Milka Bochere Gesicho

If we cannot measure progress, we cannot make progress. This dissertation assesses HIV-indicator data reporting by health facilities for a period of eight years (2011-2018), using Kenya as a case study.

The HIV epidemic remains a challenge globally with highest infected numbers of populations found in countries in east and southern Africa, which in the year 2018 accounted to 20.6 million of the total number of people living with HIV in the word . Sub-Saharan Africa is the epicenter of the epidemic and is estimated to account for 71% of the global burden. Kenya is among the countries with the highest HIV epidemic prevalence, with an estimate of 1.5 million people living with HIV as at 2017 according to the 2018 Kenya HIV estimates report.

In order to eradicate this epidemic, substantive concerted financial efforts have been put in place by various international donors in countries largely affected for purposes of scaling up HIV services such as prevention of mother to child transmission of HIV. As a result, low-middle-income-counties such as Kenya have witnessed continuous efforts aimed at strengthening of health information systems, which have resulted to transition from paper-based medical records to electronic medical records in hundreds of sites as well as implementation of HIV aggregated databases.

These systems have contributed to availability of large amounts of routinely generated HIV data given that health facilities are required by ministries of health (MoH), as well as international donor organizations to report several aggregated indicators as part of HIV Monitoring and Evaluation program. High quality data is salient in decision-making so as to eradicate the epidemic. Nonetheless, despite a longstanding requirement to report HIV-indicator data to the District Health Information Software Version 2 (DHIS2), few rigorous evaluations exist to evaluate performance of facilities reporting at meeting completeness and timeliness requirements overtime. In dissertation, we aim to conduct a comprehensive assessment of the reporting status for HIV-indicators at the national-level using facility reporting completeness and timeliness reporting requirements.

Hence, this dissertation aims to contribute to strengthening HIV monitoring and evaluation (M&E) efforts within the health system through diagnosis of problematic areas that need improvement.