EVALUATION OF THE HIV SURVEILLANCE SYSTEM WITHIN THE PREVENTION OF MOTHER-TO-CHILD TRANSMISSION PROGRAM, WESTERN AREA URBAN DISTRICT, SIERRA LEONE, 2022

Abstract

In 2015, the HIV surveillance system was established within the Prevention of Mother-to-Child Transmission (PMTCT) Program to monitor HIV epidemiological trends. To date, no studies have evaluated its performance in the Western Area Urban District. This study describes the operation of the HIV surveillance system; assess its performance on key system attributes and usefulness within the PMTCT program in the district. A descriptive cross-sectional study was conducted from October to December 2022.

Eighteen healthcare workers were purposively selected and interviewed using a semi-structured questionnaire to describe the system operations and evaluate qualitative attributes. Health facility registers and the District Health Information System (DHIS2) data were reviewed to assess quantitative attributes. The performance status of each attribute was interpreted using the following scoring system: <40% (poor), 40%-70% (average), and >70% (good).

The HIV surveillance system within the PMTCT program operates as a passive surveillance system. Data reporting is done monthly, and feedback and supervision are conducted quarterly. Simplicity was rated as good; with 73.23% (13/18) of respondents stating that they understood the HIV Testing Algorithm and can perform the test for pregnant women with ease. Acceptability was good, with 96% overall rank indicating willingness of staff to participate.

Stability was rated average, with 65.5% stating the system did not experience breakdowns. Representativeness was poor, with limited participation from private health facilities. Sensitivity was ranked good being that the test kits used to confirm cases are over 95% sensitive. Overall usefulness was average with score of 65.7%. The HIV surveillance system is useful in meeting its objectives. However, the lack of participation from private health facilities suggests that the system may miss cases. It is recommended that private health facilities receive tools and capacity-building training to enhance their participation in the HIV surveillance system.

Keywords: HIV/AIDS, PMTCT, Surveillance, Sierra Leone.