1. IPC INFECTION PREVENTION & CONTROL PROGRAM Improving post-exposure prophylaxis (PEP) reporting and documentation: Experiences from Iringa pilot Amal Ally M&E officer, Jhpiego - IPC Project November, 2014

2. Presentation Outline  Introduction  Methodology  Results  Challenges  Conclusion

3. The IPC program  The Ministry of Health and Social Welfare is strengthening Infection Prevention and Control practices in Tanzania in collaboration with CDC, PEPFAR and Jhpiego  The program is addressing the prevention of healthcare associated infections resulting from exposure to blood borne pathogens (e.g. HIV, Hepatitis B and C)  One strategy for infection control is the strengthening of post exposure prophylaxis (PEP) services, including monitoring and evaluation.

4. What is PEP?  The term PEP means the medical response to prevent the transmission of blood-borne pathogens (BBP), including HIV, following exposure to blood and body fluids  Individuals may sustain potential exposure in the course of their work [Occupational Exposure] OR  Exposure outside the work setting [Non – Occupational Exposure]

5. Characteristics of Comprehensive PEP Services  Reporting assistance and possible referral capacity  Risk assessment  Counselling services  Providing consent for PEP  Pre-and post-HIV test counselling  Drug adherence and managing side effects  Preventing the risk of transmission  HIV testing (for exposed & source persons)  Provide PEP medications (starter & full course)  Support and follow up  Appropriate record keeping and documentation (gap)** WHO/ILO (2007)

6. The PEP recording and documentation before this initiative  All facilities offering HIV/AIDS care and treatment services provide PEP services  Very few had a standardized system for collecting and documenting exposures and PEP service provision  There is limited data on implementation and use of PEP services  There is insufficient data utilization of PEP data both at facility and central level

7. PEP deliverables  National PEP Guidelines  Review IPC standards to address PEP issues  Communication materials  PEP Monitoring and Reporting Tools  Case notes (1 and 2) and patient card  PEP Register  PEP Summary form  Customize PEP summary tool into DHIS (under MOH server)

8. Pilot of Post Exposure Prophylaxis reporting forms in Iringa Region  The pilot was conducted at 9 sites selected by MOH Iringa Regional HospitalIgumbilo Health Center Mafinga District HospitalIpogolo Health Center Ilula District HospitalNgome Health Center Tosamaganga District HospitalItamba dispensary Marie Stopes Iringa

9. Methodology  Developed PEP documentation and reporting tools  Oriented selected National IPC Trainers (MoHSW) on the tools  Conducted Sensitization Meeting with C/RHMTs & HMTs  Identification of PEP focal persons and oriented on PEP M&E tools in 9 facilities  Oriented ART partners on PEP M&E reporting forms and uploading PEP data using DHIS2 system  Continuous follow up visit every 6 month

10. Number of persons provided with PEP by Exposure type (June12 to Sep14)

11. Partners oriented and started rolling out PEP M&E tools PASADA Futures Group ICAP CSSC BMC TUNAJALI/ Dilotte WRP/HJFMRI EGPAF AGPAHI MDH

12. Conclusion  Appropriately designed reporting and documentation tools for PEP are critical for improving PEP services  Integration of PEP standard tool into routine health information system, captured by electronic database will allow for data-driven PEP program planning and resource allocation.

13. Recommendations  R/CHMTs and HMTs roll out the PEP guidelines, PEP M&E tools and the PEP database to facilities in Tanzania.  Partners to support building the capacity/training of the district personnel in utilizing the DHIS2 system (through HMIS/UDSM)  Partners to support the district personnel to ensure quality of data and data completeness in the HMIS system  Establish mechanisms to follow up clients under PEP management at scheduled times and tracing source person HIV status - especially Rape/Assault cases  Improve community sensitization on availability of PEP services

14. Asante sana