Programme PACCI, Abidjan, Côte d'Ivoire.
Curr Opin HIV AIDS. 2011 Jul;6(4):245-50. doi: 10.1097/COH.0b013e3283479316.
In this review, we describe the challenges faced by using clinical cohorts to perform Monitoring and Evaluation (M&E) and the possible solutions for increasing and strengthening health systems in low-income and middle-income countries.
HIV scale-up has facilitated the transition from paper-based medical records to electronic medical records at hundreds of sites in most of the countries in sub-Saharan Africa and the implementation of national HIV databases. However, National M&E systems in resource-limited settings tend to be chronically challenged by persistently incomplete reporting and inaccurate data, which undermines their usefulness. In low-income and middle-income countries, new information technologies such as Web-based systems and mobile phone networks are expanding rapidly. Their use will improve data quality and, therefore, reduce participant dropout and improve reporting rates. These systems have the potential to allow real time access to summary reports and to integrate data from other settings such as maternal and infant health clinics.
The efforts to address the AIDS pandemic in sub-Saharan Africa will require enhanced information systems. Stronger systems are needed to deliver primary healthcare for those with and without HIV, and it is also essential to build and take advantage of synergies across health information systems.
目的综述：在本次综述中，我们描述了在使用临床队列进行监测和评估时所面临的挑战，以及为增强和加强中低收入国家卫生系统而提出的可能解决方案。
最新发现：艾滋病毒防治工作的开展促进了从撒哈拉以南非洲的大部分国家的数百个地点的纸质病历向电子病历的转变，并实现了国家艾滋病毒数据库的建立。然而，资源有限环境下的国家监测和评价系统往往受到持续不完整报告和不准确数据的长期困扰，这削弱了其有用性。在中低收入国家，基于网络的系统和移动电话网络等新信息技术正在迅速普及。这些技术的应用将提高数据质量，从而减少参与者的流失并提高报告率。这些系统有可能实时访问摘要报告，并整合来自其他领域（如母婴保健诊所）的数据。
总结：为应对撒哈拉以南非洲的艾滋病大流行，需要加强信息系统。需要建立更强有力的系统，为艾滋病毒感染者和未感染者提供基本医疗服务，并且必须建立和利用卫生信息系统之间的协同作用。
