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September 13, 2017
SIMS Data Use
2017 PEPFAR Data and Systems Applied Learning Summit
2
Welcome & Introductions
3
Agenda
Topic Estimated Time
1. SIMS data lifecycle
2. SIMS data sources and reference documents
3. Practical experience with data analysis
4. Summary and Conclusion
4
Session Learning Objectives
At the end of today’s session participants will be
able to:
• Understand the SIMS data lifecycle
• Identify sources of SIMS data and reference
documents
• Evaluate PEPFAR results in the context of
service quality using SIMS data, both in
Panorama and through ICPI tools
5
SIMS Background and Data Lifecycle
6
Purpose of SIMS
• Increase the impact of PEPFAR programs by
introducing a standardized approach to
monitoring for program quality and performance
• Primary Objectives
• Monitor capacity to provide high-quality
HIV/AIDS services in all PEPFAR supported
program areas
• Provide data for regional, national, and global
programmatic decision making
• Facilitate use of these data and quality
outcomes to improve services
7
SIMS Assessment Tools
Composed of
Sets of Core
Essential
Elements
(CEEs)
FACILITY
COMMUNITY
ABOVE SITE
Information on
IM/site; Set and CEE
selection to ‘build’ a
tailored Assessment
Tool
CEE Scoring Assessment Tools
Coversheet
8
Assessment Types
1) Comprehensive Follow-Up assessments occur annually at:
High Volume (Facility and Community)
National Entities (Above-Site)
2) USG Focused Follow-Ups are conducted within six months for any assessments that did not pass the 25/50 Rule*.
3) Implementing Partner (IP) should coordinate with the USG Activity Manager to review and agree on rescored CEEs. USG staff are responsible for entering the results from the rescored CEEs for all Follow-Up assessments.
*25/50 Rule: Any assessments that yield scores of >25% Red OR >50% Red + Yellow CEEs.
SIMS Assessment Visit Type Conducted by CEEs to be Assessed
Initial USG All relevant Sets and CEEs
Comprehensive Follow-Up1 USG All relevant Sets and CEEs
Focused Follow-Up USG2 USG Only CEEs which previously scored Red/Yellow
Focused Follow-Up IP Implementing Partner3 Only CEEs which previously scored Red/Yellow
9
What is the 25/50 rule?
A. Number of CEEs that scored RED
B. Number of CEEs that scored RED or YELLOW
C. Total number of CEEs that were assessed
To determine if the 25/50 rule applies:
• Calculate % REDS: = A / C %
• Calculate % REDS + YELLOW: = B / C %
25/50 Rule = > 25% of CEEs Red OR > 50% Red +
Yellow
10
CEE Title
F_1.18 [008] Injection Safety [ALL FACILITIES] Tool
Type
Set
#
Unique ID SET NAME
CEE Name
11
SIMS Life Cycle
Assessment Prep
Conduct Assessment
Data Entry, Review and
Cleaning
Remediation & Follow-up
Planning
SIMS
Coordination
Team
• Confirm w/Partner
• Create Coversheet
& Select Sets
• Prep Go Packs
• Logistics
• Assign Assessors
• Travel
• Record data (Paper
& Tab)
• Onsite
Checks/Dashboard
• Partner
Communication
• Data Entry/Import (Paper or
Tab)
• Data Quality Checks
• Error resolution
• Data Analysis and
Use: Program
Improvement &
Partner Management
• Partner
Communication
• Corrective Action
Plan
• Remediation
• Fiscal/Quarterly Projections
• Partner Communication
• New Assessor Certification
12
SIMS Data System Components
Data Entry Application
(Tablet or Offline Laptop)
SIMS Assessment Results
Data Management System
(HQ database) OGAC Data Exchange
Interface
DATIM
ICPI pulls data from DATIM to populate:
• Panorama
• Quarterly Dashboards
13
SIMS E-Learning Series
Training topics include: Orientation to SIMS Assessment Tools, Implementation Guide, Assessment Procedures, and Remediation
Serves as ‘101’ level training for those who want to increase general knowledge of SIMS. E-Learning is one of the required steps in the training process for all new SIMS Assessors.
