Questions/Answers
Question 1
Please provide a brief summary of the initiative including the problems/challenges it addressed and the solutions that the initiative introduced (300 words maximum)
The Kenya HIV Monitoring and Evaluation Framework for the HV program defines various data subsystems that contribute Strategic Information for decision making at all levels. These Subsystems include the District Health Information System (DHIS), KEMSA logistics Management Information System (LMIS), Community AIDS Program Reporting (CAPR), the TIBU reporting system, MAISHA Certification System among others. In addition, there are other data sources which include the annual HIV estimates data, survey and surveillance data. The M&E framework therefore recommended one county level system that could analyze and present HIV strategic information in a friendly way to inform decision making process at all levels.
The Kenya HIV Situation Room is therefore a dashboard that is highly interactive and has a high analytical capability. It is able to mine data every 20th of the month from the above mentioned M&E subsystems and presents the data in a visual manner that can facilitate data demand and utilization by the decision makers. Development and rollout of the Kenya HIV Situation Room involved the National AIDS Control Council (NACC) and other Government institutions directly engaged in the HIV response including the National AIDS and STI Control Programme (NASCOP), Health Information System (HIS- MoH) and the Kenya Medical Supplies Agency (KEMSA). This project utilized existing data management systems such as the District Health Information Systems (DHIS2), the Global AIDS Monitoring Database (AIDSInfo) and the Logistics Management Information System (LMIS) under KEMSA to visualize Strategic Information through simplified user friendly platform for Policy and programs decision making processes.
In the above scenario, it is evident that the various standalone systems held key data in silos and the desire to have these data aggregated and visualized through a single platform has been helpful in presenting the data for decision making at various levels.
a. What are the overall objectives of the initiative?
Please describe the overall objectives of the initiative (200 words maximum)
The key objectives of the Kenya HIV Situation Room were:
• Utilize the existing data to present select indicators in an interactive and dynamic way to visualize the national, and county situation of HIV and other related indicators.
• Monitor and map situation of ARVs other commodities stock-outs at service delivery points in order to ensure real-time information at local level by location and population and rapidly address service outages.
• Provide an interactive platform that end users can use to visualize the potential outcomes of programmatic and financial decisions.
• Provide simplified graphical tools to monitor new HIV infections and AIDS related deaths for targeted interventions and strengthened quality of services.
• Monitor the implementation of national policies relate to ART and Key populations
• Ensure uptake and use, and quality control of data through on-site supervision.
b. How does the initiative fit within the selected category?
Please describe how the initiative is linked to the criteria of the category (200 words maximum)
Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.
- Policy and decision makers have the full version of the truth (timely access to accurate data) of the state of important health indicators and progress towards sub-national, national and global targets.
- A focus on data capture leads to a transparent and clear approach to addressing data inconsistencies and data gaps so that during the life of the project a clear strategy is developed to ensure data availability and quality is improved continuously.
Question 2
The initiative should improve people’s lives, notably by enhancing the contribution of public services to the implementation of the 2030 Agenda for Sustainable Development and the realization of the SDGs
a. Please explain how the initiative improves the delivery of public services (200 words maximum)
The situation room has had the following outputs that have helped in improving service delivery:
1. A functional multi-agency working team is in place that ensures tracer indicators for key program at high policy levels and at technical service delivery levels across different agencies.
2. There is continuous data review to ensure updates are made as per the situation room updates algorithm.
3. Continuous production of results for key indicators by a technical team and sharing to Policy makers, while highlighting key concerns or areas for decision making.
- For example, in December 2017 the Situation Room reports, it was realized that there was a substantial drop in mothers seeking 4th ANC visit in the months of June to October which was associated with national nurses’ strike. This report was shared with the top policy makers in the Ministry of Health to show the effect of the Nurses Strike on services delivery. The report is attached.
- Coast General Hospital Mombasa has increased its data input into the DHIS system after it emerged that the data was inconsistent from the reports that were generated in the Kenya HIV Situation Room. Other Counties have identified data quality issues and started to address the same.
4. The Kenya HIV Situation Room is able to analyze stock level data on commodities at facility level and the same is being used to avoid stock-outs.
Question 3
The initiative must impact positively a group or groups of the population (i.e. children, women, elderly, people with disability, etc) and address a significant issue of public service delivery within the context of a given country or region.
a. Please explain how the initiative has addressed a significant issue related to the delivery of public services (200 words maximum)
Continuous production of results for key indicators by a technical team and sharing to Policy makers, while highlighting key concerns or areas for decision making.
- For example, in December 2017 the Situation Room reports, it was realized that there was a substantial drop in mothers seeking 4th ANC visit in the months of June to October which was associated with national nurses’ strike. This report was shared with the top policy makers in the Ministry of Health to show the effect of the Nurses Strike on services delivery.
b. Please explain how the initiative has impacted positively a group or groups of the population within the context of your country or region (200 words maximum)
The Kenya HIV Situation Room is able to analyze stock level data on commodities at facility level and the same is being used to avoid stock-outs. Stock level management in facilities have improved significantly with the use of the tool.
