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2nd Early Warning Indicator (EWI) Assessment Training 2014 June 9 -13


2nd Early Warning Indicator (EWI) Assessment Training

15 June 2014.

A 5 days long Early Warning Indicator (EWI) Assessment Training for data abstractor has been successfully completed. The EWI training was held in Kathmandu from 9-13 June 2014. Total 8 ART sites from all five regions participated in the training. Similar kind of training was also organized first time in April 2014 where 6 ART clinics participated. Major purposes of the training were to assess the extent to which ART programmes are functioning to optimize prevention of HIV Drug Resistance (HIVDR), to assess the factors at individual clinics that are associated with the emergence of HIVDR, to alert clinics and ART programmes to situations favouring emergence of HIVDR and provide an opportunity for corrective action to be taken. The data abstraction period for EWI was 16 July 2011 to 15 July 2012.

The training was inaugurated by NCASC Director Dr. Dipendra Raman Singh. In the training, ART counselors along with medical recorder of the respective hospital actively participated and have worked to abstract the data. Out of eight participating ART sites, six sites have abstracted their data completely and fitted into the data abstraction tools. Remaining two sites have abstracted data partially and committed to abstract the remaining data by 30th June 2014.

According to the EWI guideline, there are five key indicators to be monitored for HIVDR in the country namely on time pill pick up, retention in care, pharmacy stock out, dispensing practice and virological suppression. Out of these five indicators, initial four were abstracted from existing recording tools. After the data abstraction, data were analysed and possible factors were discussed. According to the dash board, on time pill pick up for adult ranges from 54% to 95%. On time pill pick up among children was found even lower up to 29% in some clinic. Similarly, retention on care varies from 67% to 94%. There was no pharmacy stock out and no mono or dual drugs were dispensed during the EWI period.

Pilot EWI was done in three ART centres in Kathmandu in December 2013. After the piloting, EWI is being expanded. Total 17 ART sites (out of 44 sites in the country) have participated in the EWI monitoring exercises.

The training was facilitated by Dr. Supriya from WHO Nepal, Dr. Hemant Chandra Ojha, Shambhu Kafle, Bir Rawal, Raju Joshi and Dinesh Bista from National Centre for AIDS and STD Control. A training completion certificate was distributed to the participants by the NCASC Director.  Dr. Singh said in his closing remarks, “NCASC will expand EWI to remaining ART sites in coming days”.