Using epidemiological profiling and Geographic Information Systems to focus for impact

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Anova’s approach to achieving the UNAIDS 90-90-90 targets

Anova is committed to curbing the AIDS epidemic in South Africa by focusing on the UNAIDS 90-90-90 targets, namely, diagnosing 90% of the HIV-infected population, treating 90% of those with a diagnosis and attaining viral suppression in 90% of those on treatment. In order to achieve these targets, we have to focus our operational efforts on the right things, in the right places, in the right way.

The traditional approach, used by many organisations, is to use cascade analyses to determine programme gaps that need to be addressed, to identify under-performing facilities for increased support and to implement best practice models based on literature and past experience.

Anova has now developed a novel approach that enables us to more specifically focus our operational efforts toward achieving the ‘right things’ in the ‘right places’ by identifying target groups who are missing from HIV care and mapping where these groups can be found. The method, which is based on triangulation of epidemiological and monitoring and evaluation (M&E) data, has the potential to enhance the focus of our efforts to improve outcomes of the HIV programme in South Africa and similar settings.

Anova’s novel approach to focus for impact

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Sample map showing which wards to focus on to most efficiently identify the target group, in this case, men aged 30-39 years:

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Lessons learned

Treatment coverage is variable in the different age and gender groups and it is therefore essential to assess programme performance for each group. Triangulating epidemiological and M&E data is a highly valuable approach to provide a nuanced understanding regarding who the HIV programme is serving, and can therefore guide efforts towards addressing gaps in the programme by identifying specific age and gender groups who are being missed.

Using maps to visualise population and programme data in these target groups can identify wards with the greatest Programme Gaps that are the most efficient to target, thereby directing HIV service provision to the right people in the right places in the most efficient way.

Anova is committed to using such evidence-based decision making to further fine-tune efforts toward achieving the 90-90-90 targets, which is increasingly important in a South African context where nuanced efforts are required to address gaps in our maturing HIV programme.

HIV-positive child in remission without treatment Anova making progress in eMTCT