Health Management information Systems and M&E

Ministers of Health meeting of 2019 made a decision to share data , but data sharing agreement to operationalize this decision has not been signed. Funds are requested to:

1. Support technical assistance to develop a roadmap for the CBRS roll out detailing the roles, functions, and accountability mechanism for the CBRS, safeguards for privacy, rights protection, gender disaggregation, TB service continuity, procedures for efficient data adjudication and data quality procedures. The road map will also include a monitoring system and methods for assessing effectiveness of CBS in improving continuity of TB services. The road map will take a differentiated approach in adaption of CBRS in each country based. This roadmap will be developed through a participatory process involving all countries.
2. Support technical assistance to develop data sharing agreements which define the data sharing protocols, data flow mechanisms and protections as well as use of the data. A regional meeting for all countries will be convened to review the CBRS roadmap and agree on the data sharing agreement.

Intervention 2: Strengthening capacity for implementation of CBRS – Under TIMS 2, 4 countries (Eswatini, Lesotho, Mozambique and Zimbabwe have been trained on the CBRS system and have installed the system in 10 heath facilities in each. 3 countries (Botswana, Namibia, and Zambia) will be trained on the use of the system once they receive the IT equipment expected before June 2021. 3 other countries (Malawi, South Africa, and Tanzania) will adopt the CBRS after streamlining of the CBRS guidelines. The roll out of CBRS will be completed by June 2021 at the close of TIMS 2. TIMS 3 will focus on strengthening the capacity of HCWs and national TB staff in the use of the CBRS in the 10 countries covered under TIMS 2 and document and share lessons with other countries. The funding request will also support the linkage of the CBRS with existing EMR systems for sustainability.

Funds will be utilized to:

1. Conduct training to NTP staff at national, regional and district levels and Healthcare Workers on the CBRS roadmap and data sharing agreement
2. Provide technical assistance to develop a monitoring tool and train the NTP staff and healthcare workers on how to monitor the use of the CBRS system
3. Provide technical assistance to document lessons learnt from the CBRS system and advise on how to link the system with other EMR systems existing in the countries
4. Convene a review meeting to assess the implementation of CBRS, lessons learnt and address any challenges

TIMS 1 and 2 supported the development of a regional HMIS to capture TB in the mines data from countries. However, due to the complexity of the design of the system, the Global Fund review recommended that this system be halted. However, the need for data on key TIMS indicators to inform regional level accountability learning and programming still needs to be addressed. Further, coordination structure proposed in module 1 will need this data to hold countries accountable for their commitments and make strategic decisions.
TIMS 3 proposes to develop a TIMS dashboard to capture TIMS data from countries based on agreed indicators. The dashboard will be an accountability tool monitoring implementation of the TIMS regional operational plan. TIMS 3 will also invest in the revision of country TB data tools to collect data required by the regional TIMS dashboard. The revision of to the tool will, among other issues, allow for collection, analysis and use of data disaggregated by sex and gender. In addition, the dashboard will be linked with the effort to monitor the SADC Protocol on Gender and Development which focuses on gender-responsive legislation, policies and programmes. This investment will build on the work done in TIMS 2 where adjustments to TB data tools was made by 7 countries (Botswana, Eswatini; Lesotho, Malawi, Namibia, Tanzania, and Zimbabwe. Mozambique). The updated tools will be reviewed to ensure they can capture all data required by the dashboard and further changes will be made as necessary.

Funds are requested to:

1. Support technical assistance to develop a detailed roadmap for the development of the dashboard. This roadmap will detail the step by step dashboard development process, establish data flow system, governance structure, the performance-based accountability mechanism within countries where source data will be generated and procedures for identifying and eliminating duplicative data at regional level, specify focal points for reporting.
2. Support technical assistance and support technical meetings to develop TIMS results framework with agreed indicators, baselines, and targets. These meetings will bring together stakeholders from all sectors implementing TIMS initiatives in the all SADC countries.
3. Provide technical assistance to develop a dashboard for TIMS Programme based on the results framework above; develop a country reporting tool as well as the dashboard user guide.
4. Provide technical assistance to countries to revise their data tools to enable them collect data required for reporting to the regional TIMS dashboard. The technical assistance will be tailored to the unique needs of each country
5. Convene annual meetings for TIMS stakeholders to review TIMS data from all countries, identify lessons learnt, challenges and solutions and develop a report for the TIMS coordination structure

1. Conduct a TB in the mining sector situational analysis in the 3 additional SADC countries (DRC, Angola, and Madagascar) and sensitise these countries on the regional response to TB in the mines. This will facilitate effective participation of the additional countries in TIMS programme.
2. Conduct a mapping and size estimation of ASM communities and develop an ASM TB initiative which will be taken up by countries for implementation. Each of the 8 countries with ASM (Mozambique, Namibia, Malawi, Tanzania, Zambia, Zimbabwe, DRC and Madagascar) will conduct the ASM mapping and size estimation to ensure ownership. Findings from this assessment will inform a regional initiative to reduce ASM vulnerability and improve access to TB and OH services. Through this initiative, countries will increase availability of TB and OH services for ASM. Country reporting on this initiative will be part of the regional TB in the mines accountability framework.