AEGiS-14IAC: Comparing the results of HIV impact modelling with reporting by the health information system: lessons learned in Namibia.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Comparing the results of HIV impact modelling with reporting by the health information system: lessons learned in Namibia.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrC1311)

Van der Veen FH, Forster N
Family Health International, Windhoek, Namibia

BACKGROUND: Namibia established in 1992 a surveillance system for HIV and AIDS, including HIV sentinel sero-surveys, case reporting of HIV positive diagnosis, hospitalizations and death from AIDS. Reporting is entirely integrated into the Health Information System (HIS). To model the impact of HIV on demographic indicatiors, a national all stakeholders agreed during a consensus meeting in 2000 to use the Spectrum program as this provides the most useful output for planning purposes.

METHODS: The outcome of modelling of the HIV epidemic was compared with data from the existing computerised Namibian Health Information System (HIS), covering the period from 1995 to 2000.

RESULTS: The modelling outcome projects an increase of deaths from all causes from 18,080 in 1995 to 28,220 in 2000 and an increase of deaths from AIDS from 1,440 in 1995 to 11,000 in 2000. The reported number of deaths in hospitals from all causes increased from 6,402 in 1995 to 12,635 in 2000 and the reported number of hospital deaths from AIDS increased from 628 in 1995 to 3,388 in 2000. The proportion of projected death from all causes occurring in hospitals increased from 35% in the year 1995 to 44% in the year 2000. This increase is mainly a result of an increased proportion of children dying in hospitals from 27% to 35%. AIDS is underreported as cause of death, particularly among children. According to projections, AIDS would cause 40% of all deaths in 2000, while only 28% hospital deaths were reported to be caused by AIDS.

CONCLUSIONS: Despite a projected doubling of the total number of deaths from all causes over the period from 1995 to 2000, hospitals have been able to cope, increasing the coverage of services, in particular for terminally ill children. HIS data provide valuable information on geographical distribution and service utilization, which are essential for monitoring of the health sector response to HIV and cannot be obtained by modelling.

Keywords: AEGIS, HIV Infections, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Death Certificates, Demography, Death, Namibia, Child, organization & administration

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WeOrC1311