Note: Please also see PDF version of this guidance located at the bottom of the page.
In 2015 the World Health Organization released new HIV treatment guidelines that recommend differentiated HIV service delivery models for stable patients in the era of “Test and Treat.” Many countries are already implementing differentiated models for ART service delivery. Feedback from field programs indicates that flexibility is needed within PEPFAR monitoring and support to align with new models of service delivery.
In the context of FY2016 APR/Q4 reporting, PEPFAR has implemented the following updates to the definition of Direct Service Delivery and Technical Assistance for Service Delivery Improvement (changes highlighted below in yellow):
- Direct Service Delivery (DSD): Individuals will be counted as receiving direct service delivery support from PEPFAR when both of the following conditions are met: Provision of key staff or commodities AND regular (at least once a year) site-level support to improve the quality of service.
- Technical Assistance for Service Delivery Improvement (TA-SDI): Individuals will be counted as supported through TA-SDI when the point of service delivery received regular (at least once a year) site-level support to improve the quality of service.
This change is appropriate given the stable HIV patients (who represent the majority of PEPFAR-supported PLHIV on ART) are now recommended to visit their clinician just once or twice a year. It is important for PEPFAR programs to fully understand the frequency of technical support that different sites are receiving from implementing partners. These data will enable the development of data-driven monitoring or support visit plans that are tailored to site needs rather than applying a single support visit schedule to all sites. Moving forward, this approach will be essential to enable “wellness” models of care for HIV.
In this context, PEPFAR has implanted reporting the frequency of site monitoring and support visits following a phased timeline. For the FY16Q4 reporting period, the number of support visits will be reported for sites that received at least once support visit during FY2016 and provide treatment services.
- For sites that received ≥4 support visits during FY2016, all required applicable indicators should be reported.
- For sites that received between 1, 2, or 3 support visits during FY2016 and provide treatment services, report only two indicators: TX_CURR & TX_RET.
These results should be reported in all areas including Scale-Up, Sustained, and Centrally Supported
Sites in DATIM
DATIM site support visit data entry for TX_CURR and TX_RET will use existing “DSD” and/or “TA-SDI” service delivery tabs. Site support visit data is only required for the numerator value and is not required for disaggregations of TX_CURR or TX_RET. It is anticipated that all sites that meet the revised definition of DSD or TA-SDI for TX_CURR and TX_RET will already be in DATIM. Any sites not in DATIM should be added following the standard procedure. The process is detailed in the following chart.
DATIM Data Entry
Beginning October 14, 2016, a new dataset – Tiered Support: Facilities Reporting TX_CURR, at the FACILITY level, will be available for DATIM users to enter the number of site visits made during the fiscal year (October through September) to facilities reporting on TX_CURR. These data are due on November 15 with the rest of the FY2016 Q4/APR Results.
DATIM Data Workflow
Since the new dataset, Tiered Support: Facilities Reporting TX_CURR, has been implemented outside the DATIM workflow data can be entered at the Partner, Agency, or Interagency level. It is expected that data will be entered by a variety of DATIM users to accommodate the shortened time period for data entry. For example, in one OU an Implementing Partner user may enter data into this form for all sites to which their organization provides service, which an Agency-level user in the same OU may enter data for all sites to which their agency provides services, or an interagency user can enter data for all sites in their OU. It is strongly suggested that data be entered at the partner level.
Availability of Data Entry Levels
- Implementing Partner (only for associated IMs)
- Agency (all IMs for agency in respective OU)
- Interagency (all IMs across all agencies in respective OU)
NOTE Data Import Countries: Only CURRENT data import OUs may submit an import file for Tiered Support. All other OUs will need to enter the data using the data entry screen. See instructions below:
Finding the Form in the DATIM Data Entry App
Data Entry Period for FY16: October 14 at 17:00 Eastern through November 15 at 17:00 Eastern
- Select the Data Entry App in DATIM
- Select the desired facility site.
- From the Data Set dropdown select Tiered Support: Facilities reporting TX_CURR.
- Select the Period for reporting. For FY16 reporting, select October 2015 – September 2016. *NOTE: The number of visits is for the ENTIRE fiscal year, but is only reported during the FYQ4 data entry period.*
- After selecting the reporting period, select the Funding Mechanism association. In DATIM, multiple IMs could technically report these data at the same facility, but please be aware that de-duplication is not applicable for site visits.
- Once the form loads, click the drop-down option to select the number of visits made to the site during the fiscal year. DO NOT manually enter a value, the number will not be saved; use the dropdown.
NOTE: Do NOT select ‘[No value]’ for sites that have received zero visits or received visits but DO NOT report TX_CURR. Sites that received zero visits or do not report TX_CURR do not require a Tiered Support value to be recorded. Instead, [No value] should ONLY be selected if you have entered a value in error for a site that does not require one and thus the erroneous value needs to be deleted.
Tiered Support Data Review
Once the data set becomes available, S/GAC will share a favorite in DATIM named PEPFAR FY16 Q4 Tiered Support Site Count Comparison. DATIM users will be able to compare the number of sites reporting TX_CURR results against the number reporting Tiered Support site visit counts. IMs with mismatched counts can be investigated further by drilling down to the SNU and facility level in DATIM across specific IMs. All sites that report TX_CURR should also have a result for Tiered Support at the facility level. Sites that do not report TX_CURR should not have a Tiered Support Value.