Tick Tock And You Don't Stop

a 10 minute update:

It's a technique I tried a few months ago; just write for a finite period of time and see what comes out. This is one of the only ways I've found to force myself to keep blogging when the pressure to write a more substantive post is preventing me from keeping up to date with this thing. There tend to be a few more typos - and the language isn't generally very pretty - but they are certainly more than serviceable for my lowbrow corner of the internet.

Re work: In addition to being the middle of my projects, I have also been asked to start training the people who will be picking up the work when I skip town. This is pretty easy for the TB-HIV coinfection study. I just need to teach an american med student how to use our chart review tool and introduce him to all of the people and clinic processes he'll need to deal with when he's on his own. However, turning over my responsibilities with the ARV decentralisation peeps is going to be quite a bit trickier. I struggle to understand all of the complexities that surround Monitoring and Evaluation and Clinical Systems Improvement - it would be quite a feat if I could manage to teach these principles to anyone else.

There's also a whole new crew of visiting med students in town. I've come to be viewed as a bit of a Resident Expert - which has its perks and drawbacks, as you might imagine. I gave a few of the girls (have we gotten to the age where I should be calling them women? probably. oh well.) driving lessons last night, in my cream colored 1990 Toyota Conquest - with its manual transmission, lack of power steering, and driving column on the opposite side of the car. Fortunately, we all survived the experience - with just minor damage done to one of my hubcaps. Teaching people to drive stick isn't easy.

Alright, that's 14 minutes. It's a beautiful day outside; a welcome change after 5 days of clouds and rain. Hopefully I can finish up these chart reviews and get down to the beach before the sun goes down. Maybe I'll even go for a run along the water. This could be turning into quite a pleasant afternoon/evening. I'm out. B.

Drop Knowledge, Not Bombs

Here are those TB-HIV slides I mentioned once upon a time:
























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ps. Monitoring and Evaluation is Awesome.

Moving from ‘Stats’ to M&E: Changing the way we think about numbers

1) Sharing our experiences with current data collection and reporting pathways

2) Make collection of daily/weekly/monthly numbers immediately relevant and practical for all clinic staff

• It is important that we receive relevant feedback on our work; it provides motivation, incentive, and recognition
• Statistics enable us to gauge where we are doing well and where we still have work to be done
• M&E as an essential part of comprehensive HIV care
• Assessing patients’ needs
• Measuring workloads
• Upreferral and downreferral pathways
• This is an area of our program that we are going to need everyone’s’ help to successfully accomplish.

3) Monitoring and Evaluation sounds pretty scary. What does it actually entail at your clinic?

Just five easy steps…
• Ongoing collection of specific, pre-determined indicators
• Compilation of numbers at the end of specified time periods
• Reporting of these figures on deadline to designated M&E staff
• Scheduling regular times to receive feedback of analysis of collected statistics
• Using Improvement Methodologies (which we will teach you!) to make small changes to current systems; addressing gaps in care and enabling proper allocation of resources

4) Our respective responsibilities

Partner Clinics
• Collect accurate statistics
• Meet reporting targets and deadlines
• Be open to systems development and change

Zoe-Life
• Provide M&E and Systems Development training/support for all staff
• Develop and implement streamlined data reporting structures
• Bring data supporters into clinics to help with collection of stats
• Provide regular feedback on progress

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I'm pretty sure that no one read to here (except for my mom: hi Mom), but thanks for trying.

Slip-N-Slide

Here are a few slides from a presentation I'm putting together for work next week. The PEPFAR-sponsored organization I'm working for here is holding orientations for staff from HIV clinics all over the greater Durban area - including several of the largest townships. (a brief aside: they call it 'orientating' in SA like it's going out of style.)

We've invited nurses, doctors, HIV counselors, and clerks/data entry from each of these sites to come by and hear about the comprehensive HIV care support we're providing for each of their clinics. I've been put in charge of presenting a fair amount of the material, including an overview of the South African National Strategic Plan on HIV/AIDS. I've written about this exciting, if somewhat controversial, document before, but for those who weren't reading my blog back then - it is the South African government's attempt to piece together a comprehensive national strategy to combat the HIV/AIDS pandemic.

My presentation certainly isn't finished yet, but I thought you guys might be curious to read about some of the goals and details of this landmark document. (Please note: The figures from the 'Implications' slides rely on some very sketchy epidemiological modeling on my part. Don't hold it against me too much; the numbers would be pretty scary regardless of model.)

Worldwide Readership Up, New Report Shows

It has been a while since I welcomed new readers to the blog. There are now readers of Smarter Than the Average Bearnot in 44 countries around the world, up 12 from the last time I reported. A big Hello to new readers in the following countries:

India
Trinidad and Tobago
Israel
Turkey
Singapore
Namibia
Palestine
Thailand
Romania
Norway
Burkina Faso
Brunei

I hope you guys are liking what you're reading so far - and I would encourage you to post comments or e-mail me directly if there are any topics relating to HIV/AIDS or life in South Africa you'd like me to address.

I am swamped under loads of work this week, including starting to design a half-day training for the staff of the clinics I have been visiting on basic Monitoring and Evaluations principals and the benefits of keeping accurate statistics on HIV and HIV-related care. It is already a bit nerve wracking to realize that I'll be leading this training session for nurses, counselors, and data capturers in three and a half weeks, but I think I have a handle on the information I need to impart. And I also have some good Power Point presentations drawn up by the United Nations and the US government covering some of the relevant information to use as templates for portions of this training.

Alright, I've distracted myself long enough. Talk to you soon.