 Okay, welcome everybody to this session, which has to do with shorty profile. I'm on location working at the implementation in our new rail. And I'm doing this together with a lot of people that will speak together a little bit later. We want this to be an interactive session with questions and comments from the audience. As I said, participation might be rewarded. So here's a bit to raise your hand and to keep the value going. It's not just a one-to-one session. So the background for this session is that in the last few months, this network has worked on creating something like for VCHAS Q2 profile. That is basically a tool that can help us to understand more on where VCHAS Q implementation is in terms of maturity. Okay, so this is maybe your VCHAS Q implementation perhaps. So the reason for having this tool is to end a slightly better way in our systematic way, trying to describe what makes this game balance and not crash and fall down. We can sort of imagine how some talk to be in our animation-wide HIV data. And the stuff below is like the more employment that nobody wants to pay for, or wants to order, or wants to ask for. So this tool that we're presenting here today is a way to highlight the things where our country is, where it's strong, where it's weak, where it makes sense to invest, co-invest maybe between partners, etc. We will hear from several people in this session. You've seen them here, it's Sora from this video. They are Andrew from the Roland Institute of Health. We have Kofi from West Central Africa. And Juan from this group. We have Mark, Andrew from the Global Fund, and Cori from Gaudi. Again, we will try to make it nice and interactive. So this is an overall picture of this tool that we have made. So the assumption is that you have to be just to implementation rest on some foundational pieces or aspects. You've seen them at the bottom. If it's hard to read, I apologize. Our goal and idea is that we need to have certain things in place in order to succeed. So things such as leadership and governance, needs to be in place. You need to have a proper strategy and investment approach to be trusted on a national scale. There are questions we look at and we are able to be employed to use that in place around security and compliance. It's important to have a strong core team, people competent and available and paid, and working there for a long time to know what they're doing. We need to be just in maintenance and development. We need strong meta-based and complete-born units in order to have complete and valid data and to make data analysis well. We need to have some sort of approach to training, both end users and your reporting. We need to know what our disabilities are and what the population in our actions are and also have a proper infrastructure in place. So all of these things we call as the foundational stuff, the pillars of a house that is violent. So if this stuff is not in place or is immature or unfortunate, it's probably better to look at this in parallel with your implementation. The other thing that we can assess through this tool is the maturity of different aggregate programs. So for example, you're aggregate H&M, you can take that on a program, EBI, surveillance, co-managing, et cetera, et cetera, and then proper programs. It's like the different things that need to be in place. It's like the different questions that will come in form. And through this kind of assessment, it leads into a bigger picture of the evaluation work or assessing work to be assessed through. The slide here basically shows that there are certain assessments you can do once you're working on. So for example, we have something called the DHS-2-ready assessment. Does it make sense for this country to get started? Is the country ready to start to DHS-2 on the same tracker? And then this maturity for calls that we're talking about here today is it's a bit of a cyclical thing that you can do regularly, one's there, one's in the second year, et cetera. And if you form other types of creative points that you should look closer into security and then they're structured for that or dive into the quality of the metadata, et cetera. And then of course we have the more in-depth research and it informs each other and it informs the planning developments and implementation. So why are we doing this? And why have we done this? I think the DHS-2 network has done various types of evaluations over the years in different types, some have been a bit structured. This is an attempt to be more structured. But one of the reasons is to encourage more coordinated investments into DHS-2. So often we find that one health program wants this, one health program needs that, one health program needs that. And then nobody wants to fight for their pay for that foundational stuff that needs house planning. So it's a way to talk about company at home, right? It also supports planning. What should the history or the country or the party work on for the next couple of years? What makes sense to you first? What should we wait? What should we do before doing something else? And as I said, it has support in mind across the rest of the United Nations. Also, it's been a request from many of our partners and also internally within this network to be able to see a bit more progress over time. It's a country-moving that all the efforts that I'm going to use to meet DHS-2 information is the health, what's the change of time? Yeah. And you can go down to the tiny URL at the bottom there if you look at the whole tool or just contact us and you can of course read it better. How can you do that? Thank you. So I'll talk a bit about this to myself and sort of what comes after the tool the planning exercise that we'll stand in here