URL Link: http://media.go2itech.org/sims/elearning.html
14
SIMS Data Sources and Reference Documents
15
SIMS Data Sources and Reference Documents
Data Sources
• SIMS Quarterly Dashboard
• Panorama
• Agency Database
Reference Documents
• SIMS:MER Linkage Reference Table
16
SIMS Quarterly Dashboard
17
SIMS Quarterly Dashboard
1. Produced every quarter
2. Includes data from FY16Q2 through present
3. Allows for quick overview by:
Assessment type (Initial, Comprehensive Follow-Up, Focused Follow-Up)
Tool type
Set
Individual CEEs
4. Allows for more thorough review of:
Individual assessment results
Aggregate results (IM, site, district)
5. Manipulate pivot tables and graphs to meet needs and interest in partner management and program improvement
18
Dashboard – Table of Contents, Overview, Data Considerations
19
Dashboard – SIMS Implementation
20
Dashboard – SIMS Score by Set
21
Dashboard – SIMS Scores by CEE
Must
match
22
Dashboard – SIMS Implementation (graph)
23
Dashboard – Individual Assessments (pivot)
24
Dashboard – SIMS CEE Scores (graph)
25
Dashboard – SIMS CEE Scores (pivot)
Click on + to
expand
26
Dashboard – SIMS CEE Scores by Type (graph)
27
Dashboard – Dataset for GIS
28
Panorama
29
Panorama
1
2
30
Panorama – Scores Scaled to Total Number
Left-click in
any bar to
see score
breakdown.
31
Panorama – Scores Scaled to 100%
32
Panorama – Scores Split at Meeting/Below Standard
33
Panorama – Implementation Graphs
Number of SIMS Assessments
Reported by Tool & Type
Number of SIMS Assessments
Reported by IM & Type
34
Panorama – Implementation Grid
Column
Sorting:
• Ascending
• Descending
• Advanced
35
Panorama - Mapping
1
3
4
2
36
SIMS:MER Linkage Reference Table
37
SIMS:MER Relationship
1) Data Use a) Program Quality and Implementation Assessment b) Partner and Site Management: Identify program and data
quality issues and best practices c) Contextualize and inform MER-Not a 1:1 relationship
2) Limitations: a) Sampling: SIMS data not a representative sample [SNU
analysis] b) Data Availability: SIMS data not available at all sites [site
analysis] c) Time bound: MER reporting (quarterly/semi-
annual/annual) vs SIMS (once or annual) [site/SNU analysis]
38
SIMS:MER Relationship
• Example 1: MER to SIMS (HTC_TST-high testing numbers/low SIMS scores)
Query: Has quality of HIV Testing been compromised to achieve testing targets? If F_1.11 scores low, are reported HTC_TST numbers accurate?
• Example 2: MER to SIMS (HTC_TST-low testing numbers/high SIMS scores)
Query: Are there testing implementation procedures that can be streamlined to increase testing numbers without compromising quality?
• Example 3 : MER to SIMS (HTC_TST-high testing numbers/high SIMS scores)
Query: Are there best practices that can be captured and used to improve performance at other sites/partners?
• Example 4: MER to SIMS (HTC_TST- low testing numbers/low SIMS scores)
Query: Has program quality and poor implementation impacted ability to achieve targets?
39
SIMS:MER Linkage Reference Table - Summary
40
SIMS:MER Linkages by MER Indicator
41
SIMS:MER Linkages by SIMS CEE
42
SIMS:MER Linkages by Program
43
Practical Experience with Data Analysis
44
Section 3 Content
Handouts
• SIMS Analysis Cheat Sheet
• Programmatic CEE Selections
45
Example: 2nd 90 Care and Treatment
National Strategic Level
Strategic Level PEPFAR
Program Level
Tactical Level
Number of PEPFAR supported PLHIV on
ART (Tx_Curr)
Number PLHIV Identified?
(HTC_Test_Pos)
Number identified Initiated? (Tx_New)
Number initiated Retained?
(Tx_Retain)
2nd 90 83% PLHIV on ART
Host Country Context
Policy env.
