Second Generation HIV/AIDS Surveillance

Activities

General description of the WHO Collaborating Centre for Capacity Building in HIV/AIDS Surveillance:

The WHO Collaborating Centre for Capacity Building in HIV/AIDS Surveillance is based at the School of Public Health "Andrija Štampar", which is part of the School of Medicine, University of Zagreb. The Andrija Štampar School of Public Health is recognized as a prestigious and unique public health institution in Eastern Europe. The Centre was established as a Knowledge Hub in 2003 under the framework of the Project "Capability Strengthening for Improved Utilization of Financial Resources to fight HIV/AIDS" and funded by GTZ and WHO EURO. The central objective of this project was to support countries in the optimal access to and use of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and other large grants through supporting the development of local technical capacity in launching large-scale responses to HIV/AIDS. The Knowledge Hub was in December 2007 designated the WHO Collaborating Centre for Capacity Building in HIV/AIDS Surveillance.

The work strategy of the Centre is built around responding to national and regional needs and achieving capacity development by:

Providing innovative teaching program

Providing technical assistance

Development of partnerships and collaborative networks with national and international institutions

Bringing together a wide range of expertise

Adapting guidelines and tools

Conducting surveillance-related research

Partnership building and the sharing of knowledge and expertise continues to be the key component of our work. Most of the activities have been done in concert with the numerous partners which include the WHO, UNAIDS, UNDP, University of California, San Francisco, the UK Health Protection Agency, US Centers for Disease Control and Prevention, the University Hospital for Infectious Diseases, Faculty for Arts and Humanities and the Croatian Institute for Public Health. These partnerships have resulted in achieving synergies in work and the further strengthening of research and teaching capacities. The Centre is supported and advised on its work by the International Advisory Board which enables our programme to be developed in collaboration with a range of experts coming from academia, international organisation and national surveillance institutions.

Our interest in assessment and evaluation of various research methodologies in surveillance help us in devising high quality surveillance systems and understanding the factors that enable or hinder their successful implementation.

The Centre is composed of a core management team, research and teaching group and managed in partnership with the UNDP Office in Croatia. The work of the Centre has been funded by WHO EURO, GTZ, the European Commission, UNDP and WHO EMRO.

Activities during September 2003 - April 2008

Training courses

Twenty-seven training courses organised by the Centre during September 2003 - April 2008 were attended more than 600 participants from 53 countries in Europe, North and Central Africa and the Middle East. Eighteen courses were organized in Croatia and nine outside Croatia. Some courses, such as the courses on respondent-driven sampling and monitoring and evaluation of HIV programmes were held several times in Zagreb, Croatia, and elsewhere.

The following training workshops were provided during 2003-2008:: Introduction to 2nd Generation HIV/AIDS Surveillance; June 2004, Zagreb; Behavioral Surveillance; June 2004, Zagreb; Surveillance and Control of Sexually Transmitted Infections; September 2004 and February 2006, Zagreb; July 2005, Islamabad, Pakistan and September 2007, London, UK (for the European Network on Surveillance of STIs); Biological HIV/AIDS Surveillance; November 2004 and November 2006, Zagreb; HIV/AIDS Surveillance in Hard-To-Reach Populations; November 2004, Zagreb; HIV surveillance among TB patients; May 2005 and May 2006, Zagreb; Monitoring and Evaluation of National AIDS Programmes; July 2005, Zagreb; February 2007, Zagreb; Regional Training Workshop on HIV Surveillance for fifteen countries of North Africa and the Middle East; September 2005, Cairo, Egypt; HIV/AIDS Surveillance in Hard-To-Reach Populations; October 2005, Zagreb; December 2006, Khartoum, Sudan; March 2007, Zagreb; Monitoring and Evaluation of National AIDS Programmes; April 2006 and February 2007, Zagreb; Biological and behavioural surveillance survey in hard to reach populations using respondent-driven sampling; September 2006, Zagreb; January 2007, Zagreb; February 2007, Montenegro; March 2007, Bosnia and Herzegovina; November 2007, Yemen; Pre-surveillance Assessment; May 2007, Aden, Yemen; September 2007, Azerbaijan; Analysis and Use of Strategic Information - Data Triangulation in HIV Surveillance; June 2007, Dubrovnik, Croatia; Designing protocols for Population-Based and Clinic-Based HIV Surveillance Surveys; March 2008, Zagreb; Biological and Behavioural Surveillance Surveys in Hard to Reach Populations using Time Location Sampling, April 2008, Zagreb

Innovative processes:

Extensive training materials with case studies and practical exercises on the HIV surveillance have been developed and implemented, mainly to settings characterised by low-level and concentrated HIV epidemics. All modules have been extensively evaluated. Training is based on interactive methods and 30-50% of time is spent on practical exercises, in particular on a protocol for the surveillance system development. Participants are encouraged to reflect upon and apply their knowledge to their own country settings and some of them plan to organise such training courses in their own countries.