on the list. So we basically set up DHS-2 to have this assessment data. So we put the question into DHS. I'm going to have some reports that we can get out. Eventually, we can also also output, support or monitoring things over time that I'm going to talk about. So we have this Excel tool, like I said, which has a sort of standard story. We have four categories, lots of questions within those categories that are on machine, the foundation areas and programmatic areas. The idea here is that this should be done a couple of days as a test review or we've added some additional programs or maybe a week without sort of going into the field and spending lots of time. So it's supposed to be like waiting. And the questions here is meant to reflect that. So this is just an example of the outputs you will get after filling in this tool and putting in Excel. So we have a overall score in these different categories which is basically just some of the different questions, some of the gears. Very important part of this is also to add a bit of context. So adding some notes on different areas and different sections as to doing this assessment. Which will be important not only to interpret some of the results but also if we think of this as something you repeat, having a bit more context than just a simple answer will help making it more consistent as we repeat it. Of course, one aspect of this is sort of looking at the status of implementation as of when it does assessment. The key thing is that this is a tool to help you plan strengthening activities around the details of the committee. So identifying and discussing, describing what seems to be the weak areas and looking at what are actually in the plans of the Ministry of Health, what is being planned in the future. Are there plans for doing case-based HIV, for example? Having that as part of the summary description of the status of the plans is important. And then the idea is to look at what specific activities should we do to strengthen these details based on what this seems like the weak areas and the future plans. So along with the assessment, we developed this short template for making the details to strengthen the plan essentially, which sort of goes hand in hand with the assessment itself. The idea is to look at the status, look at the plans, and define what should be the priority in the next year or two. So we have added a link here when you will have access to this slide so you can look at that. We basically follow the structure of these weak areas. Plans recommended the trust to strengthen activities. And like Anna said, the key thing with this is to strengthen or identify the foundational things within the trust implementation. That means strengthening. To make sure that you're sort of not having lots of tracker programs in new health areas without having any protein, without having any interest records. Because we know that what we did with our program last year is not that you train the protein, it's that they have electronic information like this week, etc. So we've sort of very generally looking at the scoring of the foundational areas which are thinking that if you're not at least in the orange category you shouldn't be adding more aggregates interventions in the way. Or before you add more tracker data you should be on the light green as a medium. That's of course simplification but as a sort of general, that's the general idea. But that's of course very hard to say in practice. First you need to do all this then you can start taking all additional amount of interventions expanding this book. But the idea is that if you're doing electronic information registry and you know that you have inconsistent protein range infrastructure the plan you make for rolling out an electronic information registry needs to take into account strengthening all those foundational areas. So it's a way when you make the plan when you make a budget using this as a way to highlight all the boring things that normally wants to pay for in those plans. So I think that's the critical critical step to think of this sort of as a dependency where you have a dependency on foundational stuff as you're adding more to the first and second floor of the house. So just as an example here comparing two countries in a way with one at the top have quite poor scoring in many other foundational areas and it's maybe not the place where you want to sort of die into lots of tracker-taste-based reporting programs unless you also address training your approach to training in your series to protein infrastructure whilst the one on the bottom is sort of doing better in the foundational areas and it's maybe more prepared to do additional for like expanding the scope of the information. So this is sort of what we're seeing as the process for the new country that we do the maturity assessment to give you an idea of implementation with the results, look at the week areas, what are the plans and then make a plan for strengthening the HHS and the HHS too and then have his groups or whoever is supporting the country's implementation follow up on those identified needs and this is something that over time will be sort of a psychic question. That was our introduction to the Q&A so our plan now is that we if there are questions, comments to the tool itself where we do that now just to help people talking for knowledge so any questions, comments we take now then we hand it over to Sora to be the country perspective that we have the few countries that have been through this now so maybe we will have some experiences So if there are questions at this point, like I said there might be other reasons for asking questions and this is very important to be helpful. We are out here and this is what you can