Position and function

This MSF position is based in Arua mission and may require regular trips to Kampala (MSF coordination and Ministry of Health and Population). The person will oversee the monitoring and evaluation of MSF supported activities in Arua.
1. Train the data analyst in data reporting and standards
2. Provide support to enable feedback and use of program process indicators and outcomes for decision-making by the medical team leader, the field coordinator and the coordination team.
3. Set up detailed monitoring for the imbedded PMTCT B+ cohort evaluation
4. Working closely with the data analyst as s/he oversees staff responsible for data entry, data cleaning, management and report generation.
 

MSF program in Arua

Arua is situated in the West Nile Region, North West of Uganda, at 45 minutes of the RDC border and at 1h of the Sudanese border by car. It is 6-7 hours by car, and 1 hour by plane from Kampala.

It is a town of 83,000 inhabitants. Although English is spoken by many people, the predominant language is Lugbara. Swahili, Alur, Lingala and Arabic are also spoken by some segments of the population. Religion-wise, the town is divided between Islam and Christian adherents. Basic services are available in the town. Security is not currently a significant problem. The prevalence of HIV in Uganda is estimated to be approximately 5 to 7 %.

Arua Regional Referral Hospital which is the referral hospital for West Nile reion, has 400 beds, projected to have an extra 500 in the near future. Technically there is an Out Patient Department (OPD), Surgical, Medical, Isolation, Paediatric, Antenatal and Labour and Maternity wards as well as support services such as Xray and a laboratory.  The Arua Hospital AIDS Programme (AHAP) has taken over from The AIDS Support Organization (TASO) and the activities managed by MSF currently include HIV Counseling and Testing (HCT), PMTCT, nutrition, TB services, Adult Isolation Ward and the HIV/AIDS inpatient and outpatient services. The prevalence of HIV in Uganda is estimated to be approximately 6.3%.

MSF involvement in Arua dates from 2000 in its role of supporting the Ministry of Health (MoH) Prevention of Transmission from Mother to Child (PMTCT) program. Subsequently MSF began an HIV/AIDS Clinic at the end of 2001 and as of July 2002 offered antiretroviral (ARV) medication. This is situated in a purpose built clinic. There are currently over 9000 people actively followed up with HIV/AIDS and an accumulative of over 19,000 were enrolled since the start of the program. People with HIV are seen in the clinic during the week with a 3 months appointments. Laboratory services are able to provide the majority of required tests. Viral Load is available using external laboratory facilities.

Decentralization in line with WHO guidelines for provision of ARVs in resource limited settings commenced in Jan 2005 in Koboko. After the activities extended to other districts like Nebbi, Adjumani and Oli. These cohorts are relatively small and MSF is currently closing the decentralized support.

Overall there is a significant amount of data collected for each of the activities (though not all entered into a database) and reporting, including separate MSF and MoH reports for the same activity. The monitoring of the project is mostly carried out vertically (unlinked to other monitoring systems used for different activities), which has led to difficulty in reviewing project data and ensuring data quality for program monitoring.  With increasing demands for accountability (ex. drug consumption and MoH reporting) there is a risk for overlap and duplication of information in different tools. It is highly recommended to simplify the tools and integrate the MoH reporting into the project activities and reduce duplication. The first step for this should be a mapping of all data tools and reports.

In general, the FUCHIA database is well maintained by a data team; however there is concern that there is absence of a standard unique ID system. This leads to duplication of patient records and disorganization in patient information and is likely to contribute to the high LFU rate in the program.  The retrospective PMTCT data entry is been recently finalized allowing for better analysis.
 

Responsibilities

1. Supporting routine Monitoring and Evaluation

• Provide technical support to routine HIV data collection for Fuchia database, including standardization of patient IDs
• Support and advise other departments in data collection (specific tools, MoH registers), including rationalization and simplification
• Provide technical support to quarterly interpretation and reporting (MOH / MSF report)
• Provide technical support to use of database and spreadsheets for routine reporting
• Create and use additional reporting functions for daily management of HIV clinics and support activities (nutrition, tracing, PMTCT)
• Review decentralization monitoring tools
   

2. Ensuring feedback and use of program process indicators and outcomes for decision-making

• Participation in internal MSF medical meetings (quarterly presentation of project data to ensure feedback of program activities to the Arua and coordination teams)
• Participation in external coordination meetings with relevant department of the Ministry of Health and Population, the National AIDS Commission, other NGOs as necessary
• Organize specific meetings with other departments to brainstorm, give feedback of the project and create a transversal dynamism.
   

3. Ensure Epidemiological support for field researches

• Implement appropriate monitoring tools and procedures for PMTCT B+ implementation
• Support of protocol implementation in the field (patient recruitment, consenting, data collection…)
• If requested, data analysis
   

Position in the organization chart

The position is part of the Arua project team, under the hierarchical responsibility of the Field Coordinator.
For medical and scientific issues her/his interlocutor is the Medical Team Leader and the Medical Coordinator.
The epidemiologist is working in close collaboration with Epicentre, through the Regional Epidemiologist.
 

Selection criteria

Degrees : Masters in Epidemiology or Medical statistics

Experience :

• Experience with data collection, management, and analysis in resource-poor settings
• Experience designing and conducting monitoring and evaluation in resource-poor settings
• Skilled in the use of statistical software such as STATA
   

Recommended :

• Experienced HIV/AIDS programme
• Previous use of Fuchia is an asset.

Language : English (written and spoken)


Please send cv, motivation letter and hereunder document fulfilled before the 9th of January 2012 to hrm@paris.msf.org