Budget/ Cost
Commodities Program Qualty
Staffing Levels
SIMS SIMS
46
Example: Identification of HIV Positives
Framing question
Specific question CEE Unique
ID Impact on HTS_Test_Pos Category
Co
uld
pro
gram
qu
alit
y h
ave
imp
acte
d o
ur
abili
ty t
o id
enti
fy P
LHIV
?
Are HIV Test Results reported accurately?
F_1.11 011
Inaccurate or incorrect HTC-TST # impact ability to detect and enroll patients in care
Data Quality
Have there been any stock-outs that could impact ability to test individuals?
F_1.20 020 Stock-outs of RTKs could impact total number of individuals tested
Testing Quality/Results
C_1.21 221
Is proficiency of testers meeting standards to ensure correct test results are recorded?
F_7.04 079
Poor testing quality may influence test results reported: impact on HTC_TST_POS number?
Testing Quality/Results
F_7.01 076 F_7.02 077 C_1.20 220 C_1.23 223 C_1.34 234
47
Example: Identification of HIV Positives
Low Number
48
Example: Linkages
Framing Question
Specific question CEE Unique
ID Impact on linkage Category
Co
uld
pro
gram
qu
alit
y h
ave
imp
acte
d o
ur
abili
ty t
o id
enti
fy
PLH
IV?
Do we have adequate referral systems for linkage of newly identified HIV positives to care?
F_7.03 078
Poor linkage and referral systems depletes number of patients who can start treatment
Referrals
F_2.08 028
F_3.11 028
C_1.19 219
49
Example: Initiation
Framing Questions
Specific question CEE Unique
ID Impact on TX_NEW Category
is t
he
imp
lem
enta
tio
n o
f te
st a
nd
st
art
hav
ing
an im
pac
t o
n
trea
tmen
t in
tiat
ion
?
Is Test and Start being implemented?
F_12.01 109 Swift transition to Test and Start increases TX_NEW
Treatment Initiation
Are we tracking and offering treatment to all pre_ART patients where Test and Start is offerred?
F_2.01 021
Poor tracking of pre-ART patients results in reduced number of patients started on treatment
Treatment Initiation
F_3.04 021 F_4.06 021 F_2.03 023 F_3.06 023 F_2.06 026
F_2.07 027
Co
uld
dat
a q
ual
ty
hav
e an
imp
act
on
re
sult
s?
Are TX_New results reported accurately?
F_1.10 010
Poor data quality/reporting impact results reported for TX_NEW
Treatment Initiation
F_2.04 024 F_3.07 024 F_4.07 024 F_2.05 025 F_3.08 025 F_4.08 025
Co
uld
av
aila
bili
ty o
f co
mm
od
itie
s h
ave
imp
acte
d
resu
lts?
Are there cases where treatment was not initiated due to ARV shortages?
F_1.16 016
Management of ARV supply chaing and stockouts may delay treatment initiation
Treatment Initiation
A_10.01 490
A_10.02 491
A_10.03 492
A_10.04 493
50
Example: Initiation
51
Example: Initiation
52
General Exercise
1. How many sites did not meet the 25/50 Rule during their initial assessment?
Instructions: Cheat Sheet 2.3, pg. 14
Tab(s): SIMS Implementation or Individual Assessments Pivot
2. How many sites received a follow-up assessment?
Instructions: Cheat Sheet 2.4, pg. 16
Tab(s): SIMS Implementation or Individual Assessments Pivot
3. Which sites did not improve?
Instructions: Cheat Sheet 2.5, pg. 17
Tab: Individual Assessments Pivot
53
How many sites did not meet the 25/50 rule during initial assessment?
Option 1: SIMS Implementation Tab
54
How many sites did not meet the 25/50 rule during initial assessment? (cont.)
By partner:
55
How many sites did not meet the 25/50 rule during initial assessment? (cont.)
Option 2: Individual Assessment (Pivot) tab
56
How many sites received a follow-up assessment?
Option 1: SIMS Implementation Tab
57
How many sites received a follow-up assessment?