know that we actually have ice cream I don't know maybe we'll look where she's at I just wanted to get your word about the team that we do what they're doing and how they work with the main programs each of these programs on TV to what extent do those programs need to participate in the success to talk about which things they are curious to know and awarded crowns of troubles Thanks So that's another good question So the way this is being rolled out as we speak more or less some global family is supporting his groups to do this exercise I don't know the exact number of countries a lot of 40-50 countries like over the coming months So the idea is that his groups will be coordinating this and we'll also hear from the his team later how they will do it in the countries they've done it so far they will depend a lot on the conflicts for relationship between his group and the ministry how practically it will be done So in some cases so far it's already been his who are supporting the class who does the first serve around assessing this and then talk to the ministry and just see if they agree to the assessment Other places perhaps the ministry is the one who actually takes the lead and completes this and his is already mostly for the team following So I think it will be very complex to depend on how this ministry work will be But the idea is that the ministry of health approves what comes out of it is not something that is doing isolation it needs to be something that the ministry is behind and of course the ministry are the ones providing the priorities of where they want to go forward So it's sort of the he's going to work in the ministry what providing the the I just have followed to that response and keep in mind that it's a heavy lift the first time you do this and then after that it's just about what changes can happen So think of this also as a performance monitoring So once you have that baseline then it becomes easier to do this monitoring on a more regular basis I just want to make that complicated I'm always interested in the relationship between a country's management and the enterprise too because if you are actually not working then your enterprise too is also not heavy and we need to entertain the territory and we can all those secrets So that's an interesting question and it's something we've been discussing while we've been doing this because I think it's sort of traditional we think of it as and then we integrate stuff but in reality that's not what is happening So how do we do this we sort of have one set of foundational indicators but in a country you might have multiple HSI instances like you said in the infrastructure perhaps there is one that tries to for a particular program hosted here there's a separate that tries to for the HMI so there are different people supporting so so at one point we did discuss to repeat everything for each instance that we tried to integrate but that would no longer be a couple of days this process and that in those in some cases it will be what's objective for generalization okay we have these people supporting this instance we have these people supporting this instance maybe some of them are the same overall we think the core team capacity is so I think that given the limited depth there will be some affirmations in many of those kind of one more question last question I think we also we have a quite one second after a little presentation we can also go back please thank you guys in my question we may have some different instances my favorite mistake or that these two taking about how in this part somehow we may discuss where we make it because we are assessing the magnitude of our instance and but we can so if there is a small instance how we do the scoring lower score or higher score that kind of thing because we are in particular electricity then it starts increasing if I do one instance so how does that come out I think every company will have more than one instance probably at some point so I just have to do your best to make this this drive the overall status of course in extreme cases where you have everything is completely different than this for example it will also do try to ask questions in the form whether the data is available for example through the HMIs female programs do you have any I think in those cases also it's important to add some description as you're doing this to say we scored it like this because of this but there is also as a protein static total limitation that we have to generalize and that's how it is I think we can welcome Andrew we can help you to understand okay you're a thoughtful person sorry Hi everyone my name is Sophie I have to say that I have the best coffee in the world I'm not weak at all but still enjoyable I'm happy to share with you the finding from the last presentation and the last something in Canberra so the contest in Canberra was that they had three years ago designed a three year professional plan who loved is there and then the plan was ending one of the things that they have just designed their first e-health national strategy because of those two changes major changes they had they were in the need to actually renew their DHS to operational plan so we went to the process and the maturity model assessment was part of the work that we had done so we had a two days workshop as we were saying and then someone has asked about who are the assessors those are the pieces of assessors that we have we had the HMI team we have the country program management teams TB, HIV, EPI and also we had undergone a series of meetings to prepare and then to finalize so when we finish the work that is what can work out we had assess the maturity level of that country and the result was that the capacities that