Table 4 Barriers and facilitators for CBVCT data integration into surveillance and M&E systems
Country pilot | Barriers | Facilitators | |
|---|---|---|---|
Slovakia | Information Technology | Lack of standardized data collection tools Technical problems integrating CBVCT indicators into Epidemiological Information System | Existence of free standardized online data collection instruments |
Legal issues | Due to lack of public health insurance, some clients tested in CBVCT services are not able to receive healthcare. People who use drugs are not allowed to receive HCV treatment | ||
Inter organizational relations | Good relations among the different stakeholders (CBVCT service, National Reference Centre for HIV/AIDS prevention, Public Health institute, Ministry of Health) | ||
Poland | Information Technology | Lack of common UCI across the CBVCT database and national case-based surveillance database | Existence of an online data collection tool and a centralized electronic CBVCT database |
Legal issues | Limited mandate of National Aids Centre (dedicated only to HIV prevention) prevented testing for other STIs in VCT services financed by the National Aids centre Legislation for linkage of different databases and data ownership Lack of unique identifier in CBVCT system Due to lack of insurance some clients who were tested in VCT cannot be linked to care and receive ART as well as treatment for hepatitis | Some CBVCT services are already performing testing for other STIs and HCV Data protection and full anonymity for clients can be guaranteed through linkage of anonymous data The extension of the National Aids centre’s mandate beyond HIV/AIDS to STIs prevention, since August 2019 extend the National Aids centre’s mandate beyond HIV/AIDS to STI prevention | |
Inter organizational relations | INTEGRATE project facilitated the cooperation among different stakeholders, mainly among National Aids Centre and National Institute of Public Health – National Institute of Hygiene | ||
Serbia | Information Technology | Data for building UCI in the National registry of HIV cases have slightly different structure than the predefined national UCI. Extra work is required to manually change the UCI generated from the register | The Center for Informatics and Biostatistics, as a part of the Serbian Institute of Public Health and part of the team which implements INTEGRATE, was committed to making the required changes to the databases |
Legal issues | All changes in VCT instruments have to be formalized, which asks for changes in existing regulation | Recommendation by Ministry of Health to guide collaboration between NGOs and regional/district Institutes of Public Health in order to implement CBVCT The official agreement between NGOs and health institutions facilitates implementation of CBVCT in line with legal requirements, and has been evaluated by NGOs as very useful | |
Inter organizational relations | Prior to INTEGRATE, ccooperation among NGOs and health institutions was occasional and not formally focused on reaching key populations | Ministry of Health was supportive in the process of implementing the pilot, as well as regional/district Institutes of Public Health s and other health institutions and NGOs reached with the pilot |