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Epidemiological Profiling Of HIV/AIDS Situation At District And Objective of data triangulation Consolidate the epidemiological profiles (epidemic scenario and programme response) at district & sub-district level with respect to HIV/AIDS for effective planning and implementation of response. Specific Objectives of data triangulation
Expected output of data triangulation A concise report for each district, describing epidemiological profile of the district and providing answers to the vital programme questions related to HIV/AIDS prevention & control in the district. Answers to Vital Programme Questions:
KERALA About the workshop National AIDS Control Organization(NACO) identified Achutha Menon Centre for Health Science Studies(AMCHSS), Sree Chitra Tirunal Institute for Medical Sciences and Technology(SCTIMST) to implement the Data Triangulation exercise in the State of Kerala. With reference to NACO's direction AIDS Prevention and Control Project (APAC) of Voluntary Health Services, Adyar, Chennai (APAC –VHS) supports AMCHSS for conducting the Data Triangulation exercise in Kerala. This is a time bound project to be completed in 3 months. It only involves collation, analysis and interpretation of data from existing sources and does not involve any data collection. It involves the collaborative work of 3 agencies, the Kerala State AIDS Control Society (KSACS), the Technical Support Unit (TSU) of KSACS, and a State Coordinating Agency, for which AMCHSS has been identified by NACO. As a part of the District Epidemiological Profiling using Data Triangulation in Kerala, a workshop was organized by AMCHSS on 15 and 16 February 2010 at the Seminar Hall, AMCHSS. The objective of the workshop was for the capacity building of district programme managers and M&E personnel in data analyses, triangulation and use of data for planning & program review and to emphasize the importance of resource & information collection in a systematic manner to understand the epidemic and response gaps in the district and facilitate evidence-based planning at district & state level. For the capacity building workshop there were 32 participants from Kerala AIDS Control Society working in all 14 districts of Kerala. They were District AIDS Prevention and Control Unit(DAPCU) programme mangers(2 Persons), DAPCU Data Managers (4 Persons), Integrated Counseling and Testing Centre(ICTC) supervisors(2 Persons), ICTC Counsellors(5 persons), M&E (10 Persons), Antiretroviral therapy(ART) Data Managers(5 persons), and ART Medical Officers(4 persons). The workshop was scheduled for two days with sessions on different steps in Data Triangulation continued with a group activity for each step. Day one (15 February) started with an introductory session by Dr. K.R, Thankappan, Professor and Head, AMCHSS. This was followed by a session by Dr.K.Srinivasan, Associate Professor on the objectives and the expected output of the exercise. This was followed by a session by Dr.Pyari T.T, Deputy Director, KSACS on “Basics of HIV/AIDS, current situation in Kerala and the services provided by KSACS”. Session two began with a presentation by Dr.Srinivasan, on “Concepts and framework, thematic areas and triangulation”. This was followed by a presentation on “Data sources” by Dr Amrita Geevarghese explaining the types and availability of data sources to be used for the data triangulation exercise. Then a group work was given to the members of the district teams to enlist all possible data sources available in a district. The post lunch session was delivered on “Quality checks and validation issues” by Dr Jagan Kumar. This was followed by a “hands on” group work for the district teams. The session ended with presentations by the district teams. A session on “HIV levels, trends and differentials” delivered by Dr.Edwin Sam. This session was followed by a group work and a presentation on the levels and trends exercise by all the district teams. Day two began with a presentation on “Drivers of HIV/AIDS epidemic” by Dr Prasanna kumar, Team Leader & Head of Technical Support Unit(TSU) for KSACS. This was followed by a group work on “Understanding drivers of epidemic and group presentations”. All district teams made their presentation on dynamics of HIV transmission and the possible drivers of epidemics. This exercise was based on the mapping data on HRG. A session on “Program response and gaps” was presented Dr Pyari. The post lunch session began with a presentation on “Data Triangulation” by Dr Srinivasan. This followed by a presentation by Dr Vani Srinivas, State Epidemiologist, Karnataka on the tabulation sheets. After this presentation, a session on “Report writing” by Dr Srinivasan was delivered. Mr. Saravanan, representing APAC shared his experience of Data Triangulation exercise done in Tamil Nadu. UTTARAKHAND About the workshop The National AIDS Control Organization (NACO) and All India Institute of Medical Sciences, New Delhi jointly organized the first capacity building workshop on HIV data triangulation for Uttarakhand. It was a three-days workshop. The Uttarakhand participants consisted of UKSACS officers, Technical Support Unit members, District Tuberculosis Officers, academicians from medical colleges of Uttarakhand, counselors, and NGO representatives. A total of 27 participants attended the workshop. We had large number of facilitators and resource persons during the workshop. The facilitators were the epidemiologist working in this project and post-graduate students of Community Medicine