1. TRACE INITIATIVE: Data Use

2. Hello! I am xxx I am here because I love to give presentations.
You can find me at:
@username

3. BACKGROUND

4. Data Use is at the Center of M&E
Improve coverage, reach and intensity of services
Improve program planning and resource allocation
Improve transparency and accountability
Improve quality of data
Make decisions based on evidence
Shape policy decisions and improve advocacy efforts
DATA USE

5. Data Use from an Informatics Perspective

6. Data Use for HIV Recency
How to use MER indicator HTS_recent:
Surveillance
Determination of the percentage of recent infection among newly diagnosed PLHIV will enable countries to identify geographic areas and subpopulations with ongoing transmission and monitor epidemic trends over time 
Programmatic response
Identification of areas and subpopulations with ongoing transmission will allow countries to fine-tune their programmatic response by targeting education, prevention, and testing resources to increase case finding and interrupt transmission.
Proxy incidence
While tests for recent infection among newly diagnosed PLHIV are not currently being used to estimate population-level incidence, a proxy measure of annual incidence among HTS clients may be calculated and serve as a standardized indicator for monitoring epidemiological impact of programs over time.
Implementation
The denominator may be used to monitor the rollout and coverage of testing for recent infection.

7. DATA USE TOOLS

8. Data Dashboards
Programmatic tool to display current, validated, and verified results
By various actors: From facility level to national level for resource and activity allocations, assessing overall impact of resources/activities 
Generated routinely using aggregate data
Over time: Longitudinal progress
Over Geographic location: Hotspots
Over Transmission Networks: Populations
Reviewed by program response team to inform prevention efforts and response to transmission clusters

9. DHIS2 Tracker: Data visualization dashboard
DHIS2 Dashboards support single-software-system solution

10. REDCap: Sample RShiny dashboard

11. Performance and Progress Monitoring Tools
A performance and progress monitoring tool is an information management tool that visually tracks, analyzes and displays
Key performance indicators and metrics: How the study is progressing
Data points to monitor a process: Issues that may need to be investigated
This data is not validated and 'messy'
Will be used to track inconsistencies that may be the result of many errors from various levels
Linkage errors at the above site level 
Incomplete records at the facility level
Lab samples not received at various points
Points to data that may serve as a trigger for further analysis (CQI)

13. Linkage with CQI
Continuous Quality Improvement (CQI) indicators will be collected and should be used to assess the quality of the provision of recency testing
CQI is a philosophy that encourages team members to continuously ask:
How are we doing?
Can we do it better?
Can we do it more efficiently?
Can we be more effective?
Can we do it faster?
Can we do it in a more timely way?

15. IMPORTANCE

16. How It All Comes Together
Data Collection 
Performance and Progress Monitoring Tools (pinpoint possible errors)
CQI Tools (Remediation of said errors)
Verified and Validated data
Data Dashboards (Programmatic use to control the epidemic)

17. Epidemiological Trends
Data can be used to look at HIV recency infection by demographic variables, HIV risk indicators, or geography

18. Example Analyses for HIV Recency Testing

19. % Recent by Assay and RITA

20. % Recent by Facility and Quarter

21. Index Testing Yield Example
HIV yield among partners by index case recency status, Central America, January-August 2018, Guatemala, Nicaragua, and Honduras

22. Recent Cases by Location
Source: Data collected by the Ministries of Health in Guatemala, Honduras, and Nicaragua and presented at the 2018 PEPFAR Annual Meeting by Northbrook S et al.

23. Recent and Long-Term Cases by Location
Source: A pragmatic approach to HIV hotspot mapping in a developing country available at

24. SaTScan Analysis
Source: Data collected by Nicaragua Ministry of Health and presented at the 2018 PEPFAR Annual Meeting by Northbrook S et al.

25. Cluster Investigation
HIV Transmission Cluster
A group of HIV-infected
persons (diagnosed or
undiagnosed) who are
connected by HIV transmission
Represent recent and ongoing transmission in a population
Identifying transmission clusters can help
Identify risk networks that are concerning and key characteristics of these underlying risk networks
Improve outcomes associated these groups and interrupt transmission
Increase knowledge of transmission dynamics to help create new targeted interventions

26. Responding to Potential Clusters
HIV Investigation
Establish an alert system to rapidly describe person, place, and time
Review programmatic data
IP performance
Site-level testing
Utilize index partner testing to target risk network
Ensure accessibility of HIV services in area
Monitor changes over time

27. DISSEMINATION & USE

28. Data Dissemination
Purpose: To inform the national HIV response and guide public health prevention and control measures
Data will be shared widely with in-country stakeholders
Dissemination of results will be in the form of reports and peer-reviewed publications.
What will be shared: Aggregate surveillance data describing where and among whom recent infections are occurring among newly diagnosed PLHIV

29. Integrated Cycle for Program Planning
1. Assessment
2. Strategic Planning
3. Design
4. Implementation/ Monitoring
5. Evaluation
6. Reporting/
Sharing Findings

30. Barriers to Using Data for Program Decision-Making
Availability of data
Quality of available data
Relevance to the population of interest
Relevance of data to planning tasks at hand
Manner in which data are presented
Organizational problems that affect the decision making process

31. Using Data to Make Program Decisions Easily
Step 1
Identify the problem or question you want answered
Step 2
What M&E data is needed to answer the question?
Step 3
Analyze / examine the data
Step 4
Develop a program improvement plan

32. Questions? Comments?

33. Thank You!