PHIA Survey Stories from the Field

Technology yields impressive results in Malawi’s Population-Based HIV Impact Assessment

Tablet technology was a critical part of the Malawi Population-Based HIV Impact Assessment (MPHIA) project that conducted national, HIV household-based surveys of adults, adolescents and children. Using 160 tablets, in three languages, the national data collection effort ran from November 2015 to August 2016. Trained survey staff used computer assisted personal interviews on android-based tablets to interview adults and children from approximately 15,000 randomly selected households with pre-programmed tablets and portable blood testing equipment. The use of the portable technology that automatically stored content reduced the amount of time required for data cleaning from six months for paper-based data to just one month for the tablets. This boost in efficiency enabled the teams to reach more people. In over 11,000 households, surveyors spoke to over 19,800 adults about HIV testing and whether or not they knew their HIV status. Participants who self-reported positive were asked whether or not they were currently taking antiretroviral medications. In addition, survey teams performed viral load testing on all participants who were found to be HIV positive. These survey efforts are now giving Malawi a national-level view of HIV incidence, pediatric HIV prevalence, viral load suppression, and use of services across its population to better help the country make critical progress towards achieving an AIDS-free generation.

The Malawi population-based HIV impact assessment was led by the Government of Malawi through the Ministry of Health, conducted with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical assistance through the U.S. Centers for Disease Control and Prevention (CDC). The survey was implemented by ICAP at Columbia University in collaboration with local partners.

Singing the praises of Zimbabwe

Zimbabwe was the first country to launch the population-based HIV impact assessment (PHIA). The PHIA is the first household survey in Zimbabwe to directly measure national HIV incidence, pediatric HIV prevalence, and viral load suppression, and use of services. The survey provides the sharpest picture to date of the HIV epidemic in the country. In Zimbabwe, survey teams visited approximately 15,000 households across the country to interview consenting participants and provide them with HIV counseling and testing, as well as syphilis testing.

In Zimbabwe, the song, “Knock, Knock, Knock,” was recorded by leading Zimbabwean poets and musicians to share the importance of the PHIA surveys with communities across the country. The song played frequently on the radio and reached cities and rural areas helping to inform communities about the house to house surveys that were happening across the country. “The ZIMPHIA song is a great example of the creative, collaborative approaches to public health promotion that CDC likes to support,” said Beth Tippett Barr, CDC Country Director, Zimbabwe. “It reflects a strong engagement with our national partners.” The success of the effort was evidenced by the nearly 12,000 people who participated in the survey from 2015-2016. Zimbabwe’s creativity and success to date in effectively responding to the HIV epidemic is a model for others working to pave the way toward an AIDS-free generation.

The Zimbabwe population-based HIV impact assessment was led by the Government of Zimbabwe through the Ministry of Health, conducted with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical assistance through the U.S. Centers for Disease Control and Prevention (CDC). The survey was implemented by ICAP at Columbia University in collaboration with local partners. Adapted from the Columbia University Mailman School of Public Health story.

Supporting the next generation of HIV surveillance in Zambia

CDC began work in Zambia in 2000. The country had previously implemented many strategies to address the HIV epidemic, but there was not enough quality data to guide national decision-making and planning. For almost a decade, CDC has worked with the Zambian government and multilateral donors to improve disease surveillance throughout the country. CDC’s earliest involvement was through surveillance which focused on sentinel surveillance and AIDS cases.

Most recently, CDC has been providing technical support to the Government of the Republic of Zambia to establish the next generation of disease surveillance. These surveys focus on improving and expanding existing surveillance methods and include bio behavioral, HIV-case, sexually transmitted infection (STI) and morbidity and mortality surveillance. One example of these surveys is the Zambia population-based HIV Impact Assessment (ZAMPHIA) survey, which began in March 2016 and concluded in August 2016. Survey teams visited approximately 15,000 households across Zambia to interview people and provide HIV counseling and testing, as well as syphilis and hepatitis B testing. ZAMPHIA survey teams collected blood samples and performed rapid HIV tests and point-of-care CD4 tests. Participants then received test results within minutes, in the privacy of their homes. Findings from the survey will not only be used to better understand the Zambia HIV epidemic, but will help shape future HIV programs and policies to confront the epidemic.

CDC Zambia is excited about the potential of working alongside our partners to bring together these surveillance strategies to better serve the needs of the country and address the HIV epidemic. The Zambia population-based HIV impact assessment was led by the Government of Zambia through the Ministry of Health, conducted with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical assistance through the U.S. Centers for Disease Control and Prevention (CDC). The survey was implemented by ICAP at Columbia University in collaboration with local partners.