1. Data Triangulation in HIV Prof Madhulekha Bhattacharya HOD ,Deptt of Community Health Administration National Institute of Health & Family Welfare Munirka,New Delhi--67
2. Data Triangulation Is an analytical approach that integrates multiple data sources to improve understanding of a public health problem and to guide programmatic decision-making to address these problems Involves the synthesis and integration of data from multiple sources through collection, examination, comparison and interpretation By collecting and comparing multiple data sets with each other, triangulation helps to overcome biases inherent in each data source bhattacrya-NIHFW
3. Gather data from multiple sources Refine hypothesis (corroborate, refute or modify) Examine data Planning Triangulation Conducting Triangulation Communicating Results (for Action) A visual representation of the triangulation process
4. Difference from --- Meta Analysis Data triangulation Meta analysis combines rigourous scientific data of similar quality and design to conduct statistical analysis Uses data from diverse sources Lists judgements and limitations of each To be used by programme managers policy makers , and also researchers bhattacrya-NIHFW
5. Steps in Data Triangulation Specify the question Identify data sources, organize the data and identify data gaps Conduct data quality and validation checks Decide on data outlier and/or missing data Refine/revisit the questions chosen for data triangulation Analyze data from different sources for each question Data triangulation Summarize findings and draw conclusions Outline next steps based on findings bhattacrya-NIHFW
6. Questions What are the levels, differentials and trends in HIV/STI in general population, high-risk groups, and the bridge population? What are the drivers of the epidemic? What are the gaps in HIV/AIDS response at district level? What are the data gaps? bhattacrya-NIHFW
12. Data sources 1. Data from HIV Sentinel Surveillance for different population groups 2. ICTC/PPTCT data on HIV prevalence 3. Mapping of HRGs - urban (under TI program) & rural (under Link Worker Program) 4. ART registration data 5. Behavioural Sentinel Survey (BSS) 6. Integrated Biological & Behavioural Assessment (IBBA) 7. Blood Bank data, STD Clinic data 8. Census of India, NFHS-3, DLHS-3 9.Any special studies bhattacrya-NIHFW NATIONAL INSTITUTE OF HEALTH & FAMILY WELFARE MUNIRKA, NEW DELHI – 110067.
24. Trends What has been the trend in HIV/STI prevalence in the general population, among FSWs, MSM-T, IDUs, and clients of FSWs in the district? bhattacrya-NIHFW
25. Comparative trend of HIV Infection among pregnant women from different sources in Gandhinagar
29. Drivers of the Epidemic Size estimation Size and distribution of HRGs and bridge population Underlying vulnerabilities Migration Risk behaviours Risk profile of HRGs and bridge population including condom use behaviour Profile of PLHIV Characteristics and geographic distribution bhattacrya-NIHFW
30. Map of HIV prevalence district wise of PPTCT and number of High Risk Groups at Gujarat.
31. Dual Drivers of STD Epidemics: Populations and Pathogens bhattacrya-NIHFW Pathogen Population Demography Sexual Structure Infectiousness Virulence Duration ß, efficiency of transmission c, contact rate between infected and susceptible D, duration of infectiousness
32. HIV Positivity Talukawise – for General Clients (ICTC) (2008-09) Gujarat HIV Positivity at ICTC – General (2008-09) Gujarat – 5.5 (14645/267840) Mehsana – 11.9 (435/3656) Rapar – 21.8 (12/55) Vadodara - 10.8 (864/7992) Bhachau – 11.7 (40/343) Rajkot – 17.6 (1278/7261) Rajula – 13.3 (8/60) Keshod – 10.1 (57/567) To 5 Amreli –11.6 (113/972) Surat City – 12.4 (2814/22609)
33. HIV prevalence amongst General Clients from ICTC by various characteristics in Gujarat, 2008
34. Drivers of the Epidemic Size estimation Size and distribution of HRGs and bridge population Underlying vulnerabilities Migration Risk behaviours Risk profile of HRGs and bridge population including condom use behaviour Profile of PLHIV Characteristics and geographic distribution
39. Response Gaps What are the gaps in HIV prevention programs HRGs yet to be covered in each taluka of the district HRGs currently being contacted on a regular basis Condom supply against requirement among HRGs HRG’s access to services What are the gaps in HIV/AIDS care, support and treatment programs? Size estimation of PLHA in the district Detection of HIV against the estimate ART registration against the diagnosed Started on ART against the registered Currently on ART against those ever started Differences in the profile of the registered, currently on ART and those who have dropped out of ART bhattacrya-NIHFW
40. Question /Response Gaps What are the gaps in HIV prevention programs HRGs yet to be covered in each taluka of the district HRGs currently being contacted on a regular basis Condom supply against requirement among HRGs HRG’s access to services What are the gaps in HIV/AIDS care, support and treatment programs? Size estimation of PLHA in the district Detection of HIV against the estimate ART registration against the diagnosed Started on ART against the registered Currently on ART against those ever started Differences in the profile of the registered, currently on ART and those who have dropped out of ART
48. IEC Programs Implemented (GUJARAT) IEC Programs Implemented (GUJARAT) I J R C D D C J I R C J D C J C J Category of District J I I R C C D J J C J J C C D J C D R C D C R J I C D U U D R C R J C D 16 DIC -12 J C C J U J 20 JEEVAN DEEP - 20 I R C J C D D J 5 UJAAS - 5 U U J U I IRHAP/LINK WORKER - 8 I D J C I R 8 RED RIBBON CLUB - 8 IDC CAMPAIGN - 22 J C C
50. Outline for presenting the triangulation process and findings…2 4. Discuss data interpretation findings (secondary findings). i. Summarize other secondary results identified through the triangulation analysis. 5. Note limitations (be honest). 6. Summarize findings. 7. Translate findings into: i. need for additional data; ii. programmatic recommendations; iii. policy recommendations. bhattacrya-NIHFW
51. Information flow in the monitoring and evaluation system within the context of strategic information: an overview Health information systems HMIS, vital statistics Programme monitoring Programme evaluation Qualitative studies Behavioural surveys DLHS 1,2,3 Operations research HIV surveillance; Pop based eg NFHS Data management Data analysis and synthesis Use of data for action Communication to the media Advocacy material Estimates (e.g. HIV, ART) Resource allocation Programme planning Reports Policy Formulation bhattacrya-NIHFW
