Enhancing and promoting data management and systematic monitoring for an improved HIV/AIDS programs in Addis Ababa, Ethiopia

Background Ethiopia Population-based HIV Impact Assessment findings showed that in Addis Ababa, only 65.2% of people living with HIV (PLHIV) know their status. We present the enhanced HIV/AIDS data management and systematic monitoring experience in Addis Ababa City Administration Health Bureau (AACAHB). Methods AACAHB established a command-post with leadership and technical team members from the health bureau, 10 sub-city health offices, and non-governmental stakeholders. The command-post improved governance, standardized HIV program implementation, and established accountability mechanism. A web-based database was established at each health facility, sub-city, and AACAHB level. Performance was scored (green, ≥75%; yellow, 50–74%; red, < 50%). The command-post reviewed performance on weekly basis. A mentorship team provided a weekly site-level support at underperforming public and private health facilities. At facility level, quality of data on recording tools such as registers, and individual medical records were maintained through continued review, feedback mechanisms and regular consistency check of data. Percentage and 95% confidence interval were computed to compare the improvement in program performance over time. Results After 6 months of intervention period, the monthly New HIV case finding in 47 health facilities increased from 422 to 734 (1.7 times) and treatment initiation increased from 302 to 616 (2 times). After 6 months, the aggregate scoring for HIV testing at city level improved from yellow to green, HIV case finding improved from red to green, and treatment initiation improved from red to yellow. An increasing trend was noted in HIV positive case finding with statistically significant improvement from 43.4% [95% Confidence Interval: 40.23–46.59%] in May 2019 to 74.9% [95% Confidence Interval: 72.03–77.6%] in September 2019. Similarly, significant improvement was recorded for new HIV treatment from 30.9% [95% Confidence Interval: 28.01–33.94%] in May 2019 to 62.5% [95% Confidence Interval: 59.38–65.6%] in September 2019. Conclusions Regular data driven HIV program review was institutionalized at city, sub-city and health facility levels which further improved HIV program monitoring and performance. The performance of HIV case finding and treatment initiation improved significantly via using intensified monitoring, data driven performance review, targeted site-level support based on the gap, and standardized approaches.

THE PLACE OF FINANCIAL MONITORING IN THE SYSTEM OF ENSURING THE ECONOMIC SECURITY OF THE STATE

На основании проведенного анализа существующих определений «мониторинг» и «финансовый мониторинг» авторы делают вывод, что финансовый мониторинг необходимо рассматривать в качестве способа систематического наблюдения и анализа за движением денежных потоков. Данный инструмент позволяет как фиксировать и анализировать уже совершенные негативные явления в финансовой сфере, так и выявлять и диагностировать нарушения, которые могут появиться в будущем. Based on the analysis of the existing definitions of «monitoring» and «financial monitoring», the authors conclude that financial monitoring should be considered as a method of systematic monitoring and analysis of the «movement» of cash flows. This tool allows you to record and analyze both already committed negative phenomena in the financial sphere, and to identify and diagnose violations that may probably appear in the future.

Material Thickness Classification Using Scattering Parameters, Dielectric Constants, and Machine Learning

Wall-thinning in building structures due to corrosion and surface erosion occurs due to the severe operating conditions and the changing of the surrounding environment, or it can result from poor workmanship and a lack of systematic monitoring during construction. Hence, the continuous monitoring of structures plays an important role in decreasing unexpected accidents. In this paper, a novel method based on the deep neural network and support vector machine approaches is investigated to build up a thickness classification model by incorporating different input features, including the dielectric constants of the material under test, which are extracted from the scattering parameters proceeded by the National Institute of Standards and Technology iterative method. The attained classification results from both machine learning algorithms are then compared and show that both of the models have a good prediction ability. While the deep neural network is the better solution with a large amount of data, the support vector machine is the more appropriate solution when employing small dataset. It can be stated that the proposed method is able to support systematic monitoring as it can help to improve the accuracy of the prediction of material thickness.

Enhancing the resilience of the rainwater for drinking (RFD) system through systematic monitoring: a case study at the Ly Nhan rural hospital in Vietnam

Many rainwater harvesting systems have been installed and operated to supply drinking water to rural regions. However, they often lacked the management method to produce safe drinking water reliable. The current practice of operating rainwater harvesting systems did not have systematic monitoring as the basis of reliable operation so that the operators did not have confidence in their operation. To overcome these limitations, a rainwater for drinking (RFD) system has been suggested which was to produce drinking water by adding the proper treatment processes and setting up the proper operational mode. This study aimed to evaluate stable regular monitoring results from a pilot RFD system at a local hospital in Vietnam. Water quality and quantity were monitored by the trained local operator on a quarterly and weekly basis. The raw dataset was then shared with the study team by uploading into an open data access platform, from where the technical support was provided to prevent the provision of unsafe water to users. Ultimately, employing systematic monitoring would help to enhance the resilience of the RFD system, contributing to resolving the drinking water issue in rural areas of developing countries, aiming at the achievement of the Sustainable Development Goal 6.