Scholarship programme:

A unique feature of the teaching programme since 2006 has been the provision of scholarships. Enrollment on the scholarship programme is based on applicants' CV, the completed application form and their letter of interest. The primary requirement is the work on HIV surveillance and an outline of future plans for work on HIV surveillance. Scholarships were provided during 2006 and 2007 to 45 participants from eastern Europe and the Middle East.

Evaluation:

Each of the training courses is extensively evaluated and the results are analysed and used to improve course content and organisation. Evaluation of each course provides the staff with the opportunity to reflect upon their performance, adapt lectures and exercises if needed and develop other professional skills. Evaluation of individual courses has demonstrated that participants are very satisfied with the quality of lectures, and that the surveillance protocol development exercises have in particular proven to be useful. It has been encouraging that participants in all modules reported that it would be possible to introduce the knowledge learned during the training into their work practice.

Follow-up:

We offer follow-up support related to participants' surveillance activities. Participants are encouraged to contact course lecturers and facilitators in case of any questions concerning surveillance and technical assistance related to development and implementation of surveillance systems.

Certification:

Participants receive a diploma that is accredited by the European Credit Transfer System (ECTS) with 3 points.

Technical assistance:

Technical assistance included different aspects of work on HIV surveillance, such as implementation of HIV surveys, systems of monitoring and evaluation and writing-up proposals for the GFATM in 10 countries: Azerbaijan, Bosnia and Herzegovina, FYR Macedonia, Iran, Lithuania, Montenegro, Pakistan, Serbia, Sudan and Yemen. We also work continously as advisors to WHO EURO, WHO EMRO, UNDP and UNICEF on carrying out various research projects and consultancy missions, and development of HIV surveillance tools and guidelines.

Adaptation of Surveillance Tools and Guidelines:

Guidelines for implementation of HIV/AIDS surveillance systems in low-level and concentrated epidemics have been developed for WHO EMRO to assist surveillance officers and programme managers in the planning, design and implementation of various components of HIV surveillance. The Guidelines are planned to be translated by WHO EMRO Office in Arabic and French.

The Centre also conducted the adaptation of the CDC training module on respondent-driven sampling for the WHO EMRO Region, and participated at the workshop on the adaptation of the HIV surveillance training manuals for WHO EMRO in Luxor, February 2008.

Research:

We carried out the bio-behavioural survey using respondent driven sampling among men who have sex with men in Zagreb, in collaboration with the University Hospital for Infectious Diseases "Dr. Fran Mihaljević", UNDP and the Croatian Ministry of Health and Social Affairs. The aims of the study are to assess the prevalence of HIV, HCV, HBV, HAV, syphilis, chlamydia and gonorrhoea (PCR on urine and rectal samples) as well as the magnitude of risk behaviors among MSM in Zagreb. This is the first study conducted among MSM using a probabilistic sampling method in Croatia, and one of the first such surveys in eastern Europe which we hope will contribute towards sharing experiences on the process of survey implementation and results. The survey was completed in December 2006.

In Croatia, we participated in the first general population sexual health survey among young people carried out in 2004.

The Centre also implemented the first probabilistic surveys on IDUs in three cities in Bosnia and Hetzegovina from January 2007 - December 2007. The project was commissioned by UNICEF Bosnia and Herzegovina and successfully carried out in collaboration with three local NGOs.

We have done the assessment of the HIV epidemics and the policy responses among MSM in eastern Europe for WHO EURO, and this work is expected to be completed in June 2008.

COURSE DATES

29 June - 3 July 2008, Dubrovnik, Cavtat: Training course in Surveillance and Control of Sexually Transmitted Infections; AGENDA (404 KB); INFORMATION NOTE FOR MEETING PARTICIPANTS (357 KB)

14-17 July 2008, Zagreb, Croatia: Training course in RDS Data Analysis; AGENDA (388 KB); INFORMATION NOTE FOR MEETING PARTICIPANTS (352 KB); MAP OVERVIEW (493 KB)

10-14 November 2008, Zagreb, Croatia: Training course on Design and Implementation of HIV surveys using respondent-driven sampling; AGENDA (335 KB)

You can register for our upcoming coureses now via our on-line aplication form