Question 4
The initiative must present an innovative idea, a distinctively new approach, or a unique policy or approach implemented in order to realize the SDGs in the context of a given country or region.
a. Please explain in which way the initiative is innovative in the context of your country or region (200 words maximum)
The Kenya HIV Situation Room was to set-up to provide national, counties and other key stakeholders with easy access to key HIV and AIDS data, illustrating complex information in a user friendly manner, and facilitating efficient decision making, programming and investment. It is a dashboard that is highly interactive and has a high analytical capability. It is able to automatically mine data every 20th of the month from the above mentioned M&E subsystems and present the data in a visual manner that can facilitate data discovery, demand and utilization by the decision makers.
This project utilized existing data management systems such as the District Health Information Systems (DHIS2), the Global AIDS Monitoring Database (AIDSInfo) and the Logistics Management Information System (LMIS) under KEMSA to visualize Strategic Information through simplified user friendly platform for Policy and programs decision making processes.
Question 4b
b. Please describe if the innovation is original or if it is an adaptation from other contexts (If it is known)? (200 words maximum)
The innovation is an adaptation of the UANIDS Situation Room which:
1.Was a physical room located at UNAIDS HQ that displayed global and country-level insight about HIV and AIDS status.
2. Was connected to 1 data source only and had global view only
3. Supported UNAIDS only in seeing a global progress perspective
4. It was web-based custom developed solution and only had predefined reports
5. had only annual Data
Question 4c
c. What resources (i.e. financial, human , material or other resources, etc) were used to implement the initiative? (200 words maximum)
1. Financial resources- technical assistance to develop the system, procurement and installation of the equipment. Funds for system maintenance and enhancement.
2. Capacity building plan- need to develop and implement a capacity development plan for the national and county levels.
3. Primary database that is interoperable and that is producing quality data.
4. A committed multi-agency task team to address technical system requirements.
5. Leadership goodwill and acceptance by the users and the policy makers.
Question 5
The initiative should be adaptable to other contexts (e.g. other cities, countries or regions). There may already be evidence that it has inspired similar innovations in other public-sector institutions within a given country, region or at the global level.
a. Has the initiative been transferred to other contexts?
Yes
The situation room was first established at the National level and then replicated in the 47 counties.
Over time, Kenya has received requests and provided technical assistance to other African countries such as Zambia, Lesotho, Zimbabwe, and Uganda. The above mentioned countries visited Kenya for experience, borrowed from the Kenyan experience and eventually managed to set up their own Situation Rooms.
Question 6
The initiative should be able to be sustained over a significant period of time.
a. Please describe whether and how the initiative is sustainable (covering the social, economic and environmental aspects) (300 words maximum)
The NACC with support from development partners has performed the following:
• Procurement, delivery and installation of equipment to all the 47 counties.
• Training of 2 officials from the County Health Department and Office of the Governor for each county.
• Generation and sharing of Monthly Situation Room reports with top policy makers at National and county level including the County Governors and County Executive
Committee members for health Offices.
• Visiting each county to engage with Health Management teams and to further engage with the respective County Executive Committee members of Health was
conducted before equipment were installed.
b. Please describe whether and how the initiative is sustainable in terms of durability in time (300 words maximum)
Once developed, the only requirement is maintenance and system improvement which is less costly. The Situation Room can be expanded indefinitely to include other indicators including the big 4 for the government like the Universal Health Care whose indicators, data sources and frequency of reporting are currently being developed.
Question 7
The initiative should have gone through a formal evaluation, showing some evidence of impact on improving people’s lives.
a. Has the initiative been formally evaluated?
No
Question 8
The initiative must demonstrate that it has engaged various actors such as from other institutions, civil society, or the private sector, when possible.
a. The 2030 Development Agenda puts emphasis on collaboration, engagement, coordination, partnerships, and inclusion. Please describe what stakeholders were engaged in designing, implementing and evaluating the initiative. Please also highlight their roles and contributions (300 words maximum)
A team consisting of the NACC M&E, NACC MIS, MoH-HIS, UNAIDS and District Health Information System support from Norway was formed to develop a platform that would extract data from different sources and perform analytics in the back-end and produce easy to use visuals.
The team held Consensus building meetings to discuss key indicators and essential decision making reports to be displayed for each programme area with the different agencies responsible including KEMSA, NASCOP, MOH and UNAIDS .
Approval from the various agencies to run an Application Programming Interface (API) into the Logistics Supply Chain Management System, the DHIS2 and AIDSInfo databases in order to draw pre-determined indicators was sought. This was granted, reports created and situation room implemented.
Engagement with Counties- The counties were engaged to determine the kind reports they needed and also the technical assistance needed to operationalize the HIV situation room in their Counties.
All the institutions that generate data for the Situation Room were involved in the design, implementation and roll out of the Situation Room. They are further involved in validation and cleaning of the primary data.
Question 9
a. Please describe the key lessons learned, and any view you have on how to further improve the initiative (200 words maximum)
Lessons learnt from this project include the need to have:
1. A functional multi-agency working team to address technical and Strategic Information issues.
2. A multi-agency team to review the correct mapping of indicators to the data elements in the source database and to ensure continuous data updates as per Situation
Room updates algorithm.
3. Continuous production of results for key indicators by a technical team and sharing to Policy makers, while highlighting key concerns or areas for decision making
4. Collaboration between agencies to ensure communication on source database changes are done in good time and remapping or realigning is done in the Kenya HIV Situation Room in a timely manner.