title: Confronting Challenges in Monitoring and Evaluation: Innovation in the Context of the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive.
abstract: The Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan), which was launched in 2011, set a series of ambitious targets, including a reduction of new HIV infections among children by 90% by 2015 (from a baseline year of 2009) and AIDS-related maternal mortality by 50% by 2015. To reach these targets, the Global Plan called for unprecedented investments in the prevention of mother-to-child transmission of HIV (PMTCT), innovative new approaches to service delivery, immense collective effort on the programmatic and policy fronts, and importantly, a renewed focus on data collection and use. We provide an overview of major achievements in monitoring and evaluation across Global Plan countries and highlight key challenges and innovative country-driven solutions using PMTCT program data. Specifically, we describe the following: (1) Uganda's development and use of a weekly reporting system for PMTCT using short message service technology that facilitates real-time monitoring and programmatic adjustments throughout the transition to a "treat all" approach for pregnant and breastfeeding women living with HIV (Option B+); (2) Uganda's work to eliminate parallel reporting systems while strengthening the national electronic district health information system; and (3) how routine PMTCT program data in Nigeria can be used to estimate HIV prevalence at the local level and address a critical gap in local descriptive epidemiologic data to better target limited resources. We also identify several ongoing challenges in data collection, analysis, and use, and we suggest potential solutions.
authors.affiliation: *Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; †US State Department, Office of the US Global AIDS Coordinator, United States President's Emergency Plan for AIDS Relief (PEPFAR), Washington, DC; ‡Centers for Disease Control and Prevention (CDC), Atlanta, GA §Centers for Disease Control and Prevention (CDC), Entebbe, Kampala, Uganda; ‖National AIDS & STI Control Program, Nigeria Federal Ministry of Health, Abuja, Nigeria; ¶United States Agency for International Development (USAID), Kampala, Uganda; #Health Information Systems Program Uganda (HISP Uganda), Kampala, Uganda; **Centers for Disease Control and Prevention (CDC), Abuja, Nigeria; ††Department of Global Health Sciences, University of California, San Francisco, CA; ‡‡Uganda Ministry of Health, Kampala, Uganda; §§United States Agency for International Development (USAID), Abuja, Nigeria; and ‖‖United States Agency for International Development (USAID), Washington, DC.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Radin
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Abutu
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Okwero
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Adler
authors.forename: Chukwuma
authors.initials: C
authors.lastname: Anyaike
authors.forename: Hilda T
authors.initials: HT
authors.lastname: Asiimwe
authors.forename: Prosper
authors.initials: P
authors.lastname: Behumbiize
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Efuntoye
authors.forename: Rachel L
authors.initials: RL
authors.lastname: King
authors.forename: Linda Nabitaka
authors.initials: LN
authors.lastname: Kisaakye
authors.forename: Dolapo T
authors.initials: DT
authors.lastname: Ogundehin
authors.forename: Benjamin Ryan
authors.initials: BR
authors.lastname: Phelps
authors.forename: Heather
authors.initials: H
authors.lastname: Watts
authors.forename: Fitti
authors.initials: F
authors.lastname: Weissglas
mesh_terms: D003140:Communicable Disease Control / Q000379:methods* / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009549:Nigeria; D011247:Pregnancy; D015397:Program Evaluation / Q000379:methods*; D014454:Uganda; D014480:United Nations