at All India institute of Medical Sciences, New Delhi. Resource persons from National AIDS Control Organization, WHO country office, Faculty members from AIIMS, and National Institute of Health and Family Welfare (NIHFW) were present during the deliberations. Their probing questions, suggestions, and approval of the process of the data triangulation were of utmost importance. The training material for the workshop was the Technical Guideline (July 2009) prepared by National AIDS Control Organization (NACO), New Delhi. Many of the resource persons (e.g. Dr. Shashi Kant, Dr. Partho Haldar, Dr. M. Bhattacharya) had contributed in the development of this guideline and hence were familiar with the philosophy and rationale of the manual. They were also the members of National Technical Team for HIV data triangulation in India. All of them had also attended the National Workshop organized by NACO at Jaipur and Lucknow for discussion and dissemination of the Technical Guidelines. The list of participants and resource persons is given as annexure in this report. The Medical Superintendent of All India Institute of Medical Sciences, New Delhi, inaugurated the workshop. The didactic teaching was abridged version of the Technical Guideline to suit the requirements of the participants. Dr. Shashi Kant welcomed the participants and explained the objectives of the workshop and the expected outcome. We started with the word DATA TRIANGULATION – what it was and why was it needed? It was expected that by the end of the workshop, the participants from Uttarakhand would have been empowered to use data triangulation method. They would then go back to their respective districts and collect additional data available at local level and make presentations on HIV/AIDS situation of their respective districts at the follow up second workshop. During the first workshop we found out that some of the participants were not comfortable in using computers and specialized software required for this process. Our resource persons worked hard with participants in different group and exposing them to the process of data triangulation. At the end, we provided them with an exercise (filling of 12 tables and making presentation of their respective district), which was to be done by the participants on their own before the commencement of the second workshop. The template for presentation was discussed with the participants. As a culmination of the workshop a presentation on these areas was made.
Second State Level Data Workshop The second capacity building workshop was the follow up of the first state level workshop for Uttarakhand on epidemiological profiling of HIV/AIDS situation at district and sub-district levels that began in the first week of March. During the first workshop we started with the word DATA TRIANGULATION – what it was and why was it needed? Now in the span of just one and a half months we had swiftly moved forward to the extent that participants from Uttarakhand have used data triangulation method and made presentations on HIV/AIDS situation of their respective districts. The Uttarakhand participants consisted of UKSACS officers, Technical Support Unit members, District Tuberculosis Officers, academicians from medical colleges of Uttarakhand, counselors, and NGO representatives. Almost all of them had participated in the first workshop as well. Therefore, we had continuity in our capacity building workshop. We had large number of facilitators and resource persons during the workshop. The facilitators were the epidemiologist working in this project and post-graduate students of Community Medicine at All India institute of Medical Sciences, New Delhi. They helped the district officials in fine tuning their presentations, and understanding the implications of the observations. Resource persons from National AIDS Control Organization, WHO country office, Faculty members from AIIMS, and funding agency (AIDS Prevention And Control, Chennai, and USAID, New Delhi) were present during the deliberations. Their probing questions, suggestions, and approval of the process and findings of the data triangulation were of utmost importance. Through this process we were able to bring transparency to the whole exercise and also secured concurrence of the findings. Volunteers, including the Accounts Officer, assisted the workshop. The list of 27 participants from Uttarakhand and 19 persons belonging to facilitators, resource persons and volunteers is given as annexure. Second workshop on epidemiological profiling of HIV/AIDS situation at district and sub-district levels was done to assess the progress made in profiling of the districts. It was evident that the effort put in by the participants was far more than the expectations of the organizers. There were presentations by the participants on nine districts of Uttarakhand namely, Champawat, Haridwar, Dehradun, Rudraprayag, Uddham Singh Nagar, Pauri Gadwal, Nanital, Chamoli, Uttarkashi. In addition we had one presentation on Uttrakhand state as a whole that was made by Mr. Gagan Deep Luthra, M7E Officer of UKSACS. The TSU made two presentations; one on TIs and HRGs and another one on ART centre, Dehradun. Presentations were adjudged to be of good quality. Participants took the pain and gathered lots of information about their district and also identified the vulnerable factors about their districts and shared with the entire group. Salient vulnerabilities identified during the presentation:
Suggestions made during the workshop
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