Option 2: Individual Assessment (Pivot) tab
58
Which sites did not improve?
Example 1
Example 2
59
Programmatic Exercise: Retention/Adherence
Framing Question
Specific question CEE Unique
ID Impact on TX_RET or
TX_PVLS Category
Co
uld
th
e le
vel o
f re
ten
tio
n/a
dh
eren
ce s
up
po
rt
imp
act
resu
lts?
Are there adequate procedures in place for tracking patients who default on appointments?
F_2.02 021 Defaulters are not retained and are not adherent
Retention/Adherence F_3.04 021 F_4.06 021
Are patients receiving adequate adherence counseling?
F_2.10 030
Poor adherence leads to reduced viral suppression
Adherence F_3.13 030 F_4.09 030 C_2.01 242 C_2.06 247
Are patient monitored for treatment failure?
F_2.11 031 High viral load may indicate poor adherence or DR
Adherence/Viral load suppression
F_3.14 031 F_4.20 031
60
Programmatic Exercise: Retention/Adherence
61
Programmatic Exercise – DREAMS/General Prevention CEEs linked to PP_PREV
C_01.12 [212] Facilitation of Small Group Sessions for HIV Prevention [AP]
C_01.13 [213] Small Group Sessions for HIV Prevention [AP]
C_01.26 [226] Condom Availability (at the Service Delivery Point) [AP-HTC]
C_05.02 [255] Preventing HIV in Girls [OPP]
C_05.03 [254] Girls Secondary Education Transition [OPP]
C_05.06 [226] Condom Availability [OPP]
CEEs linked to GEND_GBV
C_01.17 [217] Standard Guidance for Gender-Based Violence Response in Community Setting [AP]
C_01.18 [218] Gender-Based Violence Referrals in Community Setting [AP]
F_06.01 [074] Capacity to Provide Post-Violence Care Services [GBV]
F_06.02 [075] Availability of Post-Violence Care Services [GBV]
62
Programmatic Exercise – DREAMS/General Prevention
63
Programmatic Exercise – KP_PREV
CEEs linked to KP_PREV
A_04.01 [430] National Guidelines for Key Populations (National level) [GUIDE]
C_01.12 [212] Facilitation of Small Group Sessions for HIV Prevention [AP]
C_01.13 [213] Small Group Sessions for HIV Prevention [AP]
C_04.01 [226] Condom Availability [KP]
C_04.02 [249] Lubricant Availability [KP]
C_04.03 [261] STI Screening and Management Among Key Populations [KP]
C_04.04 [262] Monitoring Outreach for Key Populations [KP]
C_04.05 [263] Peer Outreach Management [KP]
C_04.06 [250] Family Planning/HIV Integration Service Delivery in Community Settings [KP]
C_04.07 [264] Service Referral System [KP]
C_04.08 [265] Data Reporting Consistency – KP_PREV [KP]
F_03.01 [049] Lubricant Availability at Point of Service [KP]
F_03.02 [050] STI Screening and Management for Key Populations [KP]
F_03.03 [051] Service Referral System [KP]
F_03.19 [105] Systems for Family Planning (FP)/HIV Integration [C&T KP]
F_03.20 [106] Family Planning (FP)/HIV Integration Service Delivery [C&T KP]
F_03.21 [032] Partner HIV Testing [C&T KP]
An additional 26 CEEs are linked programmatically to KP.
64
65
66
67
Programmatic Exercise – KP_PREV
68
Feedback
69
Summary
70
Summary
During today’s session we discussed how to:
• Understand the SIMS data lifecycle
• Identify sources of SIMS data and reference
documents
• Evaluate PEPFAR results in the context of
service quality using SIMS data, both in
Panorama and through ICPI tools
71
Questions?
72
Further Resources
Panorama
PEPFAR.net
SIMS Project Page – SIMS 3.0
SIMS Interagency Dashboards – FY17Q3
SIMS:MER Linkage Reference Table
SIMS E-Learning
SIMS Saturday Session
September 16, 2017 9:30am-12:00pm
Country Presentations
SIMS 4.0 Feedback
74
Thank You!