Ivoire Tel: +225 7 78 08 45; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.