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IPC
INFECTION PREVENTION
& CONTROL PROGRAM
Improving post-exposure prophylaxis (PEP) reporting
and documentation: Experiences from Iringa pilot
Amal Ally
M&E officer, Jhpiego - IPC Project
November, 2014
Presentation Outline
 Introduction
 Methodology
 Results
 Challenges
 Conclusion
The IPC program

The Ministry of Health and Social Welfare is
strengthening Infection Prevention and Control
practices in Tanzania in collaboration with CDC,
PEPFAR and Jhpiego

The program is addressing the prevention of
healthcare associated infections resulting from
exposure to blood borne pathogens (e.g. HIV,
Hepatitis B and C)

One strategy for infection control is the
strengthening of post exposure prophylaxis
(PEP) services, including monitoring and
evaluation.
What is PEP?
 The term PEP means the medical response to prevent the
transmission of blood-borne pathogens (BBP), including HIV,
following exposure to blood and body fluids
 Individuals may sustain potential exposure in the course of
their work [Occupational Exposure]
OR
 Exposure outside the work setting [Non – Occupational
Exposure]
Characteristics of Comprehensive PEP
Services
 Reporting assistance and possible
referral capacity
 HIV testing (for exposed & source
persons)
 Risk assessment
 Provide PEP medications (starter &
full course)
 Counselling services
 Providing consent for PEP
 Pre-and post-HIV test
counselling
 Drug adherence and managing
side effects
 Preventing the risk of
transmission
WHO/ILO (2007)
 Support and follow up
 Appropriate record keeping and
documentation (gap)**
The PEP recording and documentation
before this initiative
 All facilities offering HIV/AIDS care and treatment services provide
PEP services
 Very few had a standardized system for collecting and documenting
exposures and PEP service provision
 There is limited data on implementation and use of PEP services
 There is insufficient data utilization of PEP data both at facility and
central level
PEP deliverables

National PEP Guidelines

Review IPC standards to address
PEP issues

Communication materials

PEP Monitoring and Reporting
Tools
 Case notes (1 and 2) and
patient card
 PEP Register
 PEP Summary form

Customize PEP summary tool into
DHIS (under MOH server)
Pilot of Post Exposure Prophylaxis
reporting forms in Iringa Region
 The pilot was conducted at 9 sites selected by MOH
Iringa Regional Hospital
Igumbilo Health Center
Mafinga District Hospital
Ipogolo Health Center
Ilula District Hospital
Ngome Health Center
Tosamaganga District Hospital
Itamba dispensary
Marie Stopes Iringa
Methodology
 Developed PEP documentation and reporting tools
 Oriented selected National IPC Trainers (MoHSW) on the
tools
 Conducted Sensitization Meeting with C/RHMTs & HMTs
 Identification of PEP focal persons and oriented on PEP M&E
tools in 9 facilities
 Oriented ART partners on PEP M&E reporting forms and
uploading PEP data using DHIS2 system
 Continuous follow up visit every 6 month
Number of persons provided with PEP by
Exposure type (June12 to Sep14)
Occupational
Other non-occupational
Rape/sexual assaults victims
160
140
134
120
100
87
80
59
60
51
47
37
36
40
20
20
10
9
18
8
0
June - Dec 12
Jan - Dec 13
Jan - Sep 14
Overall
Partners oriented and started rolling out PEP
M&E tools
PASADA
Futures Group
ICAP
BMC
CSSC
TUNAJALI/ Dilotte
WRP/HJFMRI
EGPAF
AGPAHI
MDH
Conclusion
 Appropriately designed reporting and documentation tools
for PEP are critical for improving PEP services
 Integration of PEP standard tool into routine health
information system, captured by electronic database will
allow for data-driven PEP program planning and resource
allocation.
Recommendations
 R/CHMTs and HMTs roll out the PEP guidelines, PEP M&E tools and the
PEP database to facilities in Tanzania.
 Partners to support building the capacity/training of the district personnel
in utilizing the DHIS2 system (through HMIS/UDSM)
 Partners to support the district personnel to ensure quality of data and
data completeness in the HMIS system
 Establish mechanisms to follow up clients under PEP management at
scheduled times and tracing source person HIV status - especially
Rape/Assault cases
 Improve community sensitization on availability of PEP services
Asante sana