Background

Working in more than 60 countries, the President’s Emergency Plan for AIDS Relief (PEPFAR) program has been vital to the global HIV/AIDS response by supporting nearly 11.5 million people since 2003.

PEPFAR is led and managed by the U.S. Department of State’s Office of the U.S. Global AIDS Coordinator and Health Diplomacy and implemented by seven U.S. government departments and agencies, leveraging the power of a whole-of-government approach to controlling the HIV/AIDS epidemic. The agencies involved are: Department of State, U.S. Agency for International Development, Department of Health and Human Services, Department of Defense, Peace Corps, Department of Commerce, Department of Labor and Department of the Treasury.

PEPFAR’s continued success and impact is achieved by using data to make informed decisions, increase efficiencies, provide open data, and leverage partnerships, including with the private sector.

BAO Systems works as a subawardee to Cardno, who collaborates with Centers for Disease Control and Prevention (CDC) and the Office of the U.S. Global AIDS Coordinator (OGAC) to leverage the resources of the U.S. Government and private sector to meet the PEPFAR goals of improved health outcomes, sustainability, and country ownership.

Challenges

Prior to 2014 the PEPFAR program collected data per country with a variety of software solutions per country. These systems were often custom developed, thereby leading to compatibility issues between vendors collecting the same data in disparate countries. Therefore, data collection and compilation could take months to compile and assemble into the required format that would be submitted to Congress to meet PEPFAR’s mandate. Additionally, the systems were expensive to create, maintain, and support. Lastly, due to the aforementioned factors, data could only be compiled at the district level for countries.

Solution

Beginning with a pilot in Rwanda, BAO Systems was part of the team that helped develop the DHIS 2 system used by the PEPFAR in-country. After a successful pilot, DHIS 2 was modified according to PEPFAR’s needs and then deployed to all PEPFAR countries, later becoming known as Data Accountability Transparency Impact (DATIM). DATIM relies on a single large scale deployment of DHIS 2, thereby allowing countries to enter data at the facility level versus the district level. The data were all processed into a single system versus multiple country systems, thus reducing the time involved to aggregate, clean, compile, and eventually report on data.

Results

By leveraging DHIS 2 for DATIM, PEPFAR now has better methods for data entry, has reduced time to compile, and has greater insight into results via reports, data visualization, and external tools/software. By utilizing this common system instead of multiple disparate systems, PEFAR was also able to achieve the following:

  • Reduce learning curve by using one system versus one per country
  • Speed up data collection to be quarterly instead of semi-annually
  • Provide greater transparency into data collected
  • Unify support into a single platform setup by BAO Systems

Next Steps and Future Opportunities

  • Streamline data flow to include data from DATIM and other PEPFAR systems into a common data warehouse that has abilities for stakeholders to further analyze data.