Rapid Monitoring of AIDS Referrals Tested
Results from a pilot test of the Rapid Monitoring of AIDS Referral System (R-MARS) tool kit were recently presented at the Integration for Impact Conference in Nairobi, Kenya. The pilot test in Nyandarua South and Nyandarua North districts in Kenya, conducted from 2010 to 2012, assessed whether the tool kit and its instruments could be successfully adapted and used within a network of HIV/AIDS service providers and determined whether the data gathered during the pilot test were useful for these providers.
A similar pilot test was also carried out during the same time period in Thailand. It assessed whether the tool kit could be applied within networks of clinics, nongovernmental organizations, and community-based organizations in Bangkok and Pattaya that provide services to men who have sex with men.
Catherine Mbaire of MEASURE Evaluation helped implement the Kenya pilot test and presented its results at the Nairobi conference, held in September 2012. Mbaire worked with former MEASURE Evaluation colleague Svetlana Negroustoueva and others in conducting the pilot. In Kenya, the test was carried out in a network of 10 community units and 10 health facilities. For the test, health workers documented referrals to HIV-related services, completed forms, and then compiled and summarized data. The test focused on whether referrals for HIV care were effective between communities and health centers.
The test also involved assessing such steps as engaging stakeholders, training health workers on using R-MARS, assessing the referral system in the two districts, adjusting the data collection and analysis tools to comply with the units' and facilities’ needs, collecting data and reporting on R-MARS indicators, and conducting interviews with individuals involved in the pilot test.
Mbaire’s role throughout the test was to look at the data the health care workers collected and any issues they might be having, especially related to data quality. Mbaire said an example of a quality issue might be a health worker who reports seeing 15 people but claimed to have referred 25 of them. “Of course you can’t refer more people than you saw,” Mbaire said.
MEASURE Evaluation plans further research in 2013 to assess how the information gathered from monitoring the referral system is used for strengthening the health system.