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An Evaluation of Challenges Associated with Hiv-1 Early Infant Diagnosis Data Management in Kisumu East and Kisumu West Districts in Kenya

Show simple item record KING'WARA Leonard 2021-05-07T12:21:42Z 2021-05-07T12:21:42Z 2014
dc.description.abstract Recent changes to Kenya's early infant diagnosis (EID) testing algorithm have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. While programmatic efforts to reach this target are underway, obtaining complete and accurate data from clinical sites to track progress presents a major challenge. The purpose of this study was therefore to asses challenges (data completeness and accuracy) in relati'on to routine EID data management in Kisumu East and Kisumu West Districts within Kisumu County, Kenya. These districts were chosen because they are covered by six implementing partners (FACES, APHIA PLUS, ICAP, PLAN, KEMRI, and EGPAF) being targeted as opposed to other regions that are being served by only one or two partners. The study adopted a cross-sectional survey. Specifically, the design was concurrent nested mixed methods approach where both quantitative and qualitative data was collected and analyzed. In this design quantitative data was given priority and qualitative data nested within. Purposive sampling was used to select 23 active health facilities across the two districts disproportionate by partners. From the selected facilities a sampling frame of 192 patients was established and a sample size of 130 patient's data selected. Proportionate systematic random sampling was used to select patient data for the study. Quantitative data was collected from the existing raw and soft secondary EID data while qualitative data collected using an in-depth interview guide of various stakeholders. Quantitative data was analyzed using descriptive (means, standard deviation) and inferential statistics (one and two sample proportion z statistics). Accuracy and completeness was determined by computing sensitivity, specificity and predictive values. Qualitative data was analyzed guided by the principles of framework and theme by theme analysis. On accuracy; Infant sex, Infant prophylaxis, Breast feeding information, Entry point, and Test results were found to have registered proportion replicated completeness not significantly different from 99% replication at (p<O.05). The proportion replicated for the remaining data elements like Sample code, Infant Age, Date of sample collection, and PMTCT prophylaxis were found to be significantly different from the 99% replication (p<O.05).On completeness; Sample code and date of sample collection registered completeness beyond the hypothesized value, implying they were complete as required. The remaining data elements including infant sex, infant age, infant prophylaxis, PMTCT prophylaxis, breast feeding information and entry point were significantly lower than the hypothesized completeness value (p<O.OOOI) except for test results that had completeness score equal to O.99.Lastly key challenges remain data quality, level of data usage, and stability of the systems, while the key strengths of the system are the simplicity, flexibility and acceptability. The study therefore concludes that despite the shortage in staffing and other challenges, personnel working in the data management system appear to be dedicated, informed and conscientious. However, this research suggests that there is suboptimal use of the information for local action in certain areas. This assessment thus serves to enlighten policy-makers on the current state of the EID data management system in Kisumu East and West districts en_US
dc.language.iso en_US en_US
dc.publisher Maseno University en_US
dc.title An Evaluation of Challenges Associated with Hiv-1 Early Infant Diagnosis Data Management in Kisumu East and Kisumu West Districts in Kenya en_US
dc.type Thesis en_US

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