Monitoring and Evaluation: TIER.Net - Anova Health Institute

20 Pages·2014·0.59 MB·English

Mopani District
Monitoring and Evaluation: TIER.net

Presenter : Mongwe WM

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PRESENTATION OUTLINE
• Introduction
• Tier.net definition
• National TIER. Net implementation progress
reporting
• Monthly/Cohort Report
• Resources
• Tier.net Implementation report
• Data report
• Tier.net maintenance

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Introduction
• South Africa has the largest ART programme
globally with over 1.2 million people on ART.
The presidential mandate to expand access to
treatment implemented in April 2010 has seen
a rapid increase in number of clients on ART.
Standardization of ART monitoring will enable
facilities, sub-districts and districts to track
and respond to the expansion of ART services.

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Introduction (2)
• In December 2010 South Africa’s NDoH introduced the
Tiered ART Monitoring Strategy comprising of a paper-
based (Tier 1), non-networked (Tier 2) and Networked
system(Tier 3) for patient monitoring in line with the
WHOs 3 Tiered ART M&E strategy.

• The goal for the 3 Tiered approach is to provide tools
that best suit the context of the facility to facilitate
standardized reporting information management as
well as patient management nation-wide.

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Tier.net Definition
• A national new monitoring and evaluation system for
ART, called TIER.net (Three Integrated Electronic
Registers).

• The 3-Tiered approach provides the tools to support
the ART monitoring with the system that best suits the
context and resources available to the ART service
point. The three tiers complement each other and all
generate the minimum data required to manage the
ART programme and produce the monthly and
quarterly data elements as approved by the NHC and
NHIS/SA on 10 March 2010.

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Tier.net Definition

• Each of the three tools generate the same monthly and quarterly
reports required for the long-term routine monitoring of patients
on ART and these data meet the reporting requirement of the
NDoH.

• The paper register is based on the WHO paper registers and aligned
to the 2010 clinical guidelines for the management of HIV and AIDS
in Adults, Adolescents and Children. The electronic register was
developed by the Centre for Diseases and Epidemiology Research
(CIDER) at the University of Cape Town to electronically capture the
minimum data elements required monitoring the ART services.

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TIER. Net implementation progress reporting
Definitions
T1 Paper register
Phase 0 Preparation for Tier.net (Buy-in meeting with facility managers, Filing, orientation, process flow etc)
Phase 1 Installation and training
Phase 2
Back capturing
Phase 3 Back capturing with live capturing
Phase 4
Live capturing (back capturing complete) and data cleaning in progress
Phase 5 Data signoff by DIT/PIT after completion of data clean up and baseline audit
Phase 6 - completed Live site and site able to produce Monthly and Quarterly reports
T2 Eligible based on TROA as reported from DHIS
TIER.Net Impl in
Progress Sum of phase 0 - phase 5
T3 SMARTER
Non-Standard anything other than paper register, TIER.Net or SMARTER
e.g. this is not exhautive, but these could include Therapy Edge, Therapy Edge light, Bookwise, PAAB, an
excel spreadsheet, a tick register)
Please include in the comments section the name of the system or a description of the system that is
being used.
If site is listed but not please record as non-standard and highlight the comments section red and indicate that the site is not
an ART site an ART site. We will remove from the master list. It exists in the list as it had previously reported ART
data but this could have been incorrect. 7
Definition of successful
implementation
• The metric for success is facilities routinely
submit monthly and quarterly cohort data to the
DHIS according to the DHMIS Policy and the ART
M&E SOP.
• Maintenance means
– the facility follows the steps in the ART M&E SOP
– such as:
• running the missed appointment reports according to the
schedule outlined by the ART M&E SOP
• conducts quarterly audits
• cleans the data using the data clean-up document prior to
submission of quarterly cohort data

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Completeness
• Complete monthly data reporting is critical to the management of
the ART programme.

• April 2012 the number data elements reduced from 140 data
elements to 4, with two additional calculated data elements.

• These are the minimum data required to monitor the ART service
and serve an important purpose in managing the ART programme
both within a facility but also nationally.

• These data inform enrolment into the programme and also
resource utilisation and allocation, drug procurement estimations,
and other district and facility management activities.

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Monthly/Cohort Report
• Monthly report
– To be printed on the 5th of each month*
– A hard copy signed by Facility Manager
– The signed copy faxed to Sub-district Office by 5th of each month
– The signed copy filed in ring binder in Facility Managers office

• Cohort report
– Interpreted cohort report to be printed on the 5th of each new
quarter
– A hard copy signed by Facility Manager and kept in ring binder in
Facility Managers office
– A dispatch to be sent to sub-district office on 5th of each new quarter

Dates are a guide, if the province has a different data flow date, please adhere to these dates.
The intention is to ensure complete and valid data is reported on time.
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