Comparison of three interventional approaches to prevent ventilator-associated pneumonia in intensive care units (ICUs): A clinical trial study

Background: Ventilator-associated pneumonia (VAP) is an infectious pulmonary disease that develops after 48 hours of ventilation. To date, several methods have been proposed to reduce VAP occurrence, such as the VAP prevention bundle, which involves raising the head of the bed, reducing sedation, avoiding deep vein thrombosis, and preventing peptic ulcer in the gastrointestinal system. The purpose of this study was to evaluate the role of personnel in hand washing, case airway suctioning, and systematic monitoring in the prevention of VAP. Methods: In the current clinical trial, 129 patients hospitalized and intubated at Vali-e-Asr Hospital ICU in Arak, Iran, were included in the study and randomized to one of the three VAP prevention methods: group A, VAP prevention bundle measures; group B, group A measures plus washing of patients’ mouth with 0.12% chlorhexidine and suction of secretion every six hours; and finally group C, group B measures plus 72-hour suction package. Demographic information, VAP diagnosis, and outcome of each patient were recorded in the special checklist. Results: The age of the patients ranged from 18 years to 93 years with a mean of 54.6 ± 21.8 years. There was no significant difference in age, sex, Clinical Pulmonary Infection Score (CPIS), and Glasgow Coma Scale (GCS) between the three groups. However, there is a significant relationship between chest X-ray (CXR) index and pneumonia in the three groups (p < 0.05). The prevalence of pneumonia is generally seen to be higher in patients who were local, diffuse, or patchy than those who had no infiltration (p < 0.05). Conclusion: This study showed that the application of VAP prevention bundle measures, mouthwash with chlorhexidine, personnel hand washing, airway suctioning, and systematic monitoring is an efficient approach to the prevention of VAP in ICUs.

The state of vascular access teams: results of a European survey

Background: Many European health institutions have appointed multidisciplinary teams for the general management of vascular access to help improve efficiency, patient safety and reduce costs. Vascular access teams (VATs), or infusion teams, are specifically trained groups of healthcare professionals who assess, place, manage and monitor various outcomes and aspects of vascular access care. Objective: To assess the current landscape of vascular access management as a discipline across Europe. Methods: A Faculty of European VAT leads and experts developed a survey of 20 questions which was disseminated across several European countries. Questions focused on respondent and institution profile, vascular access device selection and placement, monitoring and reporting of complications, and access to training and education. The 1449 respondents included physicians, nurses, anaesthetists, radiologists and surgeons from public and private institutions ranging in size. Results: Availability of dedicated VATs vary by country, institution size, and institution type. Institutions with a VAT are more likely to utilise a tool (e.g., algorithm or guideline) to determine the appropriate vascular access device (55% vs 38%, p < 0.0002) and to have feedback on systematic monitoring of complications (40% vs 28%, p = 0.015). Respondents from institutions with a VAT are more likely to have received training on vascular access management (79% vs 53%, p < 0.0001) and indicated that the VAT was a source of support when difficulties arise. Conclusion: The survey results highlight some of the potential benefits of implementing a dedicated VAT including use of a broader range of vascular access devices, increased awareness of the presence of vascular access policies, increased likelihood of recent vascular access training, and increased rates of systematic monitoring of associated complications. The study reveals potential areas for further focus in the field of vascular access care, specifically examining the direct impact of vascular access teams.

Sustainable marine conservation, baselines, and systematic monitoring—a few lessons from coastal resource management in the Philippines

This review shares lessons learned from the establishment of early marine protected areas (MPAs) in the Philippines about the need to establish baseline information, do systematic monitoring of the status of the marine environment, and to progress towards more integrated forms of management that involve key stakeholders in coastal areas. The tendency for human society to change its perception of what is “normal” through the phenomena of “shifting baselines” is pointed to as a reason why more concerted action is not taken to stop the downward trends of Philippine coastal resources and environment. The small MPAs of Apo, Sumilon and Olango Islands as well as the large Tubbataha Reefs Natural Park, are cited as examples of how the establishment of baselines and the implementation of effective monitoring over time for both biophysical and governance parameters, has been instrumental in maintaining and improving the quality of the marine environment and bringing benefits to people. The development of integrated coastal management and coastal resource management programs within local government units is explained as a way of harnessing local institutions to lead the way towards improved management and stewardship of coastal resources and provide tangible benefits to coastal communities. And, the role of national government is highlighted as a facilitator and a source of technical support to local governments in the implementation of marine conservation and coastal resources management. Finally, the significant influence of Dr. Angel Alcala in marine conservation in the Philippines is noted through his research and related conservation efforts for small-island and fisheries management and his mode of sharing results with local communities and governments so that they could learn from their own mistakes and successes and become better stewards of their resources. KEYWORDS: Apo, community, coral reefs, Sumilon, tourism, Tubbataha