USAID’s Strategic Information Technical Support (SITES) Activity Souleymane Barry MD, MBA, MPH Chief of Party November 17 2017

Social & Scientific Systems, Inc. Dedicated to public health research and evaluation Established in 1978 to provide scientific support in health-related areas Employee-owned (>575 employees) Integrated team of scientists, public health specialists, physicians, statisticians, and information technologists SSS Company Confidential - Non-disclosure applies 2

Global Public Health Research and Evaluation Service Areas Health Policy and Data Analysis (HPDA) Health services research and policy analysis Analyses of health care cost, quality, and utilization Health insurance coverage Rapid Cycle Evaluation Performance monitoring and improving Health Technology Solutions Statistical programming, modeling and data analysis Database and application development Bioinformatics Dashboards Public Health Sciences (PHS) Survey, data collection, and analysis of data for 50,000+ women to study breast cancer risk factors Clinical Research and Bioscience (CRB) Operational and regulatory support for clinical and bioscience research Data management and biostatistics for phase I–IV trials HIV treatment protocols Steps 1, 2, 3 3

HIV-free generation by 2030 Key HIV Milestones by 2020 90% of all people living with HIV will know their HIV status. 90% of all people with known HIV infection will receive sustained antiretroviral therapy. 90% of all people receiving antiretroviral therapy will have viral suppression HIV-free generation by 2030 Steps 1, 2, 3 4

SSS Proprietary Information Steps 1, 2, 3 SSS Proprietary Information 5 5

Steps 1, 2, 3 6

Cross-cutting Strategies Continuous Evaluation & Innovations Collaborative Learning and Adapting/double feedback loop Extensive Use of Information Technology Graduation Path Approach to self-sufficiency Double-loop feedback for changing the conversations Steps 1, 2, 3 7

Build on “Occasions” for Changing the Conversations Annual Workplan Development Activity Monitoring, Evaluation and Learning Plan Quarterly and Annual Performance and Financial Report CLA and Continuous Evaluation Reports Steps 2, 3 8 8

Occasion 1: Develop a Functional System for PEPFAR Data Management Steps 2, 3 9 9

Occasion 2: Produce Quality, Timely Data for PEPFAR New Conversation? Do we need to wait for complete program reports from under-resourced 6,000+ health facilities to produce quality and timely data for PEPFAR? Alternative approaches? Progressive and predictive modeling Steps 2, 3 10 10

Example of Recent Alert Report by Implementing Partner – HIV Testing Predicted Actual Alert Index IP1 434 . 100 IP2 27,859 18,618 15.6 IP3 3,926 2,550 14.1 IP4 15,278 10,716 10.3 IP5 9,351 7,643 4.2 IP6 123,182 105,812 3.9 IP7 5,620 5,347 2.1 IP8 11,071 10,175 1.6 IP9 715 697 0.8 IP10 63,085 60,770 0.6 IP11 2,167 2,165 In this slide we have reproduced a very small portion of a recent reporting alert summary. This gives you an idea of how all this work is summarized and used. This one is by implementing partner. Results are sorted so that the IPs with the highest need for follow-up are at the top, and those with lowest need are lower on the list. We show only 11 of the 28 IPs for this indicator, but the remaining have alert levels of zero (i.e., no need for follow-up). You can see that the first IP listed had not reported any HIV testing at the time of this report. If this had occurred near or at the reporting deadline, this alert would result in a phone call or e-mail to the IP asking the status of the data. The second IP listed had at this point in time reported 18,618 HIV tests at the facilities it works with, whereas we expected almost 28,000. This generated the second-highest alert level. Again, if this were near the reporting deadline, the MEEPP Team might contact the IP for follow-up.

Occasion 3: Support to GOU Institutions New Conversation: What alternative models for country-led systems? Graduation path approach? Steps 2, 3 12 12

Occasion 4 : Roll Out Electronic Medical Record (EMR) System New Conversations: Are there alternatives to current approaches to rolling out EMR? Time table for eliminating paper-based reporting Steps 2, 3 13

Occasion 5: Improve HMIS and OVC MIS in Selected USAID and DOD-supported Districts New Conversations: Are there alternatives to current approaches to district support for achieving transformational changes? What are the key leverages to supporting districts achieve transformation changes? How to engage communities/households in improving public health?/Alternative Care models Steps 1, 2, 3 14 14

Occasion 6: SITES Analytical Agenda (Targets 11-24) Analyze “Leaks” in the cascade Continuum of Response (COR) UPHIA secondary analysis HIV prevalence and Incidence modeling DQA and HFQAP IP M&E assessment SIMS LQAS Database Steps 1, 2, 3 15 15

New Conversations on SITES Analytical Agenda How to make best use of current fragmented data? What are the innovative data collection and analytical approaches for bridging the knowledge gaps for transformative changes? CLA Steps 1, 2, 3 16 16

How do we define Success? Achieving 25 SITES Goals/Deliverables and related Milestones and Deliverables? Checking the boxes? Steps 1, 2, 3 17

How do we define Success? Sustainable system for producing a custom body of programmatic knowledge and insights to support continuous questioning and validation of current approaches, processes and service delivery models for achieving HIV program goals, and improving the overall health sector Innovations in health/HIV service models and payment methods, safety nets, technical support, resource allocations and incentives for improving health outcomes at client, household and community levels Steps 1, 2, 3 18

THANK YOU Steps 1, 2, 3 19 19