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This technical update of the 2020 viral load data quality module provides further guidance on the recommended data quality assurance activities, updated web annexes to support country implementation, and generic budgets for viral load testing data quality monitoring activities. These are part of ongoing efforts to standardize approaches to ensure that accurate and timely HIV viral load testing data and results are available for both clinical use and to strengthen programme monitoring. This aligns with recommendations outlined in the 2022 WHO Consolidated guidelines on person-centred HIV strategic information on data quality assessment and improvement. The updated guidance on the priority indicators and the key elements of data quality include: - Key indicators to be included in data quality monitoring activities; - Main activities to be included in the viral load testing data quality assessment process; - The calculation of viral load test turnaround times; - Considerations for data quality assessments for sites with electronic data systems; - Sampling for national data quality assessments of sites and clinical records; - Data quality monitoring via lot-quality assurance sampling; - Considerations for facilities with point-of-care or near point-of-care viral load testing; - Considerations for data quality assessments of viral load testing data for pregnant and breastfeeding women; and - Recording the limitations and challenges of data quality monitoring assurance activities.
To ensure that countries can effectively benefit from digital health investments, “digital adaptation kits” (DAKs) are designed to facilitate the accurate reflection of WHO’s clinical, public health and data use guidelines in the digital systems that countries are adopting. DAKs are operational, software-neutral, standardized documentations that distil clinical, public health and data use guidance into a format that can be transparently incorporated into digital systems. For this particular DAK, the operational requirements are based on systems that provide the functionalities of digital tracking and decision support (DTDS) and include components such as personas, workflows, core data elements, decision-support algorithms, scheduling logic and reporting indicators. Web annexes provide certain components in additional detail including: data dictionary (Web Annex A), decision-support logic (Web Annex B), indicator definitions (Web Annex C), and functional and non-functional requirements (Web Annex D). Data elements within the DAK (Web Annex A) are mapped to standards-based terminology, such as the International Classification of Diseases (ICD), to facilitate interoperability. This DAK focuses on providing the content requirements for a DTDS system for HIV care used by health workers in primary health care settings. It also includes cross- cutting elements focused on the client, such as self-care interventions.
WHO’s laboratory-based acquired drug resistance survey method yields robust estimates of acquired HIV drug resistance in adults, children and adolescents taking both dolutegravir and non-dolutegravir based regimens by genotyping remnant specimens from routine viral load testing. Results are used to inform programme decision making regarding optimal ART regimens and support evaluation of programme quality with respect to maximizing viral load suppression and minimizing emergence of resistance in people taking ART.
This user-friendly, comprehensive guide places evaluation in the context of HIV to give all health care professionals the necessary tools for developing and implementing successful HIV interventions. Every aspect of evaluation is discussed, including: the social and political context of evaluation coding and inter-rater reliability procedures barriers to evaluation and solution the dissemination of results the application of theory to HIV interventions. Case studies and examples from both the US and abroad to illustrate practical issues, and numerous tables and figures complement the text.
This policy brief provides guidance on the minimum criteria external quality assurance proficiency testing schemes are required to meet to be used to assess the proficiency of laboratories seeking designation or redesignation as WHO-designated laboratories for the purpose of HIV drug resistance surveillance testing. Routine monitoring and surveillance of HIV drug resistance is one of the key pillars of quality and effective antiretroviral therapy (ART) programming and helps ensure the continuous efficacy of ART and supports countries in achieving the 2030 global goal for HIV epidemic control. WHO has also established a network of HIV drug resistance genotyping laboratories (WHO HIVResNet laboratories) that support the generation of reliable quality-assured HIV drug resistance survey data. Participation in external quality assurance programmes, including annual proficiency testing, is required by WHO for laboratories to obtain and maintain HIVResNet designation status. One limitation with the existing programme is a restricted number of laboratories that can be supported due to funding constraints. To facilitate the inclusion of additional laboratories into the WHO HIVResNet Laboratory Network, WHO in collaboration with the WHO HIVResNet Laboratory Working Group developed minimum criteria for external quality assurance proficiency testing schemes that can be used to support laboratories seeking designation or redesignation by WHO for the purposes of HIV drug resistance surveillance.
The focus of this issue is on global advances in conducting monitoring and evaluation (M&E) of the global response to the HIV/AIDS epidemic. Only by implementing comprehensive and sustainable M&E systems will we know how much progress we are making, as nations and as a global community, in combating this pandemic. The chapters primarily focus on developing nations and are presented largely from the perspective of evaluators working for donors, international agencies, and national governments. Although it is clear that a comprehensive M&E system must eventually include both monitoring and evaluation, the initial aim has been to establish a foundation derived largely from surveys and monitoring information. To date, much of the focus in M&E has come from the global level because new global funding initiatives been launched and required rapid scale-up and the development of technical guidance, international standards, and indicators for monitoring progress and determining success. At the regional and country levels, the challenge has been to implement national M&E plans and systems within a context of overall low M&E capacity and a range of M&E needs.