A Database Stems HIV in Central Asia

Maxim Kan was fed up. He had been painstakingly collecting data files for the previous USAID funded project, aimed at reducing the HIV and tuberculosis epidemics among key populations throughout Central Asia. But his database was outdated. As the Regional Monitoring and Evaluation Advisor at PSI’s Central Asia Office, Maxim needed to conduct ongoing data quality checks and enable data-driven decision-making. His current database wasn’t cutting it.

Maxim dreamed of a new database that allowed PSI to better serve groups at elevated risk of contracting HIV. The previous Microsoft-Access based database didn’t allow Maxim to conduct his reviews until the end of a quarter. On top of poor internet connectivity, the interface made it even more difficult for Maxim to share information between country offices. For the new fast-paced, evidence-driven USAID Central Asia HIV Flagship Activity PSI Central Asia needed a database that could keep up with the expanding number of activities at PSI’s offices.

With a vision for an improved online database to collect information on key populations at risk for HIV, Maxim and PSI Central Asia engaged a talented local web developer – Rashid Shaimerden – to develop something new. PSI management relied on Rashid’s ability to create a new, adept database that would help achieve the project’s goals of decreasing the number of HIV infections and HIV-related deaths in Central Asia.

The database development was an iterative process with multiple meetings between departments to refine the system’s features. Rashid developed the architecture of the database and improved its usability so that teams in the field could easily use the database to record information on clients who came to be tested for HIV. “The hardest thing was to foresee the changes that were happening on a program level, like processing data on confirmation testing, changes in the coupon system, tracking work progress of peer navigators, making database user-friendly for NGOs in general, etc.,” said Rashid. “We had to catch up with those changes that could be specific for each of the three Central Asian countries. It was a time and labor-intensive endeavor.”

The regional nature of the project added to the complexity of the database design. The database covers three Central Asian countries with specific contexts. The new system, called the Management Information System (MIS), has proven to be more robust and comprehensive – it accurately captures the complex processes of HIV case detection and management in the region.

In just a year, the MIS analytical tool enabled PSI and partners to conduct ongoing monitoring and evaluation of the project activities and provide improved comprehensive support to the project teams, all while ensuring that clients’ medical needs were met in a timely manner. “The reporting and monitoring modules of the database allow us to monitor all the operations within the project and give us an opportunity to analyze and adjust our further work. The database facilitates the workload of the project coordinators, which helps them increase their efficiency at work, helping us reach the key populations more quickly,” shared a partner in the Kyrgyz Republic.

Today, program managers and Monitoring & Evaluation specialists can monitor the quality of program implementation and efficiency on a daily basis. With the MIS database, Maxim and his colleagues can now track the number of people who were tested for HIV, learn of their positive result and ensure that each of them receives the help and support they need. This could include timely treatment, other healthcare services, emotional support or legal consultations. With the help of this database, the Flagship project has been able to test more than 32,000 people for HIV, more than 800 new HIV cases have been found and more than 6,000 PLHIV (newly diagnosed, lost to follow up and those who are referred by AIDS center for adherence support) have been involved into community based case management to improve adherence to treatment.

The MIS database currently captures more than 100,000 records from the three Flagship project countries and has a version that can be used on mobile devices. “Our e-health database is an extremely innovative tool for our region, but we will not stop here. We are planning to develop a mobile application that will be synchronized with the database to completely eliminate the paper-based data collection and improve data quality,” says Rashid. “We are determined and ready to take on this new challenge.”