were there has been greater almost 60% which is the adequate level and there are some capacities missing which has been also the interest of having an overall score was that we can fill them over time and three years later we'll come back and see how they have been moving forward as they have said we had domains in the tool so you can see in that for each domain we had a scoring that again is very useful for us to picture where we have to move forward and you can see that at the foundational level there are over 50% individual level data there are some tools that have been developed some trackers that they were not using them actually and some of them were not complying with the mutual recommendations that why they got those reading as we are saying for each reading of indicators we have to provide aspirations so that we can know why we have given that reading and that inform our planning process that is the nice need that we have from our assessment I won't take a lot of time on that one so in the domain you have sub-domains and using those kind of which you can know which have domain you have to tackle first and then the weakest domain that you have found there was the administration and maintenance as I will say nobody is wanting to invest in this but that is where we have investment first to be doing and then you have security compliance and then you have a training and users those are the first investment cases that you can sell actually to help us strengthen the DHS from its foundations moving to the aggregate data you can see that DHS was something that we have to pay attention to so that's why we have stressed that in red and individual level data you can see that you have a case to address HIV surveillance and then genomic individual level data in the country they didn't have an EMR or any other individual genetic data so that was the concern for them and that was shown in the evaluation so one thing that was done was to actually use that assessment to inform their new plan so the four objectives of their new DHS operational plan directly stemmed from the maturity assessment so you can see that objective one and two relates to foundational and then the three relate to aggregate data and the fourth one was about individual level data so we directly use those findings to design the plan those are the top five weaknesses that we have been showing in the previous slide for example regarding the administration and maintenance we have identified a city to appoint several admin to train and in several DHS several hosting and also we set up a support system using a ticketing system for security for example we have come to an agreement on designing the policy for that and then implementing it the same thing for the training of users we actually have decided to implement a national training instance and then to design a tailored program for the districts and region officer to be using for the activity for TSHIs in Cameroon we have actually piloted TSHIs but they were not able to finalize the evaluation of that program so we have recommended finalization and scale it up and actually the Global Fund is very interested in that and they are eager to find there to have the detailed budgeting for that so for each of you that is really interesting which you are working in Cameroon to come across this plan we are having a session to validate it that will be next week that will be an online session and see what is going on there and then also for the HIV tracker how we have recommended to review it so the way to scale up the exercise we are to complete the one in total we have seven more countries that has been approved for that if you are working in a country that fits there and you are interested in doing that assessment you just have to reach out to any of us that you can show you the way to get there I can say that the technical assistant for this assessment is granted it is secured you just need to send a request from the country and then we can step in and help you to do that and then as they have said we continue to improve the tool any experience from the field will inform how we can make the tool more more useful for us to achieve for achieving HIV to Australian countries thank you where is the next one so our ice cream is not going to get replaced any questions to follow I'll be enjoying my ice cream yeah okay what's your hand do you guys see anyone I'm sure I do I might go talk to you I'm sure thanks is that the only part of the design that's the that's okay or do you guys want the ice cream just like so much just like so much thanks so much for that presentation I mean it's really necessary to have all of our actions I mean is there a need to teach you those actions or otherwise resources some of those I don't know I don't know this is regarding the plan if we are talking about the plan the plan is actually something to sell to sell not only to the government agencies but to the partners one of the presenters was saying this money there they are fighting against what we see usually that I can say expected approach in DHIS2 and in HMIS having this kind of plan can help inform and have some sympathy so one we have some I can say secure funding from the global fund from the World Bank and from New York City those ones are secure and they are asking us to provide them digital planning and digital budget so this I can say part one and then part two will be how we localize additional funding to move forward so we have secured some resources not all of them and we are beginning to discuss some more of them as we move forward transfer one to the next I I I I okay thank you I